Road Use Agreement RequestPolicy: 3219 – Road Use and 2022 Road Use Agreement <form-template> <fields> <field type="header" subtype="h3" label="TRUCKING COMPANY" class="header"></field> <field type="paragraph" subtype="p" label="Trucking Company doing the hauling and name of representative whom called in the move." class="paragraph"></field> <field type="text" subtype="text" required="true" label="Hauler" class="form-control text-input" name="text-1613147455884"></field> <field type="text" subtype="text" required="true" label=" Rep" class="form-control text-input" name="text-1613147471420"></field> <field type="date" required="true" label="Move Date" class="form-control calendar" name="date-1613147497668"></field> <field type="text" subtype="text" required="true" label="Telephone" class="form-control text-input" name="text-1613147515564"></field> <field type="text" subtype="text" label="Fax" class="form-control text-input" name="text-1613147525892"></field> <field type="text" subtype="text" required="true" label="Commodity" class="form-control text-input" name="text-1613147545316"></field> <field type="text" subtype="text" label="Total Loads" class="form-control text-input" name="text-1613147566700"></field> <field type="text" subtype="text" label="Permit Loads" class="form-control text-input" name="text-1613147574148"></field> <field type="text" subtype="text" label="Provincial Permit Number" class="form-control text-input" name="text-1613147599580"></field> <field type="text" subtype="text" label="Origin" class="form-control text-input" name="text-1613147617652"></field> <field type="text" subtype="text" label="Destination" class="form-control text-input" name="text-1613147626124"></field> <field type="textarea" label="Route" class="form-control text-area" name="textarea-1613147648739"></field> <field type="checkbox-group" label="Restrictions on roads" class="checkbox-group" name="checkbox-group-1613147676691"> <option value="option-1" selected="true">YES</option> <option value="option-2">NO</option> </field> <field type="text" subtype="text" label="If &quot;restrictions on road&quot; -YES, then % allowed:" class="form-control text-input" name="text-1613147712636"></field> <field type="checkbox-group" label="On bridges" class="checkbox-group" name="checkbox-group-1613147771604"> <option value="option-1" selected="true">YES</option> <option value="option-2">NO</option> </field> <field type="text" subtype="text" label="If YES, weights allowed:" class="form-control text-input" name="text-1613147821780"></field> <field type="text" subtype="text" label="Axle Type/Wt. (kg)" class="form-control text-input" name="text-1613147839204"></field> <field type="text" subtype="text" label="Gross Wt. (kg)" class="form-control text-input" name="text-1613147855028"></field> <field type="checkbox" label="Yes, the aforementioned Hauling company has been ADVISED OF THE BAN CONDITIONS (when &amp; where bans are in effect)" class="checkbox" name="checkbox-1613147873940"></field> <field type="paragraph" subtype="p" label="APPLICANT INFORMATION: Shall be responsible for cost of road repairs, regravel and any extra maintenance associated with this move. On a Banned Road, map must be attached." class="paragraph"></field> <field type="text" subtype="text" required="true" label="Company Requesting Move" class="form-control text-input" name="text-1613147920580"></field> <field type="text" subtype="text" required="true" label="Contact name" class="form-control text-input" name="text-1613147938156"></field> <field type="text" subtype="text" required="true" label="Telephone" class="form-control text-input" name="text-1613147957876"></field> <field type="text" subtype="email" required="true" label="Email" class="form-control text-input" name="text-1613147979084"></field> <field type="textarea" label="Special Conditions" class="form-control text-area" name="textarea-1613148001460"></field> </fields> </form-template> Submit Submitting...
