Handicap Parking Permit Application

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Handicap Parking Space Application

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Name:(Required)
Address:(Required)
(Please label Attachment "A" or provide an identifying name to the attachment.)
(Please label Attachment "B" or provide an identifying name to the attachment.)
(Please label Attachment "C" or provide an identifying name to the attachment.)
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Accepted file types: jpg, png, pdf, docx, Max. file size: 1,000 MB.

    Penalties: Any individual who submits a false application or violates any provision of Ordinance #366, upon conviction, will be fined $600.00 and costs, or imprisonment of not more than ninety (30) days or both. Each application submitted shall constitute a separate offense.

    I the above signed have read the penalties provision and understand the consequences of falsifying this application request

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    For Official Use Only

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    Initial Filing Fee $25.00 (new permit) (Non-Refundable)
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    Temporary Permit Fee $25.00 (Each Occasion - Non-Refundable)
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    Permanent Fee $100.00 (Annual - Non-Refundable)
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