560 021 Oversize Overweight Vehicle Single Trip Permit Application
User Manual: 021
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DOT Form 560-021
Revised 07/2015
Oversize/Overweight Vehicle
Single Trip Permit Application
Commercial Vehicle Services
PO Box 47367
7345 Linderson Way SW
Olympia, WA 98504-7367
360-704-6340 / FAX 360-704-6391
Same day service not guaranteed if customer enters oce after 3:00 p.m.
Self-Issued Permits - 24-hours a day/7 days a week
Company Name Contact Name DOT #
Street Address Phone (with Area Code) Permit Start Date
City State Zip Code Fax (with Area Code) Permit End Date
E-Mail Address
Power Unit License Number Transponder Number VIN Number (Complete)
Make Year Base State Unit #
DETAILED LOAD DESCRIPTION Tractor/Trailer (Connected by 5th Wheel)
Truck/Trailer (Connected by Hitch
Single Vehicle
Origin (City) Destination (City)
Power Unit # of Axles Trailing Unit & of Axles Gross Weight Licensed Weight Axle Spacing Report #
Width Height Total Overall Length Load Length or Trailer Length (Whichever is longer) Front O/H Rear O/H
Overweight Only: Axle spacings are required if no axle spacing report number is provided. Give axle spacing measured from center of axle to center of axle
in feet and inches and number of tires per axle.
Tires per axle:
Spacing:
Axle Weights:
Tire Size on Steer Axle Lift Axle?
Yes No
Which Axle? Tire Size? Single
Dual
Self Steering?
Yes No
Routes of Travel (State Highways with mileposts for single trip oversize/overweight required.)
Highways Beginning MP Ending MP Highways Beginning MP Ending MP
County .City Miles
Signature Date