PARK & SHOP LOT PARKING PERMIT APPLICATION

MONTH
PARK & SHOP LOT PARKING PERMIT APPLICATION
VALID FOR MONTHLY 2025
MONDAY - FRIDAY (LOT OPENS AT 7AM AND CLOSES AT 9PM)
ONLY FOR USE AT: PARK & SHOP LOT
NOT VALID FOR ANY TWO-HOUR METERS OR TEN-HOUR METERS.
WINTER OVERNIGHT PARKING RULES REMAIN IN EFFECT
By signing below, I understand and I am certifying:

1.I will not use this permit for any vehicle other than the vehicles on this original application.

2. If I dispose of a vehicle and replace it with another, I shall notify Honesdale Borough parking enforcement of all new vehicle information or I may be ticketed. If my vehicle is in the shop and I have a loaner/rental, I may use my original permit if notifying the borough by 10AM, , failure to do so, will result in tickets being valid.

3. There are no designated/reserved parking spaces for anyone.

When making application:

1. Please complete this form in its entirety (front and back)

2.Please have the following vehicle information available: a. Year, make, model, and color
Print Name
Print Address
Cell Phone #
Home
Work
Employer optional
Vehicle 1 Year Make Model Color
Vehicle 1 Plate number
Permit
Vehicle 2 Year Make Model Color
Vehicle 2 Plate number
Permit
Vehicle 3 Year Make Model Color
Vehicle 3 Plate number
Permit
Monthly permits may be renewed each month using this application. Please bring your actual permit placard into the borough office when renewing. Fee per month through December 2025: $50.00 each *No Proration* *Noteworthy: Limited number of Park & Shop spaces are available. Please check if space is
Applicant Signature

Clear
Cash
Check Number
Date

MonthDayYear
Date
Borough Representative Signature

Clear
All forms that require payment will not be processed unless that form and payment is received at the Borough building.
Should be Empty:

PARK & SHOP LOT PARKING PERMIT APPLICATION

VALID FOR MONTHLY 2025

ONLY FOR USE AT: PARK & SHOP LOT

WINTER OVERNIGHT PARKING RULES REMAIN IN EFFECT