Birthday Marker Order Form 2019
Every Home has a Birthday!
Email address *
Name *
Shorewood House Number *
Shorewood Street Name (Street only, no East or North please) *
Clear selection
Phone *
Birthday Marker Date (Year Only)
Birthday Marker Location *
Birthday Marker *
General Conditions *
Village of Shorewood General Conditions for Special Privilege Approval for Birthday Marker

1. The buyer agrees that the Village of Shorewood, its employees, agents or representatives, shall be held harmless from all liability for injury to the previously mentioned property and damages accruing there from acts of any Village employees, agents, or representatives in carrying on their assigned duties in such capacity of employment, on the property above described.
2. The buyer agrees to remove said privilege whenever public necessity so requires or when ordered upon resolution adopted by the Village Board.
3. The buyer agrees that if in the opinion of the Planning & Zoning Administrator of the Village of Shorewood, the privileges, projections or encroachments permitted herein become out of repair, unsafe or unsightly, and upon receipt of written notice thereof, buyer will, within five (5) days from receipt thereof, maintain, repair or remove such privilege, projection or encroachment at the buyer’s expense. It is further agreed and understood that should the buyer fail to comply with said notice to maintain, repair or remove said privilege, projection or encroachment, the Village of Shorewood will have the right to maintain, repair or remove such privilege, projection or encroachment and charge the cost of same to the property owner.
4. The buyer must cooperate with and be responsive to the Shorewood Department of Public Works (DPW) so that the DPW may efficiently complete tasks and activities related to cleaning and maintenance of the right of way.
A copy of your responses will be emailed to the address you provided.
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