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The Minnesota Fuel Permit Application form is an essential document for individuals and businesses needing temporary permits for various vehicle operations within the state. This application allows users to request different types of permits, including the 120 Hour Trip Permit, which is available for a fee and can be issued for vehicles up to 80,000 pounds, and the 120 Hour Fuel Trip Permit, which has no limit on the number of permits issued. Additionally, applicants may seek a Temporary Weight Increase, which allows for a specified increase in vehicle weight for a set duration, as well as a Base Plate Permit, which requires registration fees based on the vehicle's weight and model year. The form also collects crucial vehicle information, including the Vehicle Identification Number (VIN), model year, and type of vehicle, ensuring that the appropriate permits are issued for the correct vehicles. To facilitate communication, the application requires contact information for the registered owner and a designated contact person. Furthermore, it includes a data privacy statement that outlines how personal information will be used and protected, emphasizing the importance of confidentiality in the permit issuance process. Understanding these components can help streamline the application experience and ensure compliance with state regulations.

Form Example

MINNESOTA DEPARTMENT OF PUBLIC SAFETY

 

DRIVER AND VEHICLE SERVICES

 

445 Minnesota Street

 

Saint Paul, MN 55101-5188

Office Use Only

Phone: (651) 205-4141 TTY: (651) 282-6555 Fax: (651) 797-1187

Permit Number

Web: dvs.dps.mn.gov

 

Minnesota Temporary Registration / Fuel Permit Application

Section I - Type of Permit Being Requested

Permit(s) requesting:

01/21/2023

All Fields Required, unless

marked **, required if applicable

 

EFFECTIVE DATE

 

 

 

 

 

 

Check the box for for the permit(s) you are requesting.

 

 

 

 

 

 

120

Hour Trip Permit ($15, plus $10 filing fee) - One permit per vehicle every 30 days; issued up to 80,000 lbs.

120

Hour Fuel Trip Permit ($25, no filing fee) - No limit to the number of permits issued.

120 Hour Unladen Weight Hunters Permit ($10 filing fee only) - Effective date is the date of issuance; certain restrictions apply.

Temporary Weight Increase ($4.17 per ton per 30 days, rounded to the nearest whole dollar, plus $10 filing fee)

 

**Select temporary weight increase duration:

30 DAYS

60 DAYS

90 DAYS

 

**Beginning Minnesota Registered Weight:

 

 

 

**Increase to:

 

 

 

 

 

 

 

 

 

NOTE: A temporary weight increase does not replace the requirements for an overweight permit authorized by MnDOT and/or local road authority.

Base Plate Permit (See page 2 for registration fees based on duration, weight & model year of vehicle, plus $10 filing fee)

**Select base plate permit duration:

30 DAYS

60 DAYS

90 DAYS

**Registered weight being requested on permit:

 

 

 

 

 

 

 

 

 

Section II - Vehicle Information

Vehicle Identification Number:

 

 

 

 

 

 

 

 

Model Year:

Make:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Select type of vehicle:

 

Truck tractor

 

Truck

 

Bus

 

**License Plate Number:

Jurisdiction:

 

Gross weight in pounds:

**If applying for Unladen Weight Hunters permit, indicate the most recent Minnesota IRP plate

Number of axles:

 

USDOT Number:

 

(not required to be submitted for fuel or Unladed Weight Hunters permit)

**If no plate number provided, please indicate reason:

**Indicate those that apply:

I am verifying that the vehicle is less than 26,001 pounds while conducting Intrastate travel in Minnesota (verification is required if applying for Trip or Base Plate permit)

Vehicle listed above is not required to provide USDOT number as it is registered in the MN farm class, displays a MN farm plate, only traveling within the state of Minnesota and not doing any Interstate movement as defined by the Federal Motor Carrier Safety Administration.

Section III - Registered Owner and Contact Information

Name (first, middle, last):

Street address:

 

City:

 

State:

 

Zip code:

Contact information required for DVS to contact you with questions or issues regarding processing of the permit.

Contact Name:

 

Contact Phone Number:

Fax Permit to:

 

Fax number must be provided in order to receive credentials

PS2268-07 (12/13)

-OVER-

Minnesota Temporary Registration / Fuel Permit Application - Page 2

Section IV: Data Privacy Statement

DATA PRIVACY STATEMENT:

Information collected to issue this permit is used to:

Identify the owner of the vehicle

Identify the person applying for the permit

Identify the motor vehicle to which the permit is issued

You are not required to submit the information. However, if you do not submit the information the Department of Public Safety cannot issue a vehicle permit. Personal information (name and address of individuals) is classified as private data. The Department of Public Safety releases this information only as authorized or required by state and federal law. Access to motor vehicle records is governed by:

Minnesota Statues, chapter 168.346

United States code title 18, sections 2721-2725 and Minnesota Statues, chapter 13

Section V: Fees

Request by fax must have a properly completed Electronic Funds Authorization form attached along with a copy of a voided check. Please contact Driver and Vehicle Services if you have any questions on payment

Permit Fees are listed on page one with the exception of the Base Plate Permit:

Base plate permit is a $10 filing plus the monthly registration fees listed below.

GVW IN POUNDS

FIRST 8 MODEL YEARS

9th MODEL YEAR

10th MODEL YEAR & OLDER

 

 

 

 

12,000 - 15,000

$10

$10

$10

 

 

 

 

15,001 - 18,000

$12

$12

$12

 

 

 

 

18,001 - 21,000

$16

$15

$12

 

 

 

 

21,001 - 26,000

$23

$22

$17

 

 

 

 

26,001 - 33,000

$30

$29

$23

 

 

 

 

33,001 - 39,000

$40

$38

$30

 

 

 

 

39,001 - 45,000

$50

$48

$37

 

 

 

 

45,001 - 51,000

$60

$57

$45

 

 

 

 

51,001 - 57,000

$72

$69

$54

 

 

 

 

57,001 - 63,000

$85

$81

$64

 

 

 

 

63,001 - 69,000

$99

$95

$74

 

 

 

 

69,001 - 73,280

$110

$106

$83

 

 

 

 

73,281 - 78,000

$133

$127

$100

 

 

 

 

78,001 - 80,000

$147

$141

$110

 

 

 

 

Over 80,000 pounds; +4.17 per ton, per month (rounded to the nearest whole dollar)

PS2268-07 (12/13)

Form Specifications

Fact Name Description
Types of Permits The application allows for various permits, including a 120 Hour Trip Permit, a 120 Hour Fuel Trip Permit, and a Base Plate Permit, each with specific fees and conditions.
Effective Date The effective date for permits like the 120 Hour Unladen Weight Hunters Permit is the date of issuance, while others may have restrictions based on usage.
Data Privacy Information collected is classified as private data and is governed by Minnesota Statutes, chapter 168.346, and United States Code title 18, sections 2721-2725.
Fees Permit fees vary based on the type of permit requested, with additional charges for weight increases and specific filing fees for base plate permits.
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