FLH Bridge oversized or overload vehicle permit request form August 2023.pdf

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OR FLAP CRGNSA MULT(2) & WA FLAP CRGNSA MULT(2), CRGNSA Sign Inventory, Maintenance, and Replacement Project & CRGNSA Sign Project
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69056725B000008
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About this file

This is an application form for the Federal Lands Highway (FLH) program to request permits for transporting oversized and overweight loads across FLH-managed bridges.

The form requires applicants to provide essential identifying information including application date, applicant name, company name, USDOT number, phone number, and email address. Applicants must describe the load being transported and the intended route, along with the specific date of movement. The permit vehicle configuration section requires detailed specifications: width, height, length, and gross weight. Page 2 of the form includes space for vehicle top and side view sketches with dimensions and an axle table requiring axle number, axle spacing in feet, total weight per axle in pounds, and number of tires per axle. The form notes that adjacent axles with identical load, dimensions, and tires may be grouped in the table. The form includes an agency review section where FLH personnel indicate approval or denial status, reviewer name, date, and specific permit conditions. The form explicitly states that any permit submitted with incomplete, illegible, or inconsistent data will be returned for correction. The current version was revised August 7, 2023.

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Text version

Revised 8/3/23 Page 1 of 2

FLH BRIDGE OVERSIZED/OVERWEIGHT PERMIT LOAD REQUEST

APPLICATION DATE:

APPLICANTS NAME:

COMPANY NAME:

USDOT#:

PHONE NUMBER:

EMAIL ADDRESS:

DESCRIPTION OF LOAD:

DESCRIPTION OF ROUTE:

DATE OF MOVEMENT:

PERMIT VEHICLE CONFIGURATION

WIDTH: HEIGHT: LENGTH:

GROSS WEIGHT:

(COMPLETE VEHICLE CONFIGURATION SKETCH ON NEXT PAGE)

APPLICANTS SIGNATURE: DATE:

(AGENCY USE ONLY)

REVIEWED BY: DATE:

DENIED APPROVED

PERMIT CONDITIONS:

Revised 8/7/23 Page 2 of 2

VEHICLE TOP VIEW

(w/ dimensions)

VEHICLE SIDE VIEW

(w/ dimensions)

Axle Number TOTAL Axle spacing (ft) WEIGHT (lbs) Load (lbs) per axle No. of Tires per axle

*Adjacent axles carrying the exact same load, dimensions and tires may be grouped in the axle table

A PERMIT SUBMITTED WITH INCOMPLETE, ILLEGIBLE, OR INCONSISTENT DATA WILL BE RETURNED FOR CORRECTION

TOTAL WEIGHT lbsLoad lbs per axle:
Axle Number:
Axle width ft:
Load lbs per axle:
No of Tires per axle:
Axle Number2:
Axle Number3:
Axle Number6:
Axle Number7:
Axle Number8:
Axle width ft2:
Axle width ft3:
Axle width ft4:
Axle width ft5:
Axle width ft6:
Axle width ft7:
Axle Number4:
Axle Number5:
Axle Number5b:
Axle Number9:
Axle width ft8:
Axle width ft9:
Axle width ft10:
Load lbs per axle2:
No of Tires per axle2:
Load lbs per axle3:
No of Tires per axle3:
Load lbs per axle4:
No of Tires per axle4:
Load lbs per axle5:
No of Tires per axle5:
Load lbs per axle6:
No of Tires per axle6:
Load lbs per axle7:
No of Tires per axle7:
Load lbs per axle8:
No of Tires per axle8:
Load lbs per axle9:
No of Tires per axle9:
Load lbs per axle10:
Check Box1: Off
Permit Condition:
height:
length:
Date1:
Name:
Company name:
USDOT #:
Phone #:
Date3:
Date4:
Date2:
Route:
Load Description:
Email address:
Check Box2: Off
width:
GVW:
No of Tires per axle10:
Top view and side view truck:

File details come from the government source that posted it. Updated .