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Terms & Conditions:
I hereby certify that this permit in its initial form has not been altered, changed, or modified in any manner whatsoever without the express written consent of the maintenance division of the Mississippi Department Of Transportation (MDOT). I hereby agree that any alteration, change , or modification made to the initial form of this permit without the express written consent of the MDOT'S maintenance division may result in the entire permit or any portion thereof, at the sole discretion of the MDOT, being deemed null and void.
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Note: You have the option to fill in the information online and take a print out for Notarization provided you are a registered user or download the appropriate application and follow the instructions on the application. Either way, please mail the notarized copy of the application to the following address:
Mississippi Department of Transportation
Attn: Maintenance Division 75-01 
P.O. Box 1850 
Jackson, MS 39215-1850