| Issued by: | Dubuque County Engineer's Office\n1225 Seippel Rd\nDubuque, IA 52002\n563-557-7283 | Permit No. |
| Fee: | 35.00 < /td > < /tr > < /table > < table border = 1 style = 'margin: auto; word-wrap: break-word;' > < tr > < td style = 'text-align: center; word-wrap: break-word;' > Issued by: < /td > < td style = 'text-align: center; word-wrap: break-word;' > Dubuque County Engineer #x27;sOfficen1225 Seippel RdnDubuque, IA 52002n563-557-7283 < /td > < /tr > < tr > < td style = 'text-align: center; word-wrap: break-word;' > Submit to: < /td > < td style = 'text-align: center; word-wrap: break-word;' > permits@dubuquecountyiowa.govnFax 563-557-1973 < /td > < /tr > < /table > # DUBUQUE COUNTY ROAD DEPARTMENT SINGLE TRIP PERMIT (VALID FOR ONE POWER UNIT ONLY) < table border = 1 style = 'margin: auto; word-wrap: break-word;' > < tr > < td colspan = "6" > Name < /td > < td colspan = "2" > Date < /td > < td colspan = "2" > Fax Number < /td > < /tr > < tr > < td colspan = "4" > Address < /td > < td colspan = "4" > City, State, Zip < /td > < td colspan = "2" > Check/Cash/Charge < /td > < /tr > < tr > < td colspan = "2" > Power Unit Year amp; Make < /td > < td colspan = "2" > Power Unit License No. amp; State < /td > < td colspan = "2" > Power Unit Registered Weight < /td > < td colspan = "2" > Trailer Make < /td > < td colspan = "2" > Trailer License No. amp; State < /td > < /tr > < tr > < td colspan = "4" > Interstate Travel Authority Number < /td > < td colspan = "4" > Intrastate Travel Authority < /td > < td colspan = "2" > US DOT Number < /td > < /tr > < tr > < td colspan = "2" > Object or Load < /td > < td colspan = "2" > Model Number < /td > < td colspan = "3" > VIN < /td > < td colspan = "2" > Serial Number < /td > < td style = 'text-align: center; word-wrap: break-word;' > SME Qualified < /td > < /tr > < tr > < td rowspan = "2" > Overall Length < /td > < td rowspan = "2" > Width < /td > < td rowspan = "2" > Height < /td > < td rowspan = "2" > Total Weight < /td > < td rowspan = "2" > Trailer Length < /td > < td rowspan = "2" > Load Length < /td > < td colspan = "4" > Projections < /td > < /tr > < tr > < td style = 'text-align: center; word-wrap: break-word;' > Front < /td > < td colspan = "3" > Rear < /td > < /tr > < tr > < td colspan = "2" > Axle Weights < /td > < td colspan = "2" > Single < /td > < td colspan = "2" > Tandem < /td > < td colspan = "2" > Triple < /td > < td colspan = "2" > Quad < /td > < /tr > < tr > < td colspan = "2" > Axle Spacing < /td > < td colspan = "8" > < /td > < /tr > < tr > < td colspan = "4" > Trip From: < /td > < td colspan = "6" > Trip To: < /td > < /tr > < tr > < td colspan = "10" > Routes: < /td > < /tr > < tr > < td colspan = "10" > GENERAL REQUIREMENTS: ☐ Civilian front escort ☐ Civilian rear escort ☐ Mounted height pole ☐ Overdimensional signs ☐ Amber revolving light/strobe light with 360^{\circ} $ 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 |
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# IOWA GENERAL PROVISIONS FOR OVERSIZE LOAD PERMIT
The State of Iowa, the Iowa Department of Transportation, and any other permit issuing authority assume no responsibility for the property of the permit holder. During movement under permit, the permit holder must meet the terms and conditions of the permit and must take all reasonable precautions to protect and safeguard the lives and property of the traveling public and adjacent property owners. A copy of a current certificate of public liability insurance in the amounts of $100,000 bodily injury each person, $200,000 bodily injury each occurrence, and $50,000 property damage must be carried in the vehicle for which the permit has been issued. Nothing shall exempt the permit holder from compliance with any load limitations that have been or might be established on any bridge or road posted with embargo signs. The permit and any revisions will be void if the actual weights or dimensions exceed what is indicated on the permit or its revisions. Permits can be issued only for loads that are a single article that cannot be reasonably broken down to make it legal in size and weight. The permit must be carried in the cab of the vehicle for which it has been issued and be available for inspection. Proof of liability insurance may be either in writing or in electronic format.
Movement is allowed seven days a week except for designated holidays and for special events when abnormally high traffic counts can be expected. The designated holidays are Memorial Day, Independence Day, and Labor Day. No movement will be allowed on these holidays or after 12 noon on days preceding these holidays and holiday weekends that include holidays falling on Monday, except as provided for in Iowa Code 321.457.
Annual permits: Routes must be checked for construction restrictions and clearance problems using the vertical clearance maps, bridge embargo maps, pavement restriction maps, and the 511ia.org website prior to moving under permit. Maps can be found at iowadot.gov/mvd/motorcarriers.
Escort requirements: Escorts must be at least 18 years old, possess a valid Class A, B, C, or D driver's license, and carry proof of public liability insurance in the amounts of $100,000/$200,000/$50,000. The escort vehicle must be approximately the size of a normal passenger automobile or pickup and must have a flashing or strobe amber light that shall be burning while escorting a permit load. The escorting vehicle shall not be used to tow a trailer while performing escorting duties. The escort shall not assume responsibility for stopping traffic. An on-duty peace officer, as defined in Iowa Code section 321.1, shall be contacted to provide any traffic control needed.
Required warning devices and escort requirements for vehicles operating under permit