Transcription of PennDOT Home
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PennDOT Home
M-936A (11-17). OVERSIZE/OVERWEIGHT PREVIOUS. APPLICATION FOR SPECIAL PERMIT NO.: HAULING PERMIT. ''ALL LINES (EXCEPT DASHES) MUST BE COMPLETED" APPLICATION ID: TYPE PERMIT REQUESTED: Single Trip Single Trip & Return Annual Seasonal _____months Emergency Preliminary Superload Final Superload _____ of _____. PERMIT OFFICE_____ NAME_____. REGISTERED NAME (Responsible Motor Carrier). ACCOUNT STREET_____. MOTOR CARRIER/PERMIT SERVICE ADDRESS. FEIN/SSN_____ CITY-STATE-ZIP CODE_____. IF NO MOTOR CARRIER ACCT. NO. 1 = IMMEDIATE PAYMENT. 3 = MONTHLY BILLING. BILL CODE_____ 4 = GOVERNMENTAL CHECK/MO # CHECK/MO #. PERMIT FEE. <. GROSS WEIGHT_____ (lbs.) LEGAL WEIGHT = _____(lbs.) TOTAL LENGTH <. _____(ft.) _____ (in.). <. TOTAL WIDTH _____ (ft.) _____ (in.) =_____(ft.)_____ (in.)
Office of Chief Counsel, 400 North Street, 9th Floor, Harrisburg, Pennsylvania 17120-0096. A filing fee as prescribed under Chapter 491,made payable to the ''Commonwealth of Pennsylvania,'' shall …
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