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Vehicle Info: Power Unit License Number Transponder Number Power Unit VIN Power Unit Make/Model Year Base State Power Unit Equipment Number Trailing Unit License Number Trailing Unit VIN Trailing Unit Make/Model Base State Trailing Unit Equipment Number Overweight Only: Axle spacings are measured from center of axle to center of axle in feet and inches. Each single axle is not to exceed 22,000 pounds; tandem axles are not to exceed 43,000 pounds, or as provided in RCW 46.44.091. Tires per Axle: Spacing: Axle Weights: Applicant Info: Company Name Contact Name Permit # (By Agency) Street Address Phone (with Area Code) Permit Start Date City State Zip Code Email Address Permit End Date Detailed Load Description: Tractor/Trailer (Connect by 5th Wheel) Truck/Trailer (Connected by Hitch) Single Unit Vehicle Origin (Address) Destination (Address) Return Trip? Yes No On County Roads (Include a Map) Miles on County Roads Nighttime Travel? Yes No Power Unit # of Axles Trailing Unit # of Axles Gross Weight (lbs) Licensed Weight (lbs) Width (ft-in) Height (ft-in) Total Overall Length (ft-in) Load Length (ft-in) Trailer Length (ft-in) Front Overhang (ft-in) Rear Overhang (ft-in) Tire Size on Steer Axle Lift Axle? Which Axle? Tire Size? Single Self Steering? Yes No Dual Yes No SPECIAL MOTOR VEHICLE PERMIT PERMIT TO OPERATE OVERSIZE/OVERWEIGHT VEHICLES ON COUNTY ROADS Douglas County, WA Transportation and Land Services 140 19th Street NW, Suite A East Wenatchee, WA 98802

SPECIAL MOTOR VEHICLE PERMIT

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Page 1: SPECIAL MOTOR VEHICLE PERMIT

Vehicle Info:

Power Unit License Number Transponder Number Power Unit VIN

Power Unit Make/Model Year Base State Power Unit Equipment Number

Trailing Unit License Number Trailing Unit VIN

Trailing Unit Make/Model Base State Trailing Unit Equipment Number

Overweight Only: Axle spacings are measured from center of axle to center of axle in feet and inches. Each single axle is not to exceed 22,000 pounds; tandem axles are not to exceed 43,000 pounds, or as provided in RCW 46.44.091.

Tires per Axle:

Spacing:

Axle Weights:

Applicant Info:

Company Name Contact Name Permit # (By Agency)

Street Address Phone (with Area Code) Permit Start Date

City State Zip Code Email Address Permit End Date

Detailed Load Description: Tractor/Trailer (Connect by 5th Wheel)

Truck/Trailer (Connected by Hitch)

Single Unit Vehicle

Origin (Address) Destination (Address) Return Trip?

Yes No

On County Roads (Include a Map) Miles on County Roads Nighttime Travel?

Yes No

Power Unit # of Axles Trailing Unit # of Axles Gross Weight (lbs) Licensed Weight (lbs)

Width (ft-in) Height (ft-in) Total Overall Length (ft-in) Load Length (ft-in) Trailer Length (ft-in) Front Overhang (ft-in) Rear Overhang (ft-in)

Tire Size on Steer Axle Lift Axle? Which Axle? Tire Size? Single Self Steering?

Yes No Dual Yes No

SPECIAL MOTOR VEHICLE PERMITPERMIT TO OPERATE OVERSIZE/OVERWEIGHT VEHICLES ON COUNTY ROADS

Douglas County, WATransportation and Land Services

140 19th Street NW, Suite AEast Wenatchee, WA 98802