Borough of Merchantville
Overnight Parking Permit Application
Name __________________________________________________________________________________
Address _________________________________________________________________ Apt# ____________
Phone # Home: ________________________ Cell: _______________________
Email: ______________________________
Residence:
Single Family __________ Duplex __________ Apt. Complex __________
Other _________________________________________________________________________
Vehicle:
Year ________________ Make _________________ Model _________________
Body Style ________________ Tag# ________________ Color ________________
Special Conditions:
• If you have a garage, driveway or legal off street parking Space, you may not be eligible for a permit.
• The vehicle must be registered to the above address or you must show proof of residency.
Application Type:
Initial Application / New Resident __________ New Vehicle __________
Renewal __________ Replacement __________
Other _____________________________________________________________________________
By applying for and accepting this permit, I understand permits may be suspended or revoked by the Chief of Police for any
violation of the parking rules. I have read the above statements and attest that all statements herein are true.
Signature: ___________________________________________ Date: _______________________
Official Use Only
Investigated By ________________________ Badge # ________ Approved ________ Denied ________
Reason ___________________________________________________________________________________
__________________________________________________________________________________________Issues Date
_______________ Expiration Date _______________
