MCEO - formSHP-1 11222019 Page 1 of 2
2100 N. County Road 25-A, Troy, Ohio 45373
Telephone: (937) 440-5656 Fax: (937) 440-5659
Paul P. Huelskamp, PE, PS E-mail:
Miami County Engineer
Please Type or Print Legibly:
Applicant Name
City State Zip Code
Person Requesting Permit
Area Code/Telephone Number
Area Code/ Fax Number
Load will be: Overweight Oversize
Description of Load (Include make, model, & serial number)
This permit is valid:
Make and Model
License No. (State)
Empty Weight
No. of Axles
Load Weight:
Gross Weight:
Vehicle & Load Overall (Feet & Inches) Load Only (Feet & Inches) Front/Rear Overhang Length
Axle Number
No. of Tires on Axle
Tire & Rim Size
Axle Weight (lbs.)
Spacing Between Axles
(Feet & Inches)
Routing Information: From (Beginning location)
To: (Ending Location)
Via Routes:
I (We) assume the responsibility for and will save the Board of Miami County Commissioners and the Miami County Engineer, their elected officers, employees, and
representatives harmless from any and all claims for personal injuries and property damages and shall defend any action that might be brought due to this work. To cover
this responsibility, I (we) have the following insurance which is now and will remain in force during the prosecution of this work:
Insurance Co. Amount:
Address Policy #
I (We) agree to the limitations listed on the back of this form and to the special provisions as listed and/or checked on the back of this form.
Applicant’s Signature Date
*This permit is also subject to the terms and conditions as listed on page two of this permit.
MCEO - formSHP-1 11222019 Page 2 of 2
Permit for above application under the conditions agreed to is hereby granted in accordance with Ohio Revised Code Section 4513.34.
Paul P. Huelskamp, PE, PS, Miami County Engineer Date
**This application, when signed by the Miami County Engineer, shall serve as a permit as authorized by the Board of Miami County Commissioner’s
Resolution No. 19-12-1717.
1. The granting of a permit does not guarantee that the load described can be moved without damage to the pavement or structures; although
the permit is granted on the assumption that the load can be moved without damage based on the best information available.
2. Permittee will be held liable for any damage caused by the movement. The Miami County assumes no responsibility for damage to the
permittee’s equipment or load being moved due to any such failure. The permittee agrees to compensate Miami County for any damage to a
roadway or road structure and also to hold Miami County harmless from all claims, damages, or proceedings of any kind and from all
responsibility for person injury or property damage (public or private) caused directly or indirectly as a result of the transportation of said
vehicle(s) or object(s).
3. The applicant must file a certificate of his liability insurance, showing that he has procured adequate insurance to cover the provisions of
paragraph two.
4. The permit shall be in the possession of the driver at all times during the progress of transportation and will be shown on demand to any police
officer, state highway patrolman, or employee of the Miami County Engineer’s Office.
5. The permission granted restricts the movement of the vehicle(s) or object(s) to the highways specified, between the points designated, and
within the time allotted.
6. Movements under a special hauling permit shall be made during daylight hours only and in such a manner to impede the least possible extent
the normal highway traffic.
7. No vehicle(s) or object(s) being transported under a special hauling permit shall be left parked on the roadway either day or night except in the
case of an emergency, in which case adequate protection shall be provided for the traveling public. The vehicle(s) shall not be loaded or
unloaded within the limits of the highway.
8. The operator of the vehicle must comply with all laws, rules, and regulations covering movement of traffic over roadways and streets.
9. All construction equipment and other machinery shall have attached thereto a plate showing the manufacturer’s name and the model.
10. Reductions in legal weight posted on roadways and bridges must be obeyed.
11. Permits will not generally be issued for built-up loads that are divisible into legal loads, or into loads of the least over dimension or the least
over weight. If, in the event of an extenuating circumstance, a permit is issued for a divisible load, such load will be adequately described.
12. All movements shall be made at such speeds and in such a manner as to cause a minimum of interference with other traffic and minimum
impact stress on structures and pavements.
13. Loads of extremely large dimensions shall require additional protective measures when necessary for the safeguarding of other traffic. Due
regard shall be taken of traffic in both directions and every possible effort shall be made to prevent traffic congestion. One or more flagmen, or
a pilot car, may be required.
14. Non-compliance with any provision of this permit, including exceeding the weights or dimensions granted by this Permit or operating on dates
or highways other than those assigned by this Permit, shall render this Permit null and void and may render the owner and/or driver of the
vehicle subject to the charges and penalties, including without limitation the arrest of the vehicle’s operator, set forth in Ohio Revised Code
Chapter 5577.
15. A permit is void at any time road, weather, or traffic conditions make travel unsafe.
1. Display clean red flags not less than 16” square and fastened to staffs of sufficient length so as to move freely of any
obstructions, located as follows: one at each end of the front bumper at a 45-degree angle, on at each of the four corners of the
vehicle load, and if there is any part of the load wider, one at the widest point on either side.
2. “Long Load” signs to be attached to front and rear of vehicle or load.
3. “Wide Load” signs to be attached to front and rear of vehicle or load.
4. Move must be coordinated with the owners of all signs, signals, utilities, etc. which may obstruct safe, clear movement.
5. Flagman to flag traffic on turning movements or at any time any part of the vehicle or load is over the centerline of the roadway or
at any time when necessary for the safe movement of traffic.
*Check mark () indicates special provision(s) that apply to this permit.
Other remarks: