Owen Park Permit

2005

Please provide a copy your motor vehicle registration, complete this application and submit the required $10.00 annual permit fee, payable to The Town of Tisbury

I hereby make application for a permit to park at Owen Park and acknowledge that I understand and accept the regulations governing special parking privileges/permits at Owen Park as follows:  This permit is in effect April 15, 2005 and expires November 15, 2005.  If purchased after April 15^th, the day of purchase is first day of parking ability.  Use of an Owen Park Permit is for use up to a maximum of 24 hours and only when I am using my boat, which has a mooring in Vineyard Haven Inner Harbor. The permit issued must be prominently displayed on the driver’s side toward the rear of the vehicle. This permit shall only be used in the 24 hour parking places at Owen Park and is not valid in any other location. The parking permit will be permanently revoked if it is found the permit is used for any other purpose, or for extended periods.  Tickets will be issued for all parking violations and will not be voided.

Owner of Vehicle :                _______________________________________________________________

Address:                                                _______________________________________________________________

                                                _______________________________________________________________

                                                (As it appears on Motor Vehicle Registration)

Phone:                                    ________________________________________________________________

Reg. #_______________________ State ________ Make ________________________Color ____________ Year ____

The undersigned agrees to abide the above regulations and that the Town of Tisbury will not be liable for any loss or damage to the above mentioned vehicle, its equipment or contents occurring while said vehicle is parked at Owen Park.

                                                                ____________________________________ Date: _______________

                                                                Signature of Applicant

The above individual has a seasonal mooring # __________ or is a Commercial Fisherman, in our harbor and should be issued a 2005 parking permit.

                                                                ____________________________________ Date: _______________

                                                                John M. Wilbur III, Harbormaster

Office Use:

Permit # Assigned __________

$10.00 received     cash or check

Initials of issuer _________