Form M-948 - Assignment Of Permit Or License
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1ASSIGNMENT OF PERMIT OR LICENSE
M-948 (7-14)
❑ Highway Occupancy Permit (attach copy of permit)
❑ Bridge Occupancy License (attach copy of license)
www dot state pa us
SECTION 1 – PRESENT PERMITTEE (i.e., Assigner)
For value received, we hereby assign, transfer and set over unto
_____________________________________________ of ____________________________________________________
(NAME OF NEW OWNER)
(ADDRESS OF NEW OWNER)
all right, title and interest in and to ______________________________________________, dated ____________________
(PERMIT/LICENSE NUMBER)
____________________________________________________________________________________________________
(DESCRIPTION OF WORK)
subject to the approval of the Department of Transportation.
Dated at _______________________________, Pennsylvania, this _______ day of ____________________, 20________.
Attest:
Name of Assigner(s):
________________________________________________
(PRINT OR TYPE)
E-Mail address: ___________________________________
________________________________________________
Signature: _______________________________________
WITNESS SIGNATURE
❑ PRESIDENT ❑ VICE PRESIDENT ❑ OWNER
❑ (VICE) SECRETARY ❑ (VICE) TREASURER ❑ OTHER ____________________
SECTION 2 – NEW PERMITTEE (i.e., Assignee)
The above assignment and transfer of ___________________________________________________ , is hereby accepted,
(PERMIT/LICENSE NUMBER)
subject to the terms and conditions stated therein.
Dated at _______________________________, Pennsylvania, this _______ day of __________________, 20________.
Attest:
Name of Assignee(s):
________________________________________________
(PRINT OR TYPE NAME OF NEW OWNER)
E-Mail address: ___________________________________
________________________________________________
WITNESS SIGNATURE
Signature: _______________________________________
❑ (VICE) SECRETARY ❑ (VICE) TREASURER ❑ OTHER ____________________
❑ PRESIDENT ❑ VICE PRESIDENT ❑ OWNER
NOTE:
• It is recommended that proof of ownership be provided (e.g., a recorded deed to the property).
• A $10.00 fee is required for an assignment made prior to the permit being closed out. This fee is waived for assignments made after
the permit is closed out. If the permit has not been closed out, please include a check or money order in the amount of $10.00 with
your submission.
• If the NEW PERMITTEE wishes to view and maintain the permit via PennDOT’s Electronic Permitting System (EPS) in the future, an
EPS Business Partner ID (BP ID) must be obtained. Go to > More Links… > Highway Occupancy Permits (HOP)
to register and obtain a BP ID, then enter the number here: BP ID No. ________________
SECTION 3 – DISTRICT PERMIT OFFICE – DISTRICT BRIDGE UNIT
Record review of subject permit/license indicates the following Special Conditions (e.g., Agreement, Access Covenant):
____________________________________________________________________________________________________
____________________________________________________________________________________________________
________________________________________________
_________________________________________________
(ORGANIZATION)
(DISTRICT PERMIT MANAGER/BRIDGE ENGINEER)
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