Form Center

2. County Highway Permit #

   No permit will be issued during seasonal load limit postings

3. Object to be moved
5. Height
6. Width
7. Length
8. Gross Weight
10. Does the single axle or group axle weights exceed legal 9-ton roadways limits?

    1. Yes

    1. No
11. Does the single axle or group axle weights exceed legal 10-ton roadway limits?

    1. Yes

    1. No
13. Movement to be during daylight hours between the dates of
    Movement to be during daylight hours between the dates of Start Date

    —

    Movement to be during daylight hours between the dates of End Date
14. Movement to and from locations

    Please include count road number.

16. Please upload map
17. Amount of public liability and property damage insurance

    Must exceed $300,000.00 for a single claim arising from single occurrence and $1,000,000.00 for multiple claims arising from single occurrence

19. Insurance Company
20. Name & Address of local agency
22. Copy of Proof of Insurance
23. If granted this permit (I) (We) do hereby agree to comply with the provisions of the permit to take all necessary and reasonable precautions to maintain the safety of this movement and to be responsible for all liability for the personal injury or property damage which may occur in connection with this movement; and in the event any claim is made against the County of Beadle or department, office, or employee thereof, through, by reason of, or in connection with any such act or omission, applicant shall indemnify and hold them and each of them harmless from such claims.

    1. I agree
25. Applicant's Name

    Permit Company or Truck Owner 

26. Applicant's Title
28. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
30. Electronic Signature
31. Date
    Date
33. Billing Address
35. Phone #
36. Fax #
38. Permission for this movement is hereby granted subject to compliance with the provisions of the South Dakota Highway Traffic Regulations. This Permit is subject to revocation upon non-compliance. Permission for movement over roads other than County Highways must be obtained from the proper road authority. This permit does not exempt the permittee from other driving or highway laws.
40. Name & Title
41. Date
    Date
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field