Issued by: Dubuque County Engineer's Office 1225 Seippel Rd Dubuque, IA 52002 563-557-7283 Permit No.

Fee: $35.00

Issued by: Dubuque County Engineer's Office 1225 Seippel Rd Dubuque, IA 52002 563-557-7283

Submit to: permits@dubuquecountyiowa.gov Fax 563-557-1973

Name Date Fax Number

Address City, State, Zip Check/Cash/Charge

Power Unit Year & Make Power Unit License No. & State Power Unit Registered Weight Trailer Make Trailer License No. & State

Interstate Travel Authority Number Intrastate Travel Authority US DOT Number

Object or Load Model Number VIN Serial Number SME Qualified

Overall Length Width Height Total Weight Trailer Length Load Length Projections

Front Rear

Axle Weights Single Tandem Triple Quad

Axle Spacing

Trip From: Trip To:

Routes:

GENERAL REQUIREMENTS: ☐ Civilian front escort ☐ Civilian rear escort ☐ Mounted height pole ☐ Overdimensional signs ☐ Amber revolving light/strobe light with 360circ visibility ☐ Required entire route ☐ Law enforcement escort front and rear ☐ Centerline all bridges: Primary at 5 mph, interstate at posted speeds ☐ Centerline all bridges: Primary at normal speed or travel in normal lane on bridges at 5 mph ☐ Load must slow or stop when necessary to avoid approaching traffic when centerlining ☐ Must carry copy of permit and current General Provisions and comply with them ☐ Road must be clear of ice and snow and visibility must be at least $ 1/4 $ mile ☐ Necessary state and/or city permits must be obtained separately ☐ Speed shall not exceed 45 mph on secondary road system. ☐ Vertical clearances are not guaranteed. Special Requirement: ____________________

VALID DATES: ☐ 1/2 hour before sunrise to 1/2 hour after sunset ☐ 1/2 hour before sunrise to noon ☐ Continuous Dates: ____________________

Applicant Phone Number Dubuque County Permit Officer

Email Address to return approved permit and invoice: Permits available at https://dubuquecountyiowa.gov/203/Engineer-Roads