* Required

    Annapolis address (residential only) *:  
    City:
    State:
    ZIP code:
    District:

    Is there a driveway, garage or any parking area at this address? 


    Applicant
    First Name *:

    Last Name *:

    Email Address *:

    Confirm Email Address *:


    Driver's License
    State *:   Number *:


    Phone Numbers
    Home:

    Cell:

    Work:


    If you are renting, please enter your lease expiration date:


    Vehicle

    License Plate State *:

    * I hereby certify under the penalties of perjury that :

    1. I am a resident of the above residential address.
    2. The vehicle listed above does not have any unpaid City parking tickets.
    3. I acknowledge that a residential parking permit does not allow parking at parking meters, redlines, loading zones, handicapped spaces, or in areas prohibited by sign or law.
    4. I acknowledge that the residential parking permit expires on the date my lease expires/I move from the district.
    5. I have read this Application and the Parking Permit Information. My application and supporting documents are true and correct. This application is made for the purpose of obtaining a residential parking permit under the provisions of Chapter 12.32 of the Annapolis City Code.

    Today's Date *: