Type Full Name :
Sign With Hand
Junkyard
Parking Station
Parking (New Cars Only)
Parking (Used Cars Only)
Parking (New & Used Cars)
Address *
Phone *
$500.00
$300.00
$500.00
$600.00
$600.00
Block
ZIP *
Applicant Information
State *
Last Name *
City *
Last Name *
Amount Due
Application for
Open-Air Parking and
Junk Dealers/Junkyards
State *
Your
Town
Certification
Applicant Signature *
First Name *
First Name *
What is the Purpose of the Application?
123 Main Ave, Your Town, USA 90210
(555) 973-2212
www.yourtown.us
Email *
Permit Fee
Applicant Is *
License is valid from January 1st to December 31st of the SAME YEAR ONLY.
I have carefully read and understand the provisions of Chapter 324, Junk Dealers and Junkyards and Chapter 266.67-266.79, Art. VII, Open-air Parking Stations, and hereby agree, that if granted a permit to adhere strictly to each of its several requirements.
Fees, property taxes and sewer utility of the owner MUST be paid prior to receiving license (Ordinance #4803)
Property Information
Address *
Address *
Lot
ZIP *
City *