Polk County Public Works
5885 NE 14th Street
Des Moines, IA 50313
Phone: 515-286-3705 FAX: 515-286-3437
Email: publicworks@polkcountyiowa.gov
Permit Fee - $400
ANNUAL OVERSIZE/OVERWEIGHT PERMIT APPLICATION
Requested Start Date:
(Valid For One Power Unit Only)
Vehcile Owner or Lessee: Contact Name Phone No. ____________________ Cell: _____________
Address: US DOT Number
City State Zip Code FAX No. ______________________ MC No. ___________
PrivateCarrier Type: For Hire
Email Address:
Email Address: Iowa's Interstate Authority Number:
POWERUNIT INFORMATION
StatePlate Vehicle Identification Number (VIN) MakeYearPower Unit Registered Weight
DIMENISIONS/WEIGHT
Length Width Height Rear ProjectionFront ProjectionTOTAL Weight
(max 120') (max 13'-6") (max 156,000 lbs)(Max 15'-6")
TOTAL
NOTE - MAXIMUM AXLE WEIGHT = 20,000 LBS PER AXLEAXLE WT/SPACING
1Axle No. 2 3 4 5 6
Gross Wt.
1 -2 2 -3 3 -4 4 -5 5 - 6
Axle Spacing
Axle Spacing
Does applicant have public Certificate of Insurance ($100/200/50) on file with this office? With IA DOT Office of V & MC Services?
CERTIFICATION MAILING ADDRESS IF DIFFERENT FROM ABOVE
Acceptanc NAMEe of Conditions: I hereby certify that the information contained in this
is true and correct and that I will comply with the attached General Provisions
Mailing Address
___________________X __________________________________________
Customer or Authorized Agent Date METHOD OF ISSUANCE
FAX EMAIL MAIL
Polk County Approval: Date of Approval: Date of Expiration
Maximum dimensions allowed on an annual oversize/overweight permit is: Length - 120', Width - 13'-6", 15''-6" high,
& 156,000 lbs. Carrier must obtain a Polk County Approved Route Map. Only indicated approved routes shall be used.
will be the responsibility of the carrier to route themselves around low clearances, construction projects, embargoed
roads and bridges. If carrier demonstrates inability to self route permit will be denied.
Attach Route Map
Disclosure Statement: The information furnished on this application will be used by Polk County to prepare and issue permits. All information applicable to a given
Permits can be issued only for transporting single articles that exceed statutory size unless inclusion of additional
roads and bridges. If carrier demonstrates inability to self route permit will be denied.
be responsible for any damages that are the result of the move. Polk County and any other permit issuing authority resume no responisbility for the property of
given permit is required and is public information. Failure to complete the application as required will result in denial of permit. Permit issuing authorities will not
the permit holder.
articles does not cause the size or weight to further exceed the statutory limits.
Escrow Acct
Cash/Check Payable to Polk County Public Works
Permit #______________________
PROVISIONS
Polk County assumes no responsibility for property of permit holder by issuance of this permit.
The permit holder shall comply with terms and conditions of the permit, take all reasonable precautions to protect
and safeguard the lives and property of the traveling public and adjacent property owners, and shall hold the
County of Polk harmless of any damages that may be sustained on account of such move.
The permit holder shall hold Polk County harmless for any damages that may result to Polk County Roads by
movement made hereunder and shall reimburse Polk County for any expenditure which Polk County may have to
make on account of such move.
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. Permit issuing authorities will not be responsible for any damages that are the result of the move.
Movement shall be made only when roads are clear of ice and snow, and visibility is at least one-quarter mile.
Nothing in the permit shall be construed as waiving any load limitations which have been or which might be
established on any bridge or any road posted with embargo signs nor the wheel base maximum load limitations of
Section 321.463 of the Iowa Code.
Permit and any supplements or additions thereto shall be void in case the weights or dimensions of the vehicle and
load as operated exceed the weights or dimensions as provided in the permit and supplements or additions hereto.
No vehicle or combination of vehicles of illegal dimensions, with or without load, shall be moved on Polk County
highways without permit.
Permits can be issued only for loads that are a single article that cannot be reasonably broken down to make it
legal size and weight.
The permit must be carried in the cab of the vehicle for which the permit has been issued and must be made
available for inspection at all times. The vehicle that the permit has been issued for shall be open to inspection by
any peace officer or to any authorized agent of any permit granting authority.
Movement is allowed only from sunrise to sunset unless it is determined by the issuing authority that the move can
be made more safely at another time because of traffic-volume conditions. 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
those holidays or after 12 noon on days preceding these holidays and holiday weekends which include holidays
that fall on Monday, excepts as provided for in Section 321.457 of the Code.
The permit vehicle shall not exceed, consistent with the safety of the traveling public, that speed specified by the
permit.
The permit holder must take steps necessary to avoid and reduce traffic congestion by maintaining proper traffic
intervals, temporarily relinquishing the travel way in order to provide a passing opportunity for following vehicles
desiring to travel faster than the prescribed speed of the permit vehicle. This shall be done as soon as conveniently
possible as soon as a group of two or more vehicles have accumulated in back of permit vehicle.
The permit holder must notify the office of Polk County Public Works, Des Moines, Iowa, in writing of the fact of the
occurrence of any reportable motor vehicle accident involving any permit vehicle.
Each vehicle and load exceeding the width, height, and length provisions of Iowa Code Sections 321.454, 321.456,
and 321.457 must display warning devices as stated in Iowa Administrative Code Sub rule 820—(07.F)2.13.
All vehicles and loads exceeding 12 feet, 5 inches in width or 75 feet in length shall be limited to a maximum trip
distance of 50 miles on the highway system (annual permits only).
One escort shall be provided for the movement of a vehicle and load which exceeds the roadway lane width.
Either a properly equipped escort vehicle, an amber revolving light, or a strobe light shall be provided for the
movement of a vehicle and load which exceeds 80 feet in length.
Permit not valid on primary roads or within corporate limits of any municipality.
Approved escort shall be provided for the movement of vehicles and loads which exceed the roadway lane width or
80 ft. in length when operated under annual permit.