Road Weight Limit Permit
Permit Number
Date
Issued to
By the Town of Navarino, Shawano County, Wisconsin
Narure of Load
Make of Truck
Highway Route
Special Consitions:
Maintenance and Repair Of Described Route:
No Travel on Weekends or Holidays
Travel Between
Other
Permit Good From
One Trip or Recurring Trips ( Circle One )
Issued on Condition that the Permit Holder assumes complete Responsibility for
All Damages Resulting from this Permit.
Issued By:
Title:
Accepted Subject to Conditions Imposed:
Signed
Print Name