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Special Weight Single Trip Permit M-233ST - Indiana

Special Weight Single Trip Permit Form. This is a Indiana form and can be used in Motor Carrier Department Of Revenue Statewide .
 Fillable pdf Last Modified 3/4/2008
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FORM M-233ST State Form 944 R4/ 04/06 Indiana Department of Revenue Special Weight Single Trip Permit Fee: $42.50 (1) Name of Transporting Company: (2) Street Address: City: State: Zip: (3) Start Date: (4) Expiration Date and Time: (5) Quarterly Billing Authorization Number: (if applicable) (6) State Plated: (7) Make of Tractor: (8) Serial Number: (last 5 digits of the VIN) (9) License Plate Number: (10) Permit Number: Overall Length: Legal Overall Width: Legal Overall Height: Legal Allowable Weights: Single axle weight must not exceed 18,000 pounds per axle; no axle in any axle combination may exceed 13,000 pounds per axle, with the exception of one tandem group that may weigh 16,000 pounds per axle or a total of 32,000 pounds. The maximum gross weight must not exceed 134,000 pounds; axle spacings may not be less than 3'6" between each axle in an axle combination; axle spacings may not be less than 8 feet between each axle or axle combination; weight per inch width of tire measured between flanges of rim shall not exceed 800 pounds. The provisions on the reverse side of this form are incorporated by reference into this permit and are as fully binding upon the permittee as if they had appeared on the face of this permit. This permit is void or invalid if the provisions are omitted from the reverse side of this form or are not attached. This Permit is Valid Over State Roads: (1) US 41, from 129th Street in Hammond to SR 312, (2) Highway 312, from Highway 41 to State Road 912, (3) Highway 912, from Michigan Avenue in East Chicago to the U.S. 20 interchange, (4) Highway 20, from Clark Road in Gary to Highway 39, (5) Highway 12, from one-fourth (1/4) mile west of the Midwest Steel entrance to Highway 249, (6) Highway 249, from Highway 12 to Highway 20, (7) Highway 12, from one and one-half (1 1/2) miles east of the Bethlehem Steel entrance to Highway 149, (8) Highway 149, from Highway 12 to a point thirty-six hundredths (.36) of a mile south of Highway 20, (9) Highway 39, from Highway 20 to the Michigan state line, (10) Highway 20, from Highway 39 to Highway 2, (11) Highway 2, from Highway 20 to Highway 31, (12) Highway 31, from the Michigan state line to Highway 23, (13) Highway 23, from Highway 31 to Olive Street in South Bend, (14) Highway 35, from South Motts Parkway thirty-four hundredths (.34) of a mile southeast to the point where Highway 35 intersects with the overpass for Highway 20/Highway 212, (15) State Road 249 from U.S. 12 to the point where State Road 249 intersects with Nelson Drive at the Port of Indiana, (16) State Road 912 from the 15th Avenue and 169th Street interchange one and six hundredths (1.06) miles north to the U.S. 20 interchange, (17) U.S. 20 from the State Road 912 interchange three and seventeen hundredths (3.17) miles east to U.S.12, (18) U.S. 6 from the Ohio State line to State Road 9, (19) U.S. 30 from Allen County/Whitley County Line Road (also know as County Road 800 East) to State Road 9, (20) State Road 9 from U.S. 30 to U.S. 6, (21) State Road 39 from Interstate 80 to U.S. 20. No other routes, including detours, are authorized by this permit under any condition. This permit is valid only for transporting commodities under the company name shown above, and if signed by both an authorized company owner or officer, and driver. The driver's signature attests to the fact that the description of the vehicle is accurate and that the provisions on the reverse side of this permit have been read and understood by the driver. Under the penalty of perjury, I have examined this permit, and to the best of my knowledge and belief, it is true, complete and correct. I also understand that all provisions of the Transporting Agreement apply in full force. Driver's Signature Date Company Owner or Responsible Officer Date Driver's Signature Date American LegalNet, Inc. Indiana Department of Revenue Provisions of the M-233ST Special Weight Permit (1) The permitted vehicle must be on a trip utilizing the designated extra heavy duty highways as shown on the permit. (2) This permit does not cover license or other registration requirements. (3) The operator of the permitted vehicle must be at least 18 years of age and hold a valid commercial driver's license. (4) The driver of the permitted vehicle and/or load, or person in direct charge of transporting such object, will have the permit in his possession during the progress of transportation, and will produce said permit, on demand, to any police officer or authorized employee of the State of Indiana. (5) The mover and/or owner of the vehicle and/or load will be held responsible in the event that it is necessary to remove any buildings, railings, or other structures from the highway. In the event that any buildings, railings, or other structures are damaged, the cost of the removal and/or damage will be borne by the permit applicant. (6) Flagmen, in compliance with the provisions of the Indiana Manual on Uniform Traffic Control Devices, will be provided by the transporting company at all locations needing such traffic control. Locations requiring flagmen include, but are not limited to, encroachment into opposing traffic lanes and stops or blockage of traffic at locations where stops are not normally required by existing traffic control devices. (7) The permitted vehicle must not be operated at a speed in excess of 55 miles per hour. (8) The permitted vehicle and/or load must at no time block traffic from the use of the highway, nor will equipment, load or object be loaded or unloaded within the travelway, nor vehicle or object be permitted to be parked either day or night on the shoulder or right-of-way. (9) The permitted vehicle and load are not to be operated during the existence of hazardous weather, road, and traffic conditions, and/or when visibility is less than 500 feet. Oversize loads will not be operated at any time when wind velocity exceeds 25 miles per hour. (10) This permit does not apply to any state roads or bridges that are closed for construction purposes, or to any roads or bridges that are posted for gross load limit and/or any structures, wires, etc., having a restricted height clearance that will not clear said load; or to any county roads or city streets. (11) This permit is issued to the tractor designated by the serial number (last 5 digits of the VIN), may not be used with any other tractor, and the unaltered permit must be kept in the permitted vehicle. Any violation o
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