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228 WEST MAIN STREET, ROOM 19, GOLDENDALE WASHINGTON 98620 • FAX [PHONE REDACTED] • VOICE [PHONE REDACTED] 1 of 1 K L I C K I T A T C O U N T Y P U B L I C W O R K S D E P A R T M E N T Permit Number: PWOS2017- For Use On KLICKITAT COUNTY ROADS OVERWIDTH OVERWEIGHT Permission is herewith granted to: To transport: Width: Weight: Over the following County roads: For use on or between the following dates: Special Conditions: • If applicant is obtaining WS DOT Oversized permit, a copy must be provided in addition to the Axle Report with this permit request. • Should date change, please notify Klickitat County Public Works, [PHONE REDACTED] Permit holder agrees to comply with the State vehicle laws governing use of special permits. • Any damage to County roads will be the responsibility of the permit holder. • Must comply with weather restricted conditions. Permit Holder Contact: Email: Telephone: Fax: Applicant Signiture : Date: Permission granted by: Date: Public Works Director