HomeMy WebLinkAbout10/11/2022 - Complete PackageCITY OF DANIA BEACH
APPLICATION FOR
BEACH PARKING PERMIT
s5+92+6800 x3401
Please print legibly, fill in or ci'cle all itemsDANIA BEACH
sEA lT. LIVE lT. LOVE I l.
TODAYS DATE:
NAl''E:
ADDRESS:
65 OR OLDER: YES NO
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VEHICLE INFORMATION (No campers permitted)
LICENSE PLATE#: /
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PRooFoFRES|DENCY/oWNERSH|P:PLEASEsHowToCASHIERWTHAUToMoB|LEREGISTRAT|oNoNEoFTHEFoLLow|NG:
CURRENT UTILITY BILL SHOWING DANIA BEACH ADDRESS
WATER ELECTRIC PHONE CABLE VOTER'S REGISTRATION
CD
PERMIT
PRO P E RTY OWNER: YES NO
For Office tlse OnlY:
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STATE TAG ISSUED BY:
SEA IT
lT.LIVE
LOVE IT.
100 W Danla Beach Boulevard Dania Beach, FL 33004
office HoLlrs: B:00 5:00 Mon-Fri C osed HolLdaYs
Telephone:954-924 6800 oPtion 5 /'
CUSTOM ER NAMF: CIARENCE ROSE
ACCOUNT NU MBER: 54793 001
SERVICE ADDRESST 125 SF 2 CI
B LtING DATE: 09/16/2422
READ DATE: oslo4l2a22 09106120))
SERVLCE DAYS: 33
M ETER #
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CURRENT READ PREV1OUS READ USAGE (X1OOO)
FLORIDA VEHICIE REGISTRATION
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RGS . SUNSHINE STATE
SEA IT.
LIVE IT.
LOVE IT.
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ACCOUNT NUMBER:
CYCLEi
SALANCE FORWARD:
CURRENT CHARGESI
TOTAT AMOUNT DUE:
ENTER AMOUNT PAID:
54793-001
3
s0.00
s111.98 DUE BY 10/06/2022
511198
ClTY OF DANIA BEACH
1OO W DAN!A BEACH BOULEVARD
DANIA BEACH, FL 33004
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314 1AV 0.455
CLARENCE ROSE
1 25 SE 2ND CT
DANIA BEACH FL 33004-3707
Ple.se do not send cash through the mail or d|"op box. We are not
resoonsible for lost cash. Make checks oavable to:
Hlild-Too-sz-cz+o
BANK DBAFT . DO NOT PAY