Form AC-1 "Hauling Permit" - Athens County, Ohio

What Is Form AC-1?

This is a legal form that was released by the Engineer’s Office - Athens County, Ohio - a government authority operating within Ohio. The form may be used strictly within Athens County. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 15, 2014;
  • The latest edition provided by the Engineer’s Office - Athens County, Ohio;
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DATE:
Jeff Maiden, County Engineer
Form AC-1 - Revised 5/15/14
ATHENS COUNTY HAULING PERMIT
Athens County Engineer's Office
16000 Canaanville Road
Athens, Ohio 45701
Phone (740) 593-5514
Fax (740) 592-4616
COUNTY PERMIT NUMBER:
Permission is hereby requested by the following to transport the equipment and load described below:
TYPE PERMIT:
(Please type or print)
Trip (14 calendar days)
Name:
Trip & Return (14 calendar days)
Address:
90 Day Multiple Move
Annual (1 yr. from date granted)
Phone No:
Fax No:
Construction Equipment (12' legal)
E-mail
(optional):
Farm Equipment (14' legal)
(Application must be signed below in space provided.)
Manufactured Building
ALL WEIGHTS IN POUNDS
MAKE & MODEL
LICENSE NO.
STATE
WEIGHT EMPTY
Other
Truck or
THIS PERMIT IS VALID
Tractor
Beginning:
Ending:
*Semi-Trailer
All Dimensions Feet & Inches
Other Trailer
DIMENSIONS
(Jeep, Dolly)
Vehicle & Load Overall
Net Load
Description of Load including Make & Model, if applicable:
Length
Height
Width
Total Gross Weight
Check if applicable:
Load is towed on its own frame & carriage
Load Only
Load is under its own power
Variable trailers, see attached
Length
Height
Width
All weights (axle & gross are LEGAL in accordance with Section 5577.04 O.R.C.)
If checked, do not complete axle loads & spacing section of this application.
AXLE SPACING
AXLE LOADS
TIRES
MOVEMENT TO BE MADE
A
From
Axle No.
No. on Axle
Sizes
B
1.
C
2.
To:
D
3.
E
4.
Via Routes:
F
5.
G
6.
H
7.
I
8.
9.
10
Total Gross Weight
Limitations listed on back of Application Form AC-1 apply. Special provisions as checked
or listed below apply. Move only during daylight hours. Movement is prohibited Saturday,
Sunday or a holiday.
FOR OFFICE USE ONLY
VOID IF BLANK, ALTERED OR UNSIGNED
Permitee is responsible to check the route for abnormal, changed or unknown
conditions which may exist during any move.
PERMIT IS HEREBY:
I, __________________________________________ do hereby swear that I am
_____
Granted
_____
Denied
(Printed Name)
the applicant or his/their legally authorized representative and that the statements
_______________________________
made in the foregoing application are true and correct to the best of my knowledge.
By:
County Representative
SIGNATURE:
Date:
Time:
DATE:
Jeff Maiden, County Engineer
Form AC-1 - Revised 5/15/14
ATHENS COUNTY HAULING PERMIT
Athens County Engineer's Office
16000 Canaanville Road
Athens, Ohio 45701
Phone (740) 593-5514
Fax (740) 592-4616
COUNTY PERMIT NUMBER:
Permission is hereby requested by the following to transport the equipment and load described below:
TYPE PERMIT:
(Please type or print)
Trip (14 calendar days)
Name:
Trip & Return (14 calendar days)
Address:
90 Day Multiple Move
Annual (1 yr. from date granted)
Phone No:
Fax No:
Construction Equipment (12' legal)
E-mail
(optional):
Farm Equipment (14' legal)
(Application must be signed below in space provided.)
Manufactured Building
ALL WEIGHTS IN POUNDS
MAKE & MODEL
LICENSE NO.
STATE
WEIGHT EMPTY
Other
Truck or
THIS PERMIT IS VALID
Tractor
Beginning:
Ending:
*Semi-Trailer
All Dimensions Feet & Inches
Other Trailer
DIMENSIONS
(Jeep, Dolly)
Vehicle & Load Overall
Net Load
Description of Load including Make & Model, if applicable:
Length
Height
Width
Total Gross Weight
Check if applicable:
Load is towed on its own frame & carriage
Load Only
Load is under its own power
Variable trailers, see attached
Length
Height
Width
All weights (axle & gross are LEGAL in accordance with Section 5577.04 O.R.C.)
If checked, do not complete axle loads & spacing section of this application.
AXLE SPACING
AXLE LOADS
TIRES
MOVEMENT TO BE MADE
A
From
Axle No.
No. on Axle
Sizes
B
1.
C
2.
To:
D
3.
E
4.
Via Routes:
F
5.
G
6.
H
7.
I
8.
9.
10
Total Gross Weight
Limitations listed on back of Application Form AC-1 apply. Special provisions as checked
or listed below apply. Move only during daylight hours. Movement is prohibited Saturday,
Sunday or a holiday.
FOR OFFICE USE ONLY
VOID IF BLANK, ALTERED OR UNSIGNED
Permitee is responsible to check the route for abnormal, changed or unknown
conditions which may exist during any move.
PERMIT IS HEREBY:
I, __________________________________________ do hereby swear that I am
_____
Granted
_____
Denied
(Printed Name)
the applicant or his/their legally authorized representative and that the statements
_______________________________
made in the foregoing application are true and correct to the best of my knowledge.
By:
County Representative
SIGNATURE:
Date:
Time:
AC-1A
ATHENS COUNTY
LIMITATIONS ON THE USE OF A SPECIAL HAULING PERMIT
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 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 Athens County
for any damage to a roadway or road structure and also to indemnify, save harmless, and defend Athens County from and
against all and any liabilities, losses, obligations, claims, damages, penalties, suits, actions, judgments, costs and expenses of
whatsoever nature are incurred or brought against Athens County as the result of injury to or death of persons or damages to
or loss of property caused by acts or omission to act by the Permittee, its agents, servants and employees in the performance
of movements under this permit, except to the extent that the negligence of Athens County is a proximate cause of the
accident.
3.
The paper 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 load limit inspector employed by Athens County.
4.
The permission granted restricts the movement of the vehicle(s) or object(s) to the highways specified, between the point
designated, and within the time allotted.
5.
No vehicle(s) or object(s) in excess of the legal limits prescribed by law shall be permitted on the highway on Saturdays,
Sundays or during the period beginning at 12 noon on the day preceding and continuing until sunrise on the day following
national holidays or holiday weekends.
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 special hauling permit shall travel in convoy with any other
oversize/overweight vehicle or vehicle and load. Every vehicle operating under a permit shall maintain a minimum spacing
of 500’ from all vehicles traveling in front of and in the same lane as said vehicle whenever possible.
8.
The operator of the vehicle must comply with all laws, rules, or regulations covering the movement of traffic over highways
and streets.
9.
No vehicle(s) or object(s) being transported under a special hauling permit shall travel in convoy with any other
oversize/overweight vehicle or vehicle and load. Every vehicle operating under a permit shall maintain a minimum spacing
of 500’ from all vehicles traveling in front of and in the same lane as said vehicle whenever possible.
10.
All flags, signs, escort vehicles, safety lighting devices, flagpersons, etc., as required in the below listed Special Provisions
must meet the specifications as provided in Section 5501:2-1-01 through 5501:2-1-12, Ohio Administrative Code, and
Transportation Directive 24-A dated May 15, 1983.
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.
A permit is void at any time road, weather or traffic conditions make travel unsafe.
13.
Reductions in legal weight posted on roadways or bridges must be obeyed.
14.
Non-compliance with the general or special provisions of a permit, exceeding the weights or dimensions granted, or
operating on dates or upon highways other than assigned shall render the permit null and void and the operator of the vehicle
subject to arrest, as provided in Sections 5577.02 to 5577.05 inclusive of the Ohio Revised Code.
SPECIAL PROVISIONS
1.
Display clean red flags not less than 16” square and fastened to staffs of sufficient length so as to permit the flags to move
freely of any obstructions, located as follows: One at each end of the front bumper at the 45 deg. Angle, one at each of the
four corners of the vehicle or load, and if there is any part of the load wider, one at the widest point on either side.
2.
Private escort vehicle to proceed 500’ in advance of vehicle/load.
3.
Private escort vehicle to follow 500’ back of vehicle/load.
4.
Police escort required to assist traffic control.
5.
Oversize load signs must be attached to front and rear of vehicle/load.
6.
Lead escort vehicle must be equipped with a height sensing device.
7.
Driver of the escort vehicle is to act as flagman when needed.
8.
Note Limitation #5 regarding travel restrictions.
9.
Move must be coordinated with the owners of all overhead signs, signals, utilities, etc., which may obstruct safe, clear
movement.
10.
Special Provision #2 applies to bi-directional, two lane highways. Special Provision #3 applies to multiple lane highways.
11.
All movements shall be made at such speeds and in such manner as to cause a minimum of interference with other traffic and
minimum impact stresses on structures and pavements. No movement is to exceed forty (40) miles per hour at any time,
except upon that portion of a highway where the posted minimum speed is in excess thirty-five (35) miles per hour. In this
event, the maximum allowable speed is then five (5) miles per hour grater than the posted minimum speed for that highway.
*Check mark (√) indicates special provision(s) that apply to this permit.
(Revised 5/15/14)
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