FLH Bridge oversized or overload vehicle permit request form Oct 2018.pdf

145 KB Posted

Attached to
CO NP MULTI PMS(2), Pavement Preservation Colorado Phase 2
Solicitation number
69056723R000012
Issued by

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This document contains a permit request form for oversized or overweight vehicles to cross federal highway bridges. The two-page form requests information on the applicant, vehicle description including dimensions and weight, route details, and date of movement. Applicants must provide a sketch of the vehicle configuration with axle placement and load distribution. The form will be reviewed and either approved or denied by the agency.

Related to this is a federal contract opportunity posted by the Department of Transportation Federal Highway Administration. It is a solicitation for pavement preservation services in Colorado under the identification number 69056723R000012. No further information is provided on the products, services, response deadline or award date.

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Revised 10/9/2018 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 10/9/2018 Page 2 of 2

VEHICLE TOP VIEW

(w/ dimensions)

VEHICLE SIDE VIEW

(w/ dimensions)

Axle Number TOTAL Axle width (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 .