ATV - Snowmobile - Golf Cart Application

ORDINANCE #177 PERMIT APPLICATION

ATV – Snowmobile – Golf Cart Registration | FEE: $10.00 per vehicle
Date

MonthDayYear
Date
Name*
Address (Include Po Box)*

Street Address

Po Box

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
Type of Vehicle (ATV/UTV/Snow/Golf)
Make of Vehicle
Insurance Company
Year
Policy #
MN License / Current Registration #
By checking this box I understand that this application is not approved until the registration fee is paid in full and The City of Glyndon approves my permit application.*

I understand
Signature*

Clear
Date*

MonthDayYear
Date
FOR OFFICE USE ONLY
Method of Payment

CashCheck # _____________________DebitCredit
City Hall: 36 3rd Street SE | PO Box 223 | Glyndon, MN 56547 | www.glyndonmn.com | 218-498-2578 | Fax: 218-498-2579
Should be Empty:

ORDINANCE #177 PERMIT APPLICATION