"*" indicates required fields Applicant and Property Owner DataApplicant Name* Applicant Address* Street Address City State ZIP Code Applicant Phone Number* Applicant Fax Applicant Email* Property Owner Name* Property Owner Address* Street Address City State ZIP Code Property Owner Phone Number* Property Owner Fax Property Owner Email* Vehicle InformationLocation of Stored Vehicle* Street Address City State ZIP Code Year of Vehicle* Make of Vehicle* Model of Vehicle* Color of Vehicle* License Plate Number* State of Issuance* Condition of Vehicle*Manner and/or Purpose of Keeping Vehicle (Check Appropriate Boxes)* Stored in Enclosed Building Stored in Public Street Stored in Private Property Stored Covered *If vehicle stored in location other than public street, property owner shall provide written permission authorizing storage of vehicle. Terms of Permit: 1) Any grass and weeds near the vehicle shall be kept trimmed. 2) The area where the vehicle is stored shall be kept free of debris. 3) Vehicle shall be covered with a tarp in good condition when not being worked on. 4) Vehicle storage permit is good for a period of six (6) months.AuthorizationSignature of Applicant* Date* CAPTCHACommentsThis field is for validation purposes and should be left unchanged. Δ
