Terms and Conditions Agreement
Oversized Load Permit Application and Special Provisions
| Name of Applicant |
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| I agree to the terms and conditions of the Oversized Load Permit |
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Applicant Information
Contact Information
| Company Name |
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| Business Street Address |
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| City, State and Zipcode |
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| Office Phone Number |
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| Office Fax Number |
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| Email Address |
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| Date of Application |
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Load Information
| Load Type |
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| Description of the Load or Equipment and Model Number |
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Vehicle Information
| Description of Hauling Equipment |
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| Vehicle Width (Example: 12' 5") |
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| Semi-Trailer Length (Example: 45') |
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| Kingpin to Last Axle Length (Example: 40') |
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| Combination Vehicle Length (Example: 65') |
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| Maximum Allowable Weight (40,000 lbs) |
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Loading Vehicle Dimensions
| Loaded Height (Example: 14') |
14' 0"
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| Loaded Width (Example: 10' 6") |
15' 0"
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| Loaded Overall Length (Example 65' 10") |
75' 0"
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| Loaded Overhang (Example: 1' 6") |
5' 0"
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| Weight Class |
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Tires per Axle
| Number of Tires on Axle 1 |
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| Number of Tires on Axle 2 |
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| Number of Tires on Axle 3 |
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| Number of Tires on Axle 4 |
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| Number of Tires on Axle 5 |
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| Number of Tires on Axle 6 |
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| Number of Tires on Axle 7 |
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| Number of Tires on Axle 8 |
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| Number of Tires on Axle 9 |
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Dates of Travel
| Is the Inbound Trip an Oversized Load? |
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| Outbound Date |
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| Is the Outbound Trip an Oversized Load? |
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Route Information
Date and Time Permit Processed
Date and Time of Permit Final Review
