Clear Form
Special Transport Permit
Larimer County
Engineering Department
200 W. Oak St, Ste 3000
PO Box 1190
Fort Collins CO 80522-1190
Phone: (970) 498-5700
Fax:
(970) 498-7986
County Use Only:
Date:
Fee: $
Paid:
Check#:
5 Working Days Required for Review of Permit
(Please Print)
__________________________________________________________________
Applicant
Mailing Address
__________________________________________________
City
State
Zip
Proposed date of shipment
_____________________________________________________
Shipment consists of
PROPOSED ROUTE WITH HIGHLIGHTED MAP REQUIRED
(
)
(
)
(
)
Phone Number
Alternate #
Fax
__________________________________________________
E-mail address (if applicable)
From:
To:
To:
To:
Tow Vehicle Make/Type/ Year
Tow Vehicle License Number
Trailer License Number
Number of axles
___________________________
Gross weight
___________________________
Distance between 1st and last axle
Vehicle diagram: Please indicate all applicable measurements with corresponding letter.
A
B
C
D
E
A
F
G
__________
H
__________
I
__________
J
D
B
C
E
G
F
H
I
J
Call (970) 498-5709 For Final Inspection. 72 hours Notice Required
County Use Only
Notification of the following Overhead Utilities are required.
Overhead Utility Company
Phone number
Overhead Utility Company
Phone Number
Overhead Utility Company
Phone number
Overhead Utility Company
Phone number
Phone Companies
Phone numbers
TV Cable Companies
Phone number
Other Overhead Companies
Phone number
Other Overhead Companies
Phone number
The following restrictions must be observed as checked:
Flagmen Required
No.
Reg. Flag Displayed
Dept. Inspector Required
Pilot Car Required
No.
Oversize Load Signs
Other:
Special Provisions:
This application, when signed by the Larimer County Access and Utility Coordinator or his authorized representative in the space provided below, becomes the requested permit
subject to the below conditions, and with the understanding that no liability is assumed by Larimer County by reason of its issuance in regard to condition of roads or capacity of
culverts and bridges. The applicant is charged to make necessary examination and inspection as to the adequacy of roads or bridges and to care for the traffic movement. In case
of emergency the Engineering Department or its authorized agents have the authority to suspend this permit until emergency conditions have passed.
Applicant Signature
County Engineering Department
Date
Date
4/13/09
General Provisions
White – Office Yellow – Inspector
Pink – Applicant
LCE – 371
E-mail To Engineering
Be it understood by the applicant that this permit, when issued, is valid only on those roads under the jurisdiction of Larimer County. To
operate on highways under other jurisdictions, State Highways or Local Streets, it is necessary to obtain a separate permit from the
authorities having jurisdiction thereover.
If the requested permit is granted, the undersigned agrees:
1) To take every precaution to protect the roads and the traffic from damage or injury using pilot cars or flagpersons to warn the
traveling public on all blind curves, both vertical and horizontal.
2) In the case of overweight and oversized loads, the load is to be placed on the vehicle with the overhangs as far to the right as possible,
and in any event the material shall be loaded so as to present the minimum hazard to traffic.
3) To make any structural movements only between DAYLIGHT and DUSK and to remove the load from the road except between
those hours.
4) To be financially responsible and to make prompt payment for any damage caused to the traffic, traffic lights, signs, bridges, wires,
cables, and other installations by the transportation of this load. Bridge rails are to be removed 24 hours in advance as needed and
replaced within 24 hours of movement of the load.
5) That the operator of the vehicle is duly licensed according to state statute.
6) To operate the vehicle at all times in accordance with any and all provisions of the law, except as exempted herein.
7) Except when a permit is requested and granted for an overweight load, the applicant specifically states that this load is within legal
weight limits and cannot be loaded to conform to the statute. He or she certifies that he/she understands and accepts all provisions and
requirements of this permit.
8) To fully defend and indemnify Larimer County, it’s officers and agents from and against any loss or liability that occurs or arises as a
result of the special transport hereby permitted or otherwise as a result of the issuance of this permit.
County Provisions
The cost of supervision will be based on a minimum of $40.00 per hour or fraction thereof, for an inspector with transportation plus any
additional actual cost for barricades or flagpersons required. All repair costs incurred by Larimer County necessary to protect or restore
property and insure safety to the public shall be chargeable to the applicant. The inspector will have full authority to stop the permitee at
any time for failure to comply with the terms of the permit.
The timing of the move shall be determined by the Access and Utility Coordinator and as final condition of issuance the permitee must
certify that the legal requirements imposed by Colorado law have been fulfilled and permission has been obtained from all public utility
agencies affected.
This permit is to be made out in duplicate and both copies signed by both the applicant and, if granted, by the Access and Utility
Coordinator or his authorized representative. The original is retained by the Larimer County Engineering Department; the second copy is
given to the applicant.
Every such permit shall be carried in the vehicle or combination of vehicles to which it refers and shall be open to inspection by any
police officer or authorized agent of any Larimer County authority granting such permit, and no person shall violate any of the terms or
conditions of such special permit.
Permitted loads shall be prohibited on MEMORIAL DAY, INDEPENDENCE DAY and LABOR DAY. If the holiday falls on a
Saturday, the previous Friday shall also be restricted as a holiday. If the holiday falls on a Sunday, the following Monday shall be
restricted as a holiday.
White – Office Yellow – Inspector
Pink – Applicant
LCE – 371