FLH Bridge oversized or overload vehicle permit request form Oct 2018.pdf
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- Solicitation number
- 69056724B000012
About this file
This document is a Bridge Oversized/Overweight Permit Load Request Application. It outlines the information required to request a permit for the transportation of oversized or overweight vehicles on Federal Lands Highways (FLH) bridges. The application includes fields for the applicant's name, company, USDOT number, contact information, a description of the load and route, and details about the permit vehicle configuration such as width, height, length, and gross weight. The applicant must provide a top-view and side-view sketch of the vehicle. There is also an axle table to capture details about the number of axles, axle width, weight, and number of tires. The application must be reviewed and either approved or denied by the agency. This appears to be a standard template form rather than related to a specific federal contract opportunity.
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Text version
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 .