Fillable Overweight Application Form July 2017 (Thames Coromandel District Council New Zealand)

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Overweight Application Form July 2017 (Thames Coromandel District Council New Zealand)

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Combined Forms NZTA 803 and NZTA 804 - Updated July 2017
Page 1 of 5
Notes to applicants
1. The information requested is required to process any permit application. Please refer to page 4 for an explanation of
the terms ‘vehicle’ and ‘unit’ used here.
2. Overweight permits can only be issued to vehicles that comply with Section 5.8 of the Vehicle Dimensions and Mass
Rule 2016. The NZ Transport Agency as a road controlling authority may include conditions in the permit as provided
by the Rule.
3. It is the applicant’s responsibility to operate within the regulatory requirements relating to SRT, Brake Code and
other applicable vehicle ratings.
4. * Denotes a mandatory field (These must be completed fully otherwise the application cannot be processed).
Company Name *
TSL Number*
Contact Person *
TSL Name*
Depot Location *
BESS Co. Number
Postal Address *
Postal Code
Email
Tel No *
Cellphone No.
Fax
Date Permit Required
Comments ( eg Previous related permit number, etc )
Permit Type (tick) * Single Multiple (Enter number of trips = …… ) Continuous Area
Feasibility Study (tick) *
Yes No
Permit from date *
Permit to date *
Route from *
Route to *
Route Description *
Vehicle type*
Units
Reg Numbers
GVM *
No. of axles*
Dimensions ( vehicle+ payload ) ( m )
Unit 1
Total width *
Unit 2
Total height *
Unit 3
Total length *
Unit 4
Width to outside of tyres *
Unit 5
Vehicle Tare Mass *
Unit 6
Payload Weight *
If more than 9 axles required, please refer to Page 5 ‘10+ Axle Data’ sheet
Axle Number
1
2
3
4
5
6
7
8
9
Axle Type *
Axle Set type*
Tyre Size *
Suspension Type *
Track Outer (m) *
Track Inner (m)
Weight (tonnes) *
Spacing from prev (m) *
Unit Information (complete for all units that make up the vehicle)
Load Description *
(must be Indivisible load)
Max Vehicle Speed (km/h) *
Overweight permit application
Select one
Combined Forms NZTA 803 and NZTA 804 - Updated July 2017
Page 2 of 5
Unit Types: Tractor, Trailer, Dolly, Mobile Crane, Tag Axle
Description of Info Unit 1 Unit 2 Unit 3 Unit 4 Unit 5 Unit 6
Unit Type (select from
above) *
Registration Number *
Make *
GCM (kg) (from COL) *
(where applicable)
GVM (kg) (from COL) *
Number of Axles *
Model*
Year
Engine Power (kw)
Pivot Point (m)
Width (m)
Deck Height (m)
Deck Length (m)
Gooseneck Position (m)
Gooseneck Height (m)
* Denotes a mandatory field
It is the permit holders’ responsibility to operate within the regulatory requirements relating to SRT, Brake Code,
GVM/GCM, RUC, Load anchorage point ratings, draw beam / draw bar / 5
th
wheel mount rating, as well as any other
conditions detailed in the permit or legislation. The NZ Transport Agency can revoke permits under Section 5.7 of
the Vehicle Dimensions and Mass Rule 2016 (Rule 41001).
I declare that the particulars contained in this application are true and correct.
Signature of
applicant:
Date:
Combined Forms NZTA 803 and NZTA 804 - Updated July 2017
Page 3 of 5
Notes for applicants
Use one form for each combination of tractor, dolly (if used) and trailer.
Variations produced by clip-on or tag axles or different king-pin positions are also to be shown on separate forms.
Axle Number
Axles are numbered from the front of the vehicle
Axle Type
S for single tyred axle
T for twin tyred axle
SL for single large tyred axle
SM for single mega tyred axle
4 for four tyred oscillating axle
8 for eight tyred oscillating axle
Axle Set Type
Enter the appropriate axle set from the following list:
(IN) Individual, (TS) Twin steer,(T) Tandem, (Tri) Tri-axle, (Q) Quad-axle.
Comments
State if jib or counterweights are removed from a crane, etc. The comments area can
also be used to provide additional helpful information like the previous Permit Number
to be used as a base.
Certificate of Loading
A document issued by a Certificate Of Fitness issuing authority e.g. VTNZ, on which is
stated the maximum permissible loading.
Dolly pivot point
See diagram below
Dolly width
Distance to outside of tyres. If this can be varied, indicate the range of widths
Engine Power
Rated engine power of the tractor unit after allowing for ancillaries (1 BHP = 0.75 kW)
GVM
( Gross Vehicle Mass ) – in the industry the term vehicle is used here but it relates to
the term ‘unit’ as stated above. The GVM is the legal maximum load limit allowed for
that unit ( as stated on the Certificate of Loading ).
GCM
(Gross Combination Mass) means, for a vehicle that is permitted to tow another vehicle,
the maximum permitted combined mass of the towing vehicle and any combination of
attached trailers or vehicles, determined by the vehicle manufacturer and approved by the
NZTA, or determined by the NZTA.
Load Description
Description of indivisible load carried. Note: the items listed in clause 5.8(3) of the rule are
defined as indivisible for the purposes of overweight permits
Payload Weight
The weight that will ( if necessary ) be transported / loaded onto the Vehicle
Suspension Type
A for Air Bag
H for Hydraulic
L for Leaf Spring
B for Walking Beam (may be in combination with leaf spring)
R for Wire Rope
O for Other
D if on Drive Axle
Tractor pivot point
See diagram below
Tractor width
Distance outside to outside of tyres
Trailer deck height
Height of the deck above the ground. If this can be varied, indicate the range of
heights.
Trailer deck length
Distance measured from base of gooseneck – see diagram
Trailer gooseneck
position
Distance from base of gooseneck to centre of leading axle on trailer – see diagram
below.
Trailer gooseneck
height
Distance from deck of trailer to highest point on gooseneck.
Trailer width
As for dolly width
TSL Number
Transport Service Licence Number ( not required for crane companies).
Tyre Size
State "standard" if smaller than 13.00-24 or 14.00-20
State tyre code designation for single specified standard tyres (eg 12.00-20)
State tyre size if equal to or larger than 13.00-24 or 14.00-20.
Vehicle
For permit issuing purposes a ‘Vehicle’ is defined as the complete combination that the
permit will be issued for. Different combinations of units (i.e. vehicle) will require a
different permit.
Vehicle TARE
For vehicle in operating condition ie with full fuel tank and normal running gear. For air
bag axles, the value required is the tare at zero bag pressure.
Unit
For permit issuing purposes a ‘Unit’ is defined as something that can be used singularly
or in conjunction with other Units to make an overall vehicle.
Combined Forms NZTA 803 and NZTA 804 - Updated July 2017
Page 4 of 5
Explanation of terms used
NOTE: The vehicle type shown here is made up of three units as follows.
AXLE
NUMBER
1 2 3 4 5 6 7
UNIT
NUMBER
UNIT 1 UNIT 2 UNIT 3
UNIT
TYPE
TRACTOR DOLLY TRAILER
VEHICLE
TYPE
TRANSPORTER
Combined Forms NZTA 803 and NZTA 804 - Updated August 2013
Page 5 of 5
10+ Axle Data sheet – when more than 9 axles required
Axle Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Axle Type
Axle Set Type
Axle Weight
Axle Spacing (m)
Tyre Size
Additional Information
Suspension Type
Track Outer (m)
Track Inner (m)
Continuing from above if required
Axle Number 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Axle Type
Axle Set Type
Axle Weight
Axle Spacing (m)
Tyre Size
Additional Information
Suspension Type
Track Outer (m)
Track Inner (m)
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Overweight Application Form July 2017 (Thames Coromandel District Council New Zealand)

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Completed 29 July 2020

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