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Proof of Residency Required <br />Vehicle Registration Required <br />Driver's License Required <br />DATE OF ISSUANCE: <br />NAME: <br />ADDRESS: <br />PROPERTY OWNER: <br />TELEPHONE: <br /> TENANT: <br />EMAIL: <br />VEHICLE VEHICLE <br />MODEL <br />VEHICLE <br />MAKE <br />VEHICLE <br />YEAR <br />LICENCE <br />PLATE NO. <br />PERMIT <br />NUMBER <br />NO. 1 <br />NO. 2 <br />NO. 3 <br />NO. 4 <br />Residential Parking Permits are renewed in March every five years (2016, 2021, etc.). It <br />is the resident's responsibility to renew parking permits before the expiration date listed on the <br />permit. If you do not renew or obtain new parking permits, you are liable for any parking tickets <br />that may be issued. If you wish to be notified of pending expiration dates, you must provide a <br />current email address. No reminder letters will be sent out. <br />By signing this Application, you agree to all the terms that apply from the information <br />section of this sheet, the terms of the applicable Municipal Code and the initial application for <br />residential parking in the affected area. <br />VISITOR PERMIT(S) <br />Only two (2) Permits Per Address <br />No. 1 <br /> No. 2 <br />Signature <br />Date of Issuance <br /> Date of Issuance <br />Date <br />RESIDENTIAL PARKING ZONE AND/OR VISITOR PERMIT(S) <br />APPLICATION <br />City of South Bend – Board of Public Works <br />227 W. Jefferson Boulevard, Ste. 1316 <br />South Bend, IN 46601