Form M-936slca - Super Load City Approval Application
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2M-936SLCA (1-09)
SUPER LOAD CITY
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Application ID#:
APPROVAL APPLICATION
ATTENTION: CITY OFFICIAL
The motor carrier who provided you with this document has applied to PennDOT to move a “super load” oversize/overweight
vehicle or combination on a non-limited access State Route within your jurisdiction. Super loads are vehicles, combinations
or loads exceeding 201,000 pounds Gross Weight, or 160 feet in Length, or 16 feet in Width.
Motor carriers transporting any oversize/overweight vehicle on a local road need the local authorityʼs permission, but
PennDOT Regulations, Section 179.8(4)(iii)(D), also require super load applicants to receive permission from all cities
through which they propose to travel, even if all roads are State Routes. Although PennDOT staff will thoroughly review the
motor carrierʼs application and proposed State Routes, please determine if there will be any obstacles within your jurisdiction,
such as new or temporary one-way streets, turning restrictions, parking restrictions, special events, holiday decorations or
other situations that either prohibit movement or require special permit conditions, and note these below.
MOTOR CARRIER INFORMATION: (Please Print)
Motor Carrierʼs Name: ______________________________________________________________________________
Address:
________________________________________________________________________________________
City: _____________________________________________
State: __________ Zip Code:
__________________
Contact Person: ____________________________________________
Phone Number: ________________________________
Fax Number: ______________________________________
Email Address: _____________________________________________
Insurance Company: _________________________________ Policy Number: ________________________________
Weight and Maximum Dimensions of Vehicle(s) and Load:
Gross Weight: ______________________ LBS.
Overall Length: __________FT. ________ IN.
Overall Width: __________FT. ________ IN.
Overall Height: __________FT. ________ IN.
Projected number of moves: _______ Anticipated move dates: FROM: _______________ TO:
________________
Affected route(s) in the City: __________________________________________________________________________
CITY INFORMATION: (Please Print)
On behalf of the City of _____________________________________________________, I acknowledge that I have
received notice of the above described super load movement(s) within this jurisdiction. Permission is granted to the
applicant to travel through the City on the above listed routes, once the applicant receives a valid Permit from PennDOT.
Special Conditions: The City
does/
does not want to be notified at least 24-hours before each movement.
J
J
______________________________________________________________________________________________
______________________________________________________________________________________________
City Official Name: ________________________________ Title/Department: ________________________________
Phone Number: ________________________________
Fax Number:
__________________________________
Email Address: ___________________________________________________
City Official Signature: _____________________________________________ Date: ________________________
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