"Oversize/Overweight Route Survey Form for the State of Connecticut Highway Operations Oversize/Overweight Permit Unit" - Connecticut

Oversize/Overweight Route Survey Form for the State of Connecticut Highway Operations Oversize/Overweight Permit Unit is a legal document that was released by the Connecticut Department of Transportation - a government authority operating within Connecticut.

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Download "Oversize/Overweight Route Survey Form for the State of Connecticut Highway Operations Oversize/Overweight Permit Unit" - Connecticut

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S T A T E O F C O N N E C T I C U T
DEPARTMENT OF TRANSPORTATION
2800 BERLIN TURNPIKE, P.O. BOX 317546
NEWINGTON, CONNECTICUT 06131-7546
Phone: (860) 594-2880
Fax: (860) 594-2949
OVERSIZE/OVERWEIGHT ROUTE SURVEY FORM FOR THE STATE OF CONNECTICUT
HIGHWAY OPERATIONS
OVERSIZE/OVERWEIGHT PERMIT UNIT
The following routes have been physically surveyed for___________________________
(Permittee Name)
and certified by__________________________on_______________________________
(Person Performing Survey)
(Date Survey Performed)
that there is safe and sufficient clearance to all permanent overhead obstacles and that the gross vehicle
weight as stated does not exceed highway and/or structural weight postings on any routes.
ORIGIN:
DESTINATION:
ROUTES:
LOAD DESCRIPTION:
OVERALL DIMENSIONS:
HEIGHT: ________________
WIDTH: _________________
LENGTH: ________________
GROSS VEHICLE WEIGHT: ______________ AXLES:_____
SURVEY COMPANY NAME AND ADDRESS:
TELEPHONE NO: _______________________FAX NO:_______________________
AUTHORIZED SIGNATURE: _________________________________
An Equal Opportunity Employer
Printed on Recycled or Recovered Paper
S T A T E O F C O N N E C T I C U T
DEPARTMENT OF TRANSPORTATION
2800 BERLIN TURNPIKE, P.O. BOX 317546
NEWINGTON, CONNECTICUT 06131-7546
Phone: (860) 594-2880
Fax: (860) 594-2949
OVERSIZE/OVERWEIGHT ROUTE SURVEY FORM FOR THE STATE OF CONNECTICUT
HIGHWAY OPERATIONS
OVERSIZE/OVERWEIGHT PERMIT UNIT
The following routes have been physically surveyed for___________________________
(Permittee Name)
and certified by__________________________on_______________________________
(Person Performing Survey)
(Date Survey Performed)
that there is safe and sufficient clearance to all permanent overhead obstacles and that the gross vehicle
weight as stated does not exceed highway and/or structural weight postings on any routes.
ORIGIN:
DESTINATION:
ROUTES:
LOAD DESCRIPTION:
OVERALL DIMENSIONS:
HEIGHT: ________________
WIDTH: _________________
LENGTH: ________________
GROSS VEHICLE WEIGHT: ______________ AXLES:_____
SURVEY COMPANY NAME AND ADDRESS:
TELEPHONE NO: _______________________FAX NO:_______________________
AUTHORIZED SIGNATURE: _________________________________
An Equal Opportunity Employer
Printed on Recycled or Recovered Paper