HomeMy WebLinkAboutParking Permit Application_Fillable 10.27.16Department of Public Works
County of Hawaii
HAWAII COUNTY FACILITY
BLACK PARKING PERMIT APPLICATION -Aupuni Center/County Building
To be completed by all applicants/users of permit:
. . -
NAME: DATE:
DEPARTMENT/AFFILIATION:
PHONE NUMBER(S)/CONTACT PERSON:· -----~
PRIMARY VEHICLE
MAKE:
MODEL:
YEAR:
LICENSE NO.:
REGISTERED OWNER:
SECONDARY VEHICLE
MAKE:
MODEL:
YEAR:
LICENSE NO.:
REGISTERED OWNER:
Driver's License Expiration Date:
Date Issued: By:
APPROVED BY:
Permit Number
1. Whenever there is a change in vehicle, a new application form must be completed.
· 2. When attending to official county business, permit will be valid only in the designated
parking areas and only in the metered stalls when the designated areas are full.
3. The permit shall be displayed a·nd be clearly visible on the dashbo.ard of the vehicle or on
· the inside of the rear view mirror so that the face of the card can be seen from the outside
of the vehicle.
4. Vehicle operation will be subject to parking fines or have permit revoked if not in compliance
with rules governing use of parking permit.
5. Upon completion of commission term, BLACK permit shall be returned to respect
department/affiliation to be re-issued to new commissioner.
6. Upon completion of daily use, COLORED PERMIT pass shall be returned to Division
Secretary.
7. Department is responsible for submitting new application form for new commissioner and
for monitoring these permits.
Revised 10/27 /16
County of Hawai'i is an Equal Opportunity Provider and Employer.