Richmond Township Ordinance 02-2010                Permit No:
Richmond Township                  
563 Valley Road        Special Hauling Permit        
Mansfield  PA  16933                
570-662-3774    
FAX: 570-662-1284    (if you are faxing the permit in - please fax your PennDOT permit also.)       
Subject to all the conditions, restrictions, and regulations prescribed by Richmond Township in
Ordinance 02-2010        
  
MOTOR CARRIER NAME AND ADDRESS                
              
PERMIT                
Permit Type:         Duration:        
Date Issued:                
Time Issued:                
Total Fee:                
  
SIZE INFORMATION        Length / Width / Height        
  
  
LOAD INFORMATION        Quantity / Load Type        
  
  
WEIGHT INFORMATION        Gross Weight / Legal Weight        
  
  
AXLES                
  
  
ROUTE INFORMATION                
Origin:                
Destination:                
Take shortest route to delivery point on a Richmond Township road.                
  
PERMIT RESTRICTIONS                
Same restrictions as permit M-936P from PennDOT.                
  
AUTHORIZED ROUTES                
NAME OF ROAD        NUMBER OF ROAD        LENGTH OF ROAD
Airport Road                        730                                        1.23
Austin Drive *                       492                                        0.32
Benson Drive                      772                                         0.08
Blacktop Lane                     494                                         0.62
Brooklyn Road **                754                                         1.19
Brueilly Road                       775                                         0.32
Bryant Road                         573                                         1.68
Bullock Road                       678                                         2.42
Burley Ridge Road *          503                                         0.3
Carpenter Road                  543                                         1.68
Cherry Ridge Road *          510                                         0.21
Cooper Road                       499                                         0.31
Crittenden Drive                  774                                         0.23
East Mulberry Hill Road *  732                                         1.42
Erie Avenue *                       488                                         0.05
Firetower Road                   713                                         1.23
Fish Road **                        546                                         0.12
Fourth Street                        505                                         0.11
Hemlock Drive *                  485                                         0.15
Hollow Road                        491                                         1.6
Inscho Lane                         776                                         0.14
Kellytown Road                    571                                        3.34
Kelsey Road                         676                                        0.74
Kingsley Road                      575                                        1.92
Korb Road                             568                                        0.02
Lake Road                             680                                        0.48
Lambs Creek Road * (2000' dirt)  844                            2.17
Mann Creek Heights Road  542                                       0.61
Mann Creek Road                 545                                       2.68
Mitchell Tree Road                711                                       0.17
Moore Road                           710                                        0.92
Mudge Road                          646                                        0.82
Mulberry Hill Road                731                                        1.46
Mulberry Lane *                     490                                        0.26
O’Dell Road                           728                                        1.19
Old Mainesburg Road         507                                         0.32
Orebed Road                        501                                         4.53
Pitts Road                             497                                          1.95
Putnam Road                       565                                          0.15
Rice Road                             496                                          0.48
Richmond Drive *                489                                          0.1
Ritz Road                               521                                         0.3
Schodac Road                      708                                         1.37
Scouten Road                       519                                         0.81
Shaw Road                            541                                         2.9
Skyline Drive                          777                                         0.22
Smith Road                            569                                         1.21
Smoke Rise Road *             509                                         0.42
Spencer Road **                   493                                         3.38
Sportsmens Club Road      712                                         0.62
Spruce Drive *                        487                                         0.15
Sumner Road                         539                                        1.58
Thorn Apple Lane *               486                                         0.09
Valley Road *                          498                                         1.66
Westgate Road                      770                                         1.67
Whittaker Road                      495                                         1.6
Wood Road                            574                                         1.63
* Black Top                
** Bridge                
  
Driver's Signature                
Date                
        
Richmond Township Ordinance 02-2010                Permit No:
Richmond Township                  
563 Valley Road        Notice of Determination of Local Traffic        
Mansfield  PA  16933                
570-662-3774        Subject to all the conditions, restrictions, and regulations prescribed by         
email: richmondtwp@epix.net        Richmond Township in Ordinance 02-2010        
  
Determination Type                
Richmond Township has reviewed the anticipated overweight / oversize hauling request of the
individual or company listed below.  As of this review, Richmond Township has determined the
hauler is taking the only available route to or from the stated destination and will not cause
significant damage to the highway therefore should be considered "Local Traffic" in accordance
with the provisions listed below.                
  
IT IS AGREED:                
This Determination may be terminated at any time by the Township, acting through Richmond
Township or the Enforcement Authority, if it has been determined that fraud or abuse of the "Local
Traffic" privilege exist.  This designation does not authorize the bearer to exceed any maximum
vehicles size or weight limits other than exceeding said posted weight limit.  In order for the "Notice
of Determination of Local Traffic" to be valid, the original of this document shall be carried in the
vehicle while traveling upon the highway specified.                
  
"NO PHOTO COPIES ARE PERMITTED" In the absence of this document the user may be subject
to fines and penalties.  If deterioration occurs due to said heavy hauling, the bearer will be notified
and required to enter into an Excess Maintenance Agreement.                
  
Maximum, Number of Loads:                
A maximum of 2 load(s) per day with a total not to exceed 14 loads(s) per week, regardless of the
number of vehicles utilized beginning at:                
  
Hauler Information:                
Individual/Company:                
Address:                
Vehicle License Number:                
  
Route Designation                
Origin:                                                                          Destination:        
Township: Richmond        County: Tioga        
  
Certifications                
I, the undersigned hereby certify the information supplied is correct to the best of my knowledge and
belief.                
  
User Signature        Title        Date
  
Richmond Township        Title        Date
Oversize/Overweight Permitting
Your name:
Your email address:
Your phone number:
Comments:
Richmond Township is making every effort to have the permits available for you to fill out 24/7.  
Please work with Richmond Township and
FAX your permit to us
as soon as you know you will be moving an
Oversize/Overweight load on our roads.  
Please call/fax/email us any questions you might have.
If you block and copy this permit
form and paste it into WORD, you
can add your information.  When
information is requested about the
vehicle, simply put "See PennDOT
Permit".  Circle the roads you will
be using.
Fax this to me with the copy of your
PennDOT Permit
(fax-570-662-1284).  I will fax it back
to you signed with a Permit #.  Have
your driver sign it and put it with the
PennDOT Permit that he will carry
in his truck.  Our fee is $15 per
complete move.  If you have 6 items
going from Point A to Point B that
equals "One Move".  I hope this
information helps - please call with
any questions you might have.
Phone 570-662-3774