Event Parking Permit Request Form
Instructions: Please complete all sections and ensure the request is signed by the person authorized to
approve the Parking Permit Invoice. Return this form to the Parking Coordinator via email at
bheslop@csum.edu or the Police Department front window. For questions, please contact Cal Maritime
Police Department at (707) 654-1681 or (707) 654-1179.
IMPORTANT: To ensure timely delivery of your permit(s), please submit the Event Parking Permit Request
Form no later than one week in advance.
(If time permits, parking permit(s) will be delivered to the requestor. If not, the requestor will be required to pick up the permit(s) at the
Police Department front window. The Police Department front window hours are: Monday-Friday, 9:00am-5:00pm).
1. Event name, day/date, time (include start time and end time with any allowance necessary to protect
vehicle(s) from being issued a parking citation):
Request Date: ____________ Event Name: ____________________________________________
Event Day / Date: _____________________________________ Time: ______________________
Lot(s): _________________ Comments: ______________________________________________
(Vehicles will normally be assigned to park in Lots B, D and O, Monday-Friday. Lot A is restricted for
employee parking, visitors of the President and Foundation Members only)
2. Cost: # of permits: $Amount:
$3.00 x _____ $ _______ (evening event, after 5pm)
$5.00 x _____ $ _______ (up to 8 hours)
$7.00 x _____ $ _______ (reserved spaces up to 8 hours)
$7.00 x _____ $ _______ (24-hours)
Grand Total: $ ___________
3. Chartfield string:
Account: Fund: Department: Class: (if applicable)
617001 48485 # ___________________ # ______________
4. Person authorized to approve the Parking Permit Invoice:
Print Name: ______________________ Signature: ____________________ Title: ____________
5. Parking Permit Requestor:
Print Name: ______________________ Signature: ____________________ Date: ____________
Please note Lot-O is available for additional overflow parking during daytime hours. Lot-O will also be used for larger campus events
requiring additional parking. Any valid CSUM parking permit will be accepted in Lot-O (excluding Maritime North Student Permits).
Campus parking does not allow for buses, trailers, or motorhomes. Motorcycles must park in motorcycle spaces only. For additional
information regarding Parking, Rules and Regulations and other Police Department Services, please visit our website at:
www.csum.edu/web/police-department/parking-and-transportation
Office Use:
Special Event Permit(s) Color: ______________ Series: # ____________________________ Number or Permits: ______________
Person Receiving Permits: I verify that I am in receipt of the above described permits.
Print Name: ______________________ Signature: ________________________ Date: ____________
