City of Annapolis
Residential Parking Permit Application

(Licensing Year: July 1, through June 30)


To print this application, click on your web browser's "Print" button or go to "File" > "Print"

District No. __________

APPLICANT:_______________________________________________________________
                         First                                  Middle                          Last

DRIVER'S LICENSE NO: State:__________ No.:________________________________

DAYTIME PHONE NO: Home: ________________________ Work:__________________

ANNAPOLIS ADDRESS: _____________________________________________________

Do you have off-street parking?    _____Yes     ______No

VEHICLE INFORMATION: (Office Use Only)

Car #

Permit # State Tag # Make Color Fee
1            
2            
3            
4            
Total            

 

I HEREBY CERTIFY UNDER THE PENALTIES OF PERJURY THAT:
a. I am a permanent resident of the above address and I intend to reside at that location for at least 101 days; I am also the authorized user of the above vehicle.
b. The information stated above is true and correct and made for the purpose of obtaining a residential parking permit under the provisions of Chapter 12.32 of the Code of the City of Annapolis.
c. I acknowledge that a residential parking permit does not allow me to park at parking meters or in areas prohibited by sign.

DATE: _______________ SIGNATURE:________________________________________

Office Use Only     _____ off street parking _____ non-resident permit 

 

To print this application, click on your browser's "Print" button or "File">"Print"