INCORPORATED VILLAGE OF LINDENHURST APPLICATION FOR A 2011 NON-RESIDENT COMMUTER PARKING PERMIT

Name                                                                                                    

Address                                                                                                

Phone Number (Daytime)                                                   

Vehicle Make             Year      License Plate #                         Model                   Color           State        

Name and address vehicle is registered in:

                                            

                                                

                                                

PLEASE NOTE:    No more than one application may be submitted for any one person or vehicle.  Successful applications may not be transferred to any other person or vehicle.

This application must be received at the Village Hall, 430 South Wellwood Avenue, Lindenhurst, NY, 11757 by 11:00 a.m. on December 3, 2010.  (Please return full sheet.)  The Village will conduct a public lottery-style drawing of applications submitted to determine allocation of non-resident parking permits and the order of the waiting list.  The drawing will be held at 1:00 p.m. on December 3, 2010 at the Village Hall. Persons applying after the drawing will be placed on the waiting list in the order in which the applications are received.  Applicants need not be present at the drawing.  The fee for 2011 is $155.00. 

DO NOT ENCLOSE PAYMENT WITH THIS APPLICATION.

For more information, call the office of the Village Administrator Clerk-Treasurer Shawn Cullinane at 957-7500.

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