PONOKA COUNTY - ROAD PERMIT APPLICATION
Requested By:
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First Name
Last Name
COMPANY/PERSON WORKING FOR
TRUCKING/HAULING COMPANY NAME
Phone Number
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Valid Email:
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Effective Date:
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Month
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Day
Year
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Expiry Date:
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Month
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Day
Year
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Permit Type (Select One):
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Over-Weight on a Banned Road
Multiple Loads (3+)
Number of Loads (Approx.)
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Commodity:
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ROUTE SPECIFIED
From Point of Origin at:
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Roads Being Used
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Destination:
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Proposed Weight %
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I HAVE READ AND AGREED TO THE PONOKA COUNTY
GENERAL CONDITIONS
Note: This permit application is not valid until a countersigned confirmation email reply is received by the applicant. This permit application may be cancelled at any time. The applicant is subject to and must strictly adhere to any special conditions issued along with the countersigned confirmation.
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