EmailMeForm
Contact Name
*
Company Name
*
Mailing Address
*
City
*
State
*
Zip Code
*
Email
Daytime Phone
*
Cell Phone
*
WORK TO BE PERFORMED WITHIN RIGHT-OF-WAY
Desired Route:
Description of work to be performed within right-of-way
Oversized or Overweight Movement
Other
Detailed Description
(as needed, add attachment if necessary)
Upload State of Ohio Permit or Configuration Sheet
*
View
FCEO-Axle-Weight-Configuration-Sheet
Work will commence on or about
MM
/
DD
/
YYYY
Will require # of days to complete
enter # of days
GENERAL PERMIT REQUIREMENTS
BY SUBMITTING THIS FORM YOU AGREE TO THE FOLLOWING:
I agree to comply with all conditions, restrictions, and regulations of the Fairfield County Engineer. If compliance is not met in the opinion of the Fairfield County Engineer, it is understood that the County Engineer reserves the right to stop work being performed and restore the right-of-way to an acceptable condition at the expense of the applicant.
PLEASE ENTER FULL NAME:
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SIGNATURE:
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