STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
Rule 14-26.00411, F.A.C.
FORM 850-040-02
MAINTENANCE
OVERSIZED / OVERWEIGHT PERMIT APPLICATION FORM
OGC 06/16
Fax(850) 410-5779 Phone (850) 410-5777 or visit www.fdotmaint.com/permitnew for more information or to apply online.
APPLICATION INFORMATION - Please select type of permit needed and quantity. Trip permits require a separate application for each load.
___ TRIP (single load, valid for 10 days, specific route) ___ BLANKET (specific vehicle configuration, valid for 1 year) QUANTITY ________
CONTACT INFORMATION - Please provide information requested below.
PERMITEE NAME: ___________________________________________________ PHONE NUMBER: (_____) ______ - ___________
INVOICE NAME :_____________________________________________________ FAX NUMBER: (_____) ______ - ___________
MAILING ADDRESS: __________________________________________________ EMAIL ADDRESS :__________________________
CITY, STATE, ZIP : ____________________________________________________ Travel Begin Date: ________________________
PAYMENT METHOD - Please select one of the following payment methods.
___ CHECK
___ CASH
___ MONEY ORDER
___ CREDIT CARD
___
ROUTING INFORMATION - To be completed only for a trip permit
FROM (CITY):________________________________________
TO (CITY): __________________________________________
ROUTE : _____________________________________________________________________________________________________
___________________________________________________________________________________
____ RETURN TRIP NEEDED
VEHICLE CONFIGURATION - Select the configuration which applies and describe the load as needed.
Is this a Divisible Load?
___ TRUCK TRACTOR SEMITRAILER HAULING: ___________________________________.
___ Yes ___ No
___ TRUCK TRACTOR WITH 48(+)’ - 53’ SEMITRAILER WITH KINGPIN SETTING > 41’.
___ Yes ___ No
___ TRUCK TRACTOR WITH SEMITRAILER OVER 53’ BUT NOT GREATER THAN 57’6”.
___ Yes ___ No
___ STRAIGHT TRUCK TOWING OR TOWING A TRAILER CARRYING: _________________________________.
___ Yes ___ No
___ STRAIGHT TRUCK HAULING: ___________________________________________________.
___ MOBILE HOME - MAKE: _________________________ SERIAL NUMBER (LAST 4 DIGITS): ____________________.
___ SEALED CONTAINERIZED CARGO UNIT - SEAL NUMBER (LAST 4 DIGITS):________________________.
___ WRECKER TOWING A DISABLED VEHICLE.
___ SELF PROPELLED: ___________________________________________________.
___ INNERBRIDGE
___ NATURAL GAS FUELED VEHICLES
___ AUTOMOBILE TRANSPORTER
___ TURNPIKE TANDEM:
COMPANY ID: ____________________
CERTIFICATION #: ____________________
IDENTITY OF LOAD - Please select type of identity and provide number.
___ TRUCK OR TRAILER TAG #
___ LOAD ID #
___ TRAILER OR TRUCK UNIT #
___ BILL OF LADING #
___ VIN # ON EQUIPMENT
NUMBER: ____________________________________________________________________________________________________
TRUCK DIMENSIONS - Please provide all vehicle dimensions.
OVERALL HEIGHT : _________ ft _________ in
TRAILER LENGTH : _________ ft _________ in
OVERALL WIDTH : _________ ft _________ in
KINGPIN SETTING : _________ ft _________ in
OVERALL LENGTH : _________ ft _________ in
FRONT OVERHANG: _________ ft _________ in
REAR OVERHANG: _________ ft _________ in
TRUCK CONFIGURATION -
AXLE CONFIGURATION -
The following must be completed for overweight vehicles
Complete for Cranes or
or marked as legal when axle/gross weight is legal. Attach additional pages as needed.
loads greater than 199,000 lbs.
AXLE SPACINGS
AXLE WEIGHTS
# OF TIRES PER AXLE
TIRE WIDTH
1 to 2 : _______ft _______ in
Axle 1 : ______________lbs
1. __________
___________ in
2 to 3 : _______ft _______ in
Axle 2 : ______________lbs
2. __________
___________ in
3 to 4 : _______ft _______ in
Axle 3 : ______________lbs
3. __________
___________ in
4 to 5 : _______ft _______ in
Axle 4 : ______________lbs
4. __________
___________ in
5 to 6 : _______ft _______ in
Axle 5 : ______________lbs
5. __________
___________ in
6 to 7 : _______ft _______ in
Axle 6 : ______________lbs
6. __________
___________ in
7 to 8 : _______ft _______ in
Axle 7 : ______________lbs
7. __________
___________ in
8 to 9 : _______ft _______ in
Axle 8 : ______________lbs
8. __________
___________ in
9 to 10 : _______ft _______ in
Axle 9 : ______________lbs
9. __________
___________ in
10 to 11 : _______ft _______ in
Axle 10 : ______________lbs
10. __________
___________ in
11 to 12 : _______ft _______ in
Axle 11 : ______________lbs
11. __________
___________ in
12 to 13 : _______ft _______ in
Axle 12 : ______________lbs
12. __________
___________ in
13 to 14 : _______ft _______ in
Axle 13 : ______________lbs
13. __________
___________ in
14 to 15 : _______ft _______ in
Axle 14 : ______________lbs
14. __________
___________ in
Axle 15 : ______________lbs
15. __________
___________ in
OFFICE USE ONLY - Do not write anything in this space.
TOTAL # OF AXLES:____________________
CLASS:
S
N
E
DIMENSION CODE: _________________
TOTAL OUTERBRIDGE: ______ ft _____ in
1
2
3
4
MIN O.B. REQUIRED: _______________
TOTAL GROSS WEIGHT: _____________lbs
PERMIT FEE: _________________
TECH INITIALS: _____________________
APPLICANT NAME AND DATE:
AXLE CODE: _________________
SPECIAL NOTES: ____________________
____________________________________
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
Rule 14-26.00411, F.A.C.
FORM 850-040-02
MAINTENANCE
OVERSIZED / OVERWEIGHT PERMIT APPLICATION FORM
OGC 06/16
Fax(850) 410-5779 Phone (850) 410-5777 or visit www.fdotmaint.com/permitnew for more information or to apply online.
APPLICATION INFORMATION - Please select type of permit needed and quantity. Trip permits require a separate application for each load.
___ TRIP (single load, valid for 10 days, specific route) ___ BLANKET (specific vehicle configuration, valid for 1 year) QUANTITY ________
CONTACT INFORMATION - Please provide information requested below.
PERMITEE NAME: ___________________________________________________ PHONE NUMBER: (_____) ______ - ___________
INVOICE NAME :_____________________________________________________ FAX NUMBER: (_____) ______ - ___________
MAILING ADDRESS: __________________________________________________ EMAIL ADDRESS :__________________________
CITY, STATE, ZIP : ____________________________________________________ Travel Begin Date: ________________________
PAYMENT METHOD - Please select one of the following payment methods.
___ CHECK
___ CASH
___ MONEY ORDER
___ CREDIT CARD
___
ROUTING INFORMATION - To be completed only for a trip permit
FROM (CITY):________________________________________
TO (CITY): __________________________________________
ROUTE : _____________________________________________________________________________________________________
___________________________________________________________________________________
____ RETURN TRIP NEEDED
VEHICLE CONFIGURATION - Select the configuration which applies and describe the load as needed.
Is this a Divisible Load?
___ TRUCK TRACTOR SEMITRAILER HAULING: ___________________________________.
___ Yes ___ No
___ TRUCK TRACTOR WITH 48(+)’ - 53’ SEMITRAILER WITH KINGPIN SETTING > 41’.
___ Yes ___ No
___ TRUCK TRACTOR WITH SEMITRAILER OVER 53’ BUT NOT GREATER THAN 57’6”.
___ Yes ___ No
___ STRAIGHT TRUCK TOWING OR TOWING A TRAILER CARRYING: _________________________________.
___ Yes ___ No
___ STRAIGHT TRUCK HAULING: ___________________________________________________.
___ MOBILE HOME - MAKE: _________________________ SERIAL NUMBER (LAST 4 DIGITS): ____________________.
___ SEALED CONTAINERIZED CARGO UNIT - SEAL NUMBER (LAST 4 DIGITS):________________________.
___ WRECKER TOWING A DISABLED VEHICLE.
___ SELF PROPELLED: ___________________________________________________.
___ INNERBRIDGE
___ NATURAL GAS FUELED VEHICLES
___ AUTOMOBILE TRANSPORTER
___ TURNPIKE TANDEM:
COMPANY ID: ____________________
CERTIFICATION #: ____________________
IDENTITY OF LOAD - Please select type of identity and provide number.
___ TRUCK OR TRAILER TAG #
___ LOAD ID #
___ TRAILER OR TRUCK UNIT #
___ BILL OF LADING #
___ VIN # ON EQUIPMENT
NUMBER: ____________________________________________________________________________________________________
TRUCK DIMENSIONS - Please provide all vehicle dimensions.
OVERALL HEIGHT : _________ ft _________ in
TRAILER LENGTH : _________ ft _________ in
OVERALL WIDTH : _________ ft _________ in
KINGPIN SETTING : _________ ft _________ in
OVERALL LENGTH : _________ ft _________ in
FRONT OVERHANG: _________ ft _________ in
REAR OVERHANG: _________ ft _________ in
TRUCK CONFIGURATION -
AXLE CONFIGURATION -
The following must be completed for overweight vehicles
Complete for Cranes or
or marked as legal when axle/gross weight is legal. Attach additional pages as needed.
loads greater than 199,000 lbs.
AXLE SPACINGS
AXLE WEIGHTS
# OF TIRES PER AXLE
TIRE WIDTH
1 to 2 : _______ft _______ in
Axle 1 : ______________lbs
1. __________
___________ in
2 to 3 : _______ft _______ in
Axle 2 : ______________lbs
2. __________
___________ in
3 to 4 : _______ft _______ in
Axle 3 : ______________lbs
3. __________
___________ in
4 to 5 : _______ft _______ in
Axle 4 : ______________lbs
4. __________
___________ in
5 to 6 : _______ft _______ in
Axle 5 : ______________lbs
5. __________
___________ in
6 to 7 : _______ft _______ in
Axle 6 : ______________lbs
6. __________
___________ in
7 to 8 : _______ft _______ in
Axle 7 : ______________lbs
7. __________
___________ in
8 to 9 : _______ft _______ in
Axle 8 : ______________lbs
8. __________
___________ in
9 to 10 : _______ft _______ in
Axle 9 : ______________lbs
9. __________
___________ in
10 to 11 : _______ft _______ in
Axle 10 : ______________lbs
10. __________
___________ in
11 to 12 : _______ft _______ in
Axle 11 : ______________lbs
11. __________
___________ in
12 to 13 : _______ft _______ in
Axle 12 : ______________lbs
12. __________
___________ in
13 to 14 : _______ft _______ in
Axle 13 : ______________lbs
13. __________
___________ in
14 to 15 : _______ft _______ in
Axle 14 : ______________lbs
14. __________
___________ in
Axle 15 : ______________lbs
15. __________
___________ in
OFFICE USE ONLY - Do not write anything in this space.
TOTAL # OF AXLES:____________________
CLASS:
S
N
E
DIMENSION CODE: _________________
TOTAL OUTERBRIDGE: ______ ft _____ in
1
2
3
4
MIN O.B. REQUIRED: _______________
TOTAL GROSS WEIGHT: _____________lbs
PERMIT FEE: _________________
TECH INITIALS: _____________________
APPLICANT NAME AND DATE:
AXLE CODE: _________________
SPECIAL NOTES: ____________________
____________________________________
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