HomeMy WebLinkAboutDraft Parking Permit Application
CITY OF CAPE CANAVERAL RESIDENT BEACH END PARKING PERMIT
EFFECTIVE PERIOD – TO DECEMBER 31, 2012
Instructions for Parking Permit Applications
Provide all information requested on the form. Have your signature notarized and return to City Hall via mail or in person, 105 Polk Avenue, P. O. Box 326, Cape Canaveral, FL 32920-0326,
Attention: Finance Office.
REQUIREMENTS: In addition to the completed application,
(1) Copy of Florida Driver’s License OR Florida ID
(2) Copy of current vehicle registration
(3) Copy of Utility or FPL Bill showing address
CITY OF CAPE CANAVERAL BEACH END PARKING PERMIT APPLICATION
I HEREBY CERTIFY THAT I RESIDE AT THE ADDRESS SET FORTH BELOW, AND THAT I AM A RESIDENT OF THE CITY OF CAPE CANAVERAL, AND THAT I AM THE OWNER OF THE MOTOR VEHICLE HEREIN AFTER DESCRIBED,
AND THAT I MAKE APPLICATION FOR A BEACH END PARKING PERMIT TO PARK SUCH MOTOR VEHICLE AS DESCRIBED IN ORDINANCE NO. ____________.
I AGREE THAT THE CITY OF CAPE CANAVERAL SHALL NOT BE LIABLE FOR ANY LOSS OF, OR DAMAGE TO THE BELOW DESCRIBED MOTOR VEHICLE OR ITS EQUIPMENT, OCCURRING WHILE SUCH MOTOR VEHICLE IS PARKED
AT ANY BEACH END PARKING METER.
PLEASE TYPE OR PRINT CLEARLY
NAME:_____________________________________________
STREET ADDRESS:__________________________________
POST OFFICE AND ZIP:______________________________
FOR OFFICE USE ONLY:
VEHICLE MAKE & YEAR:____________________________ Check______ Cash______
Date Issued____________
FLORIDA LICENSE PLATE NO:_______________________ Issued By_____________
PERMIT NO.__________
FEE: _______________________
I hereby request that my ad valorem taxes be used to offset the
parking permit fee.
__________________________________________
SIGNATURE OF APPLICANT