Transportation Permit Form Transportation Application Form Company Name PERMIT VALID START DATE ADDRESS CITY/STATE/ZIP OFFICE PHONE NUMBER (Incl. Area Code) OFFICE FAX NUMBER (Incl. Area Code) CUSTOMER EMAIL ADDRESS DESCRIPTION OF THE LOAD OR EQUIPMENT AND MODEL NO. HAUL DRIVE TOW DIMENSIONS OF LOAD DESCRIPTION OF HAULING EQUIPMENT VEHICLE WIDTH KINGPIN TO LAST AXLE SEMI-TRAILER LENGTH COMB VEHICLE LENGTH AXLE NUMBER 123456789 NUMBER OF TIRES PER AXLE DISTANCE BETWEEN AXLES WIDTH OF AXLES AT TIRE SIDEWALL Weight Per Axle Requested Route LOADED HEIGHT LOADED WIDTH LOADED OVERALL LENGTH LOADED OVERHANG UNIT # ORIGIN DESTINATION Pilot Car YES NO Submit Request
