City of Sumner Restricted Parking Zone Permit Application Community Development 1104 Maple Street, Suite 250 Sumner, WA 98390 Tel. (253)299-5530 Fax: (253)299-5539 www.ci.sumner.wa.us Please return this completed form with appropriate documentation in one of the following ways: • • • In person at the Permit Center in Sumner City Hall In the black utility mailbox in front of City Hall By mail to Permit Center, City of Sumner, 1104 Maple St, Sumner, WA 98390 Zone Number: RPZ - Date: Name: Address: Telephone: Please complete the following information for each vehicle for which a Restricted Parking Zone Permit is being requested. For each vehicle listed, the following information must be submitted: Current proof of residency showing your name and address, such as a driver’s license, bill, rental agreement, etc. Photocopy of current Washington State vehicle registration. Out-of-state registrations accepted only for active military personnel or non-resident college or trade school students showing proof of status. Permit No. Permit No. Make: Make: Model: Model: Color: Color: License Plate Number: License Plate Number: Expiration Date: Expiration Date: Permit No. Permit No. Make: Model: Color: License Plate Number: Expiration Date: Make: Model: Color: License Plate Number: Expiration Date: Yes, I would like a guest permit. No, I do not need a guest permit at this time. ONE guest permit per household. (Note: This application must be signed on the reverse side to be valid.) UNDERSTANDING/OBLIGATIONS I understand that a vehicle with a valid, properly affixed Restricted Parking Zoned (RPZ) permit will be exempt from RPZ prohibitions in my RPZ zone ONLY, and does not exempt the vehicle from any other parking restrictions or controls. I understand that the permit is only valid if affixed to the lower left-hand (driver’s side) front windshield of the vehicle for which the permit was issued. THIS PERMIT MAY NOT BE TRANSFERRED TO ANOTHER VEHICLE. In the event that a permit is lost or stolen, or the vehicle is sold or transferred to another owner, I will report this information to the City of Sumner at 253-299-5530 within three business days. I understand there will be a $25 charge for replacement permits, unless the old permit is returned to the City of Sumner Permit Center. I understand that guest permits may only be used by hanging them from the interior rear view mirror of vehicles of persons actually visiting a resident household. I understand that RPZ permits and guest permits expire on the date shown on this form, and that I may re-apply for a replacement permit at that time. I acknowledge I have read and understand this information, and that the information I have provided on this form is accurate and true to the best of my knowledge. Applicant’s signature ______________________________ Date ____________