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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: _ Over the following county roads: For use on or between the following dates: Special conditions: (Must Follow DOT requirements) • Should date change, please notify Klickitat County Public Works, [PHONE REDACTED] • Any damage to county road will be the responsibility of the permit holder. • Must comply with weather restricted conditions. Permit holder agrees to comply with the state vehicle laws governing use of special permits. Permit Holder Contact: _ Email: Telephone: _ Fax: _ Applicant Signiture : Date: Permission granted by: Date: Public Works Director