Appendix 7A: Sample Landowner Work Permit

Table of Contents

According to Iowa Code Section 317.13, landowners who want to burn, mow, or spray in roadsides must obtain a work permit. The following sample work permit contains excerpted sections from permits found in county integrated roadside vegetation management (IRVM) plans. This sample permit is not meant to be comprehensive or a direct template. See the county IRVM plans on the Living Roadway Trust Fund’s IRVM website for examples of actual permits.

Prairie County Secondary Roads Department 
Permit to Perform Work Within the Right-of-Way

 

Date:____/____/________

 

Name:______________________________________________________________________

Address:____________________________________________________________________

Phone:______________________________________________________________________

Email:_______________________________________________________________________

Work site address or road name(s):______________________________________________

Section:_______________________ Township:_______________________

Other identifying information (e.g., near a landmark): _______________________________

 

Request details (what work do you want to do and why?): ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

  1. Permits are required before any physical change can be made. 
  2. Work must comply with the County's integrated roadside vegetation management regulations any all laws now in effect or that may be hereafter enacted.
  3. The permittee must take all reasonable precautions during the work to protect and safeguard the lives and property of road users and adjacent property owners. The County shall be held harmless for any injuries, damages, or losses that may occur. Proper warning signs and/or devices in compliance with the Uniform Traffic Control Devices for Streets and Highways shall be used to alert road users of work being done. 
  4. The permittee shall hold the County harmless for any damage to the road due to the work being done. The permittee shall reimburse the County for any costs incurred due to the permittee's work.