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Permit Number

WASHINGTON

SPECIAL TRANSPORT PERMIT – DRILLING RIG

COUNTY

DR________

COLORADO

150 ASH AVE ● AKRON COLORADO ● 80720

*Fee $500 per move*

Ph: 970.345.2701 Fax: 970.345.2702

The Undersigned hereby applies for a SPECIAL ONE WAY PERMIT to transport vehicles and/or loads exceeding limits fixed by statute,

as follows:

Name of Transporter /Contact_____________________________________________________________

Company Name ________________________________________________________________________

Address_______________________________________________________________________________

City

Zip

Phone #_______________________Fax #____________________Email___________________________

Owner of Property Being Moved____________________________________________________________

Date(s) to be Transported_________________________________________________________________

(Permit valid for 10 working days from date specified)

Washington County Roads to be Traveled____________________________________________________

P.U.C.

Vehicle License /Number

Trailer License

Gross Weight (Pounds):

Length (Feet):

Width (Feet):

Height (Feet):

Number of Axles:

Oil Rig Moves:

_________________

Start Township /Range /Section

End Township /Range /Section

_______________________________________________________________________________________

(Applicable to Washington County roads only)

It is understood by the applicant that this permit when issued is valid only on those roads and highways under the jurisdiction of the

Board of County Commissioners of Washington County.

If the requested permit is granted, the undersigned agrees:

To take every precaution to protect the highways and the traffic from damage or injury, using pilot cars or flagmen to warn the traveling

public on all blind curves, both vertical and horizontal.

In case of over-width of load, the same is to be placed on the vehicle with the overhangs as far to the right as possible, and in any

event the material is to be loaded so as to present the minimum hazard to traffic.

Transport of equipment is only allowed between DAYLIGHT and DARK. All traffic loads must be removed from highways and county

roads except between DAYLIGHT and DARK.

To be financially responsible and to make prompt payment for any damage caused to the traffic or highway and county roads or

bridges by the transportation of this load in excess limitations prescribed by statute. Further to be financially responsible for any

damage to utilities which adjoin or cross the county road rights of way including electricity, telephone and oil and gas pipelines.

That the operators of the vehicles are duly licensed according to statute.

To operate the vehicle or vehicles at all times in accordance with any and all provisions of law, except as exempted herein with regard

to motor vehicles and the operation thereof.

Except when a permit is requested and granted for overweight, the undersigned applicant specifically states that his load is legal

weight, and the same cannot be loaded to conform to the statute.

THIS PERMIT IS NOT GOOD SATURDAYS, SUNDAYS OR HOLIDAYS

This application when signed by the County Board of Commissioners of Washington County, Colorado or their authorized agent, in the

space below becomes the requested permit subject to the conditions with the understanding that no liability is assumed by the County of

Washington by reason of it’s issuance, in regard to conditions of roads or capacity of culverts and bridges, and the applicant is charged

to make necessary examination and inspection as to the adequacy of roads and bridges to care for the traffic movement. In case of an

emergency, The Board of County Commissioners of Washington County or their authorized agent has authority to suspend this permit

until emergency conditions have passed.

Signature /transporter__________________________________________________ Date___________________

APPROVED BY

WASHINGTON COUNTY _______________________________________Date______________________

BOARD OF COUNTY COMMISSIONERS CHAIRMAN

AGENT _______________________________________Date______________________

PERMIT WILL BE PROCESSED UPON RECEIPT OF APPLICATION AND

FEE.

To expedite process you may fax permit application with copy of issued check and overnight actual check to above address. Copy of approved permit will

be faxed as soon as proof of payment is received. Remit fee of $300/permit to Washington County Commissioners at above address.

Specialtransportpermit

cc road & bridge district;

rev11/15

Special Transport Permit - Drilling Rig - The Board Of County Commissioners Of Washington County, Colorado

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