Parking Permit Application Residents - Rockdale City Council

Parking Permit ApplicationRESIDENT PARKING PERMITSOFFICE USEPer application – first vehicle annual fee $40 (GST exempt) Permit Number ______________Per application – additional vehicle annual fee $60 (GST exempt) Permit Number ______________Holders of Pensioner Concession Card issued by $0.00 Permit Number ______________Centrelink or Gold Card issued by Dept ofVeteran Affairs– this is applied to the 1 st car onlyReplacement permit $20 (GST exempt) Permit Number ______________RESIDENT’S VISITOR PARKING PERMITVisitor parking permit per month – maximum 4 $20 (GST exempt) Permit Number ______________month periodOvernight Guest Parking Permit $10 (GST exempt) Permit Number ______________Applicant and Vehicle DetailsMs/Mr/Mrs/Other (please state) Family Name Given NameNo. Street Suburb PostcodeMailing Address (if different)Email AddressTel 1 (Home/Work/Mobile)Pensioner Concession Card No.Tel 2 (Home/Work/Mobile)First Vehicle Details:RegistrationSecond Vehicle Details:RegistrationRESIDENT’S VISITORVehicle MakeVehicle MakeVehicle ModelVehicle ModelVehicle Details:Vehicle MakeVehicle ModelRegistrationPlease note – Proof of the current vehicle registration papers, and residential status (and the aboveconcession card if applying for the discount rate) must be presented for sighting when you lodgethe parking permit application. Conditions of this parking permit application are shown overleaf.Applicant’s Signature ____________________________________Date _____ / _____ / _____Privacy StatementThe personal information provided on this form (including your name and otherdetails) will be handled in accordance with the Privacy and Personal InformationProtection Act 1998 and may be available to the public under various legislation.Refer also to the Privacy Statement on Council's website.Rockdale City CouncilOffice: 8.30am – 4.30pm (Mon-Fri); 9am – 1pm (Sat)2 Bryant Street / PO Box 21, Rockdale NSW 2216rcc@rockdale.nsw.gov.au www.rockdale.nsw.gov.auTel 02 9562 1666 Fax 02 9562 1777ABN 66 169 730 052Form reference14/89295 @July2014

Page 2 of 2Conditions of Parking Permit1. Residents in a designated area may obtain a permit for a car which exempts the vehicle from time limitsimposed by sign posting bearing the words “Permit Holders Excepted” and the corresponding streets orareas. The permit does not give permit holders any special rights outside of these zones.2. Proof of Residential Status must be submitted with the application to be sighted. Acceptable proof can be:Rates Notices, Electoral Roll, a duly completed residential lease document and the current Roads andMaritime Services’ Driver Licence in the name of the applicant.3. You are responsible to display this parking permit clearly on the bottom left hand side of the frontwindscreen inside the vehicle. If you apply for a replacement permit, you must either returned thedamaged permit or provide evidence that your permit was stolen. The fee of $20 is applied for thereplacement of lost or damaged permit or transfer to the newly qualified vehicle number plate.4. The resident must apply for the visitor parking permit and pay Council’s fees on behalf of the visitor.5. Details of the Concession card issued by Centrelink or Gold Card issued by Dept of Veteran Affairs arerequired. The Holder of these Cards may have only one free parking permit for his/her first vehicle. Theholder is required to pay for his/her second car parking permit at an annual fee of $60.6. Previously, residents with on-site parking spaces were not entitled to receive permits. However, in thisyear’s resident parking permit scheme, a maximum of two (2) permits can be issued per household. Thenumber of permits to be issued for an area should not exceed the number of available on-street parkingspaces in the area.7. The vehicle needs not to be registered in the name of the applicant but proof is required from theregistered owner that the vehicle is normally used by the applicant.8. Heavy vehicles (i.e vehicles with a GVM of 4.5 tonnes or more) and long vehicles (i.e a vehicle that,together with any load or projection, is 7.5 metres long, or longer), buses or tractors are not allowed forthis permit. Residents who own a vehicle with GMV less than 4.5 tonnes, or a boat shorter than 7.5mshall apply for a parking permit to park in this Resident Parking Permit area. A motor cycle is treated thesame as any other motor vehicle. If it is parked in a permit parking area it is required to display a permitto be exempted from the time limit.9. Please be advised that the personal information required on this form may be available for public accessunder various legislation.10. The applicant must pay fees in accordance with Council’s Fees and Charges at the Rockdale CityCouncil’s Customer Service at 2 Bryant Street, Rockdale, NSW 2216. The annual resident parkingpermits will be charged half price if the application is made between 1January 2015 and 30 June 2015.Office Use OnlyVehicle Registration sightedResidency status sightedPension card sightedPermit Issued Yes and Driver Licence Number…………………… Yes YesSigned______________ Date_______/__________/________