APPLICATION FOR DOCTORS’ PARKING PERMITS

Name: Name of Practice: Vehicle Licence Number: Location of Practice in Hamilton: (Building Name, Street Name/Number, Postal Code) Mailing Address: Tel. Fax: Email: Requirement

• Submit application with a cover letter detailing valid justification for the bay request

Signed: Print Name: Date of Application: FOR CORPORATION USE ONLY Permit Issued:____________________________________________________________________ Date Permit # Valid From: To: Paid: Amount Receipt # Issued by: _________________________________________________________________

Permit No.