APPLICATION FOR PERMISSION TO TRUCK/HAUL

OVER TOWN OF HANCOCK POSTED ROAD(S)

 

Permission is granted from the Town of Hancock, Highway Department to the below named entity or individual to utilize the road stated herein for the transportation of goods in excess of 12,000 pounds, gross vehicle weight, during the following listed times and dates. This permit is: only valid if the temperatures are BELOW 29¡ (as measured at the Hancock Highway Department) and have been for at least 4 hours. Any violation of the permit requirements will result in an immediate suspension of the waiver and will require a restoration bond to re-issue the waiver. The Town of Hancock reserves the right to request a restoration bond before approving any waiver. Current temperatures for Hancock can be found at http://www.hancocknh.org/weather/Current_Vantage_Pro.htm

 

Additional Conditions:

 

ROADS: _____________________________________________

 

 

VALID DATES: _____________________________________________

 

VALID TIMES: ______________________________________________

 

COMPANY/BUSINESS ______________________________________

 

ADDRESS: _______________________________________________

 

Phone:  _______________ Cell: ______________________

 

STREET/JOB SITE LOCATION:

                                                                                    

Signature of Applicant:________________________________________

 

 

Permit Authorized by:  ______________________________________