DANIA
BEACH
S
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.
CITY
OF
DANIA
BEACH
APPLICATION
FOR
GARAGE
PARKING
PERMIT
Please
print
legibly, fill
in
or
circle all items
TODAY
'S
DATE:
___________________________
---'
NAME:
____________________________________________________________
~
EMPLOYERNAME:
__________________________
~
EM
PLOYER
ADDRESS:
____________________________________________________
---'
CITY
:
___________________________
STATE
:
_______
ZIP
:
______________
__=_
EM
PLOYER
PHON
E N U M
BER:
______________________________________________
-----'-
VEHICLE
INFORMATION: (Passenger Vehicles Only)
LICENSE
PLATE
#:
_______________________
STATE
TAG
ISSUED
:
__________
---'
MAKE:
_______
MODEL
:
_______
.
STYLE:
(2DR)
(4DR)
(VAN) (Me)
(PK)
(SUV)
(TRK)
(SW)
(JP)
(CV)
Circle One
COLOR
:
___________
VIN
#:
__________________
-----!
Permit Cost: $55.00 plus sales tax
PLEASE
PROVIDE
CASHIER
WITH
THE
FOLLOWING
DOCUMENTATION:
•
VALID
DRIVERS
LICENSE
•
VALID
VEHICLE
REGISTRATION
• $55.00
MONTHLY
PAYMENT
(6
months prepay max.)
•
LOST
CARD
FEE
$55.00
(if
applicable)
ACKNOWLEDGEMENT:
I acknowledge
that
I am a business
owner
or
employee
of
a business,
with
an
active
BTR,
that
is
located
within
440 yards
of
the
municipal parking garage. Parking spaces in
the
garage are non-
exclusive and are provided
as
available. Overnight parking in
the
garage is prohibited. Violation
of
these restrictions, providing false
information
on this application
or
violating applicable City
Ordinances shall result in
immediate
termination
of
the
parking
permit,
parking citation
and/or
removal
of
the
vehicle
from
the
municipal parking garage.
Applicants Signature:
________________
--.:
