Public Works Permits Annual OS/OW Company Move Permits Company Single Trip Move UID # 35433 Annual OS/OW Company Move Permits: Permit # ACMP-2021-0038 App. Status: IncompleteFreeborn County Public Works 3300 Bridge Av Albert Lea, MN 56007 507-377-5188
Applicant
Company Representative:
Name:
Tim Johnson
Company Name:
Johnson Ground Clearing and Dirt Work LLC
Phone:
(641
) 390
- 0777
eMail:
johnsonvinyl@yahoo.com
Mailing Address:
93 8th Street North
Northwood
IA
50459
Vehicle
Vehicle License Plate Number:
Vehicle Year:
Vehicle Make:
Vehicle Model:
Attachments:
Trailers
Trailer(s):
Identification
Build
Trailer License
Trailer State
Trailer Make
Trailer Model
Move Date/Other Permits
Date of Move:
Number of Duplicate Moves Today and number of days? Example "10 x 6" for 10 loads a day for 6 days.
1
Are there any other State, City or Township Permits?
Please Upload and Attach Other Permits:
Overall Dimensions
Description of Load:
Overall Length of Truck, Trailer, and Load (nearest foot):
Width (nearest 1/2 foot 12.5, 13.5 for example):
Height (nearest 1/2 foot 12.5, 13.5 for example):
Front Overhang (nearest foot):
Rear Overhang (nearest foot):
Left Overhang (nearest 1/2 foot 12.5, 13.5 for example):
Right Overhang (nearest 1/2 foot 12.5, 13.5 for example):
Axle Configuration
Configuration:
Axle(s):
Axle Group
Axle Weight
Axle Width
Spacing
Wheels
Route
Load From:
Moving To:
Miles Traveled on County Roads:
Miles
Roads:
Axle Fee Calculations
Calculated Moving Fee:
Dollars
Total Axle Weight:
Pounds
Number of Axles:
Axles
Total Over Design Axle Weight Value:
Invoice #11310 (05/30/2021)
Charge
Cost
Quantity
Total
Grand Total
Total
$0.00
Due
$0.00
This Application has not been submitted, so you may not pay for this Invoice.
