QUEENSLAND POLICE SERVICE Transport Operations (Road Use Management) Act 1995 and Regulation there under APPLICATION FOR WIDE LOAD MOVEMENT COVERSHEET To: Superintendent of Traffic HEAVY VEHICLE ROAD OPERATION PROGRAM OFFICE Level 9, 40 Tank Street, Brisbane QLD 4000 Telephone: 1300 077 020 |
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TMR/NHVR Permit No./s |
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I, |
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On behalf of |
Name of Company |
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Address of Company |
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Telephone No |
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Fax No: |
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Mobile No: |
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Hereby apply for a permit to transport |
, in the following combination: |
Single load: |
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Multiple-loads: |
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Convoy formation: |
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From |
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From Date |
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From Time |
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To Date |
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To Time |
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Via the following roads |
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Length |
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Width |
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Height |
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Total Mass |
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Prime Mover Reg. Nos |
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Work Plan |
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Date |
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Time |
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Driver Details |
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Mobile |
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I Declare That: (i) The route shown on the application has been inspected and found to be safe and suitable for the movement of the above shown vehicle and loading. (ii) The Information And Particulars Set Out Herein, Are True and Correct
Signature of Applicant |
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Date |
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Privacy Collection Statement
The collection of this information is authorised by the Police Service Administration Act 1990 and the Transport Operations (Road Use Management) Act 1995.The information may be used to assist in performing the statutory functions and responsibilities of the Queensland Police Service (QPS). The QPS may disclose some or all of this information to other State and Federal Government agencies as provided for by legislation or in accordance with the Queensland Government’s Privacy Policy.
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Tags: (road use, operations (road, operations, transport, queensland, (road, police, service, management)