utp-multi-pms2_FLH Bridge oversized or overload vehicle permit .pdf

PDF 175 KB Posted

Attached to
UT NP MULTI PMS(2), Pavement Preservation Southern Utah & NV NP GRBA PMS(1), Pavement Preservation Great Basin
Solicitation number
69056723R000004
Issued by

About this file

This document contains an application for an oversized or overweight vehicle permit from the Federal Highway Administration. The application requests information on the vehicle configuration including width, height, length and gross weight. It also requires a sketch of the vehicle configuration including top and side views with axle spacing and load details. The applicant must provide contact information, a description of the load and route, and the proposed date of movement. If approved, the permit will include any conditions.

The related federal contract opportunity is for pavement preservation services in southern Utah and Nevada as well as in the Great Basin area. The solicitation was issued by the Department of Transportation Federal Highway Administration for pavement preservation work on multiple price-motivated services contracts.

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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 8/9/2021 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 .