Incorporated   Village of Floral Park, NY                                                                          OFFICE USE ONLY
                                 APPLICATION FOR CREEDMOOR PARKING FIELD PERMIT                                                                           Parking License #................................................
                            PURSUANT TO CHAPTER 96, ARTICLE XIV OF VILLAGE ORDINANCE                                                            Date of Issue.........................................................
                                                    TRUCK PARKING PERMIT                                                                                              Expires.................................................................
LICENSE FEE - $1,000.00

To the Clerk of the Village of Floral Park: Pursuant to the provisions of Local Law No. 12, 1984, Chapter 96, Article XIV, and Local Law No. 3, 2007, Chapter 96-64, the undersigned, who resides at the address set forth below, and who is the owner of the motor vehicle hereinafter described, hereby makes application for a license to park such motor vehicle in licensed parking areas described in said Ordinance FOR A 24 HOUR PERIOD OR DAYTIME (6:00 A.M. TO 8:00 P.M.):

1. Print Name ..............................................................................................................................................................................................................................

2. Street Address .......................................................................................................................3. Phone #.................................................................................................

4. City ................................................................................................State ................................................. Zip Code...............................................................

5. Make of Vehicle .............................................6. Type of Vehicle ........................................................7. License Plate # ..............................................

8. Length of Vehicle............................................................feet               9. Width of Vehicle ..................................................... feet
I agree that the Incorporated Village of Floral Park shall not be liable for any loss of or damage to the above described motor vehicle or its equipment, occurring while such motor vehicle is parked in any licensed parking area in said Village. Issuance of a permit does not guarantee a parking spot. All permits issued are non-refundable. The parking license tag issued herewith must be securely attached to the rear left bumper of the licensed vehicle.  It is understood that the permit is void if attached to any other vehicle. Proof of car registration to be submitted with application. Enclosed is $ 1,000.00 in payment of the License Fee required under said Ordinance.

............................................................................................................................................................................................... Signature of Owner
--------------------------------------------------------------------------------------------------------------------------------------
                                              Incorporated Village of Floral Park, NY (DUPLICATE)
                                                                CREEDMOOR PARKING FIELD PERMIT  PURSUANT TO CHAPTER 96, ARTICLE XIV OF VILLAGE ORDINANCE
                                        TRUCK PARKING PERMIT    24 hour period or daytime 6:00 a.m. to 8:00 p.m.

Parking License No. ..........................................................Date of Issue ................................................ EXPIRES....................................................................
                                                                                                                 (Do not write in above spaces)  
A License pursuant to Chapter 96, Article XIV of Village Ordinance is hereby granted to:

Print Name ................................................................................................ Address .......................................................................................................................
to park the following described motor vehicle in licensed parking area described in said Ordinance:

1. Make of Vehicle ...............................................................2. Type of Vehicle.................................................................. 3. License Plate #......................................................

4. Length of Vehicle ..............................................feet        5. Width of Vehicle .................................................feet
The Village assumes no responsibility for loss of or damage to the above described motor vehicle or its equipment while the same is parked in a licensed parking area. Issuance of a permit does not guarantee a parking spot. All permits issued are non-refundable. The parking license tag issued herewith must be securely attached to the rear left bumper of the licensed vehicle. It is understood that the permit is void if attached to any other vehicle.

..................................................................................................................... Village Clerk

NOT VALID UNTIL DATED, NUMBERED AND SIGNED BY VILLAGE CLERK, NOT ASSIGNABLE WITHOUT THE APPROVAL OF THE BOARD OF TRUSTEES.
--------------------------------------------------------------------------------------------------------------------------------------
                                              Incorporated Village of Floral Park, NY (DUPLICATE)
                                                            CREEDMOOR PARKING FIELD PERMIT PURSUANT TO CHAPTER 96, ARTICLE XIV OF VILLAGE ORDINANCE
                                                           TRUCK PARKING PERMIT      24 hour period or daytime 6:00 a.m. to 8:00 p.m.

Parking License No. ..........................................................Date of Issue ................................................ EXPIRES....................................................................
                                                                                                   (Do not write in above spaces)
A License pursuant to Chapter 96, Article XIV of Village Ordinance is hereby granted to:

Print Name ................................................................................................ Address ..........................................................................Phone #.............................................
to park the following described motor vehicle in licensed parking area described in said Ordinance:

1. Make of Car ...............................................................2. Type of Car ......................................................................... 3. License Plate #............................................................

4. Length of Vehicle ..............................................feet        5. Width of Vehicle .................................................feet
The Village assumes no responsibility for loss of or damage to the above described motor vehicle or its equipment while the same is parked in a licensed parking area. Issuance of a permit does not guarantee a parking spot. All permits issued are non-refundable. The parking license tag issued herewith must be securely attached to the rear left bumper of the licensed vehicle. It is understood that the permit is void if attached to any other vehicle.

..................................................................................................................... Village Clerk

NOT VALID UNTIL DATED, NUMBERED AND SIGNED BY VILLAGE CLERK, NOT ASSIGNABLE WITHOUT THE APPROVAL OF THE BOARD OF TRUSTEES.