Fillable RESTRICTED PARKING ZONE PERMIT APPLICATION (City of Sumner)

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RESTRICTED PARKING ZONE PERMIT APPLICATION (City of Sumner)

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RESTRICTED PARKING ZONE
PERMIT APPLICATION
Shaded Areas for Official Use Only
Zone Number: RPZ-________ Date:
Name:
Address:
Phone: Email:
Please complete the following information for each vehicle for which a Restricted Parking Zone Permit
is being requested. For each vehicle listed, the following information must be submitted, either the
documents themselves if in person, a scan if emailing, or a photocopy if mailing in your application.
Cur
rent proof of residency showing your name and address, such as a recent utility bill (water,
power, cable, etc.) rental agreement, vehicle registration, property tax statement, e
tc.
Permit No.
Permit No.
Make:
Make:
Model:
Model:
Color:
Color:
License Plate Number:
License Plate Number:
Permit No.
Permit No.
Make:
Make:
Model:
Model:
Color:
Color:
License Plate Number:
License Plate Number:
Please read and sign page 2.
This application must be signed on page 2 in order to be valid.
Sumner Police Department 1104 Maple Street, Sumner WA 98390 253-863-6384 Fax: 253-299-5669
policerecords@sumnerwa.gov
Print Form
UNDERSTANDING/OBLIGATIONS
I understand that a vehicle with a valid, properly affixed Restricted Parking Zoned (RPZ) permit
will be exempt from RPZ prohibitions in my RPZ zone ONLY, and does not exempt the vehicle
from any other parking restrictions or violations.
I understand that the permit is only valid if affixed to the lower left-hand (driver’s side) front
windshield of the vehicle for which the permit was issued. This permit may not be
transferred to another vehicle. In the event that a permit is lost or stolen, or the vehicle is
sold or transferred to another owner, I will report this information to the Sumner Police
Department at 253-863-6384 within three business days.
I understand there will be a $25 charge for replacement permits, unless the old permit is
returned to the Sumner Police Department.
I understand that guest permits may only be used by hanging them from the interior rear view
mirror of vehicles of persons actually visiting a resident household.
I understand that there is a limit of four RPZ permits per address.
I acknowledge I have read and understand this information, and that the information I have
provided on this form is accurate and true to the best of my knowledge.
Applicant’s signature: Date:
Yes, I would like a guest permit.
No, I do not need a guest permit.
Limit of one guest permit per household.
To Return Application:
In person: visit the Police desk at City Hall during open hours with your complete application
form, proof of residency and your vehicle(s) registration.
By mail: mail your complete application and copies of your proof of residency and vehicle(s)
registration to City of Sumner, RPZ Passes, 1104 Maple Street, Sumner WA 98390.
By email: send your complete application and scans of your proof of residency and vehicle(s)
registration to policerecords@sumnerwa.gov
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RESTRICTED PARKING ZONE PERMIT APPLICATION (City of Sumner)

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Completed 16 July 2020

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