Fillable Disability-Working-Parking-Permit-form Disabled Working Parking Permit Application Form

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Disability-Working-Parking-Permit-form Disabled Working Parking Permit Application Form

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COMLIA-1301853500-125 November 2018
Disabled working parking permit
Whangarei District Council provides disabled working parking permits for eligible individuals
whose place of employment does not have all day free parking options within the immediate
vicinity.
Please note that in order to apply for a disabled working parking permit, you must hold a
disability parking permit from CCS.
To make your application you will need to provide the following:
• Completed application form
• Letter of support from your employer confirming days of employment, hours of work, and
location of employment (see attached suggested draft letter you will need to have your
employer prepare to support your application)
• Photocopy of disabled parking badge (certified by CCS as current). Please call at the CCS
offices in Kamo Road and they will assist you with this requirement
• Photographic identification (please have the customer services representative at Whangarei
District Council sight and copy your original identification i.e. driver’s licence, and attach
photocopy to your application)
• One passport-sized photograph. Council will hold this on file, but it will not be placed on
the permit issued to you.
Please present the above requirements for processing to our customer services offices at Forum
North.
There is no application fee payable. Applications will be processed within 7-14 working
days.
Please note that you will have ongoing requirements to keep Council advised if your status
changes in a significant way. For example, if:
a You change employers
b Your employer shifts to different premises
c You change your vehicle
d You are no longer entitled to a CCS parking badge.
Conditions of use
• This card entitles the holder to park their vehicle in car parking spaces that are time
restricted and/or spaces for which payment is required, without payment, or being subject
to the time restrictions.
• This permit applies during your stated working hours, and for 1 hour either side of your
stated working hours.
• This permit does not entitle you to park in a designated mobility parking space for longer
than the advertised time for that space.
• The card must be prominently displayed with the crest side (logo side) visible on the
dashboard/windscreen behind the steering wheel.
• Failure to display the card and CCS permit may result in an infringement notice being
issued. Council accepts no liability in this event.
COMLIA-1301853500-125 November 2018 2
Application for disabled working parking permit
Personal details
Family name
First names
Address
Phone
Mobile
Work phone
Email
Licence no
Class
Issue date
Expiry date
CCS Disability parking permit number
Vehicle registration
Work details
Occupation
Name of employer
Address of employment
Employer contact name
Contact phone number
Office use
Date of issue
Expiry date
WDC staff name
WDC staff signature
COMLIA-1301853500-125 November 2018 3
Suggested letter of support
(on Letterhead of employer)
Date
Whangarei District
Council Private Bag 9023
WHANGAREI 0148
Attention Customer Services
Dear Whangarei District Council
Application for disabled working parking permit for (applicant’s name)
We write to confirm our support for the application of the above-
named. We confirm that (applicant’s name) works as a
(occupation).
The days of work are: (days) i.e.
Mondays and Tuesdays only; or
Monday to Friday inclusive
The hours of work are: (insert hours worked) i.e.
All day 8.30am – 5.00pm;
or Monday 8.30am – 3.00pm
Tuesday 8.30am – noon
Location of our business is (physical address)
Yours faithfully
Name
Position
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Disability-Working-Parking-Permit-form Disabled Working Parking Permit Application Form

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Completed 15 May 2020

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