Town of Hickory Creek
1075 Ronald Reagan Ave, Hickory Creek, TX 75065
Office: 940-497-3520 Fax: 940-497-3531 www.hickorycreek-tx.gov
GOLF CART PERMIT APPLICATION
New Renewal
Middle:
State:
Zip:
Date of Application:
Last Name: First:
Address: City:
Address where golf cart is stored. If same as the address above, check here:
Address: City:
State:
Zip:
Home Phone: Cell Phone: Work Phone:
Date of Birth: Drivers License No.
E-Mail Address (Optional):
GOLF CART INFORMATION
Vehicle Identification Number and/or Serial Number:
Year: Make / Model: Color:
Electric or Gas? Identifying Features:
Do Not Write Below This Line Office Use Only
REQUIRED INSPECTION ITEMS:
Headlamps (2 required)
Tail Lamps (2 required)
Side Reflectors (2 front - amber; 2 rear - red)
Proof of Liability Insurance
Parking Brake
Pass /
Fail
Inspected by: Date:
Fee: $25.00
Received By: Date:
PERMIT NO. EXPIRATION DATE:
Exhaust System (gas)
Stop Lamps
Turn Signals (front and rear visible)
Seat Belts - All occupants
Left side and passenger or center mounted mirror
s (view to 200 ft)
Slow Moving Vehicle Emblem
I acknowledge I have received, understand, and will follow all rules and regulations outlined in the Town of Hickory Creek’s Code of Ordinances,
Chapter 12.06, in addition to following all applicable Texas Transportation Code regulations. I also understand the operation of carts is restricted to
the streets and roadways outlined on the map I was provided, and it is unlawful to operate a cart on any other street or roadway under any
circumstances.
Signature:
Date:
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