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 oce 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