HomeMy WebLinkAbout10/17/2022 - ApplicationDANIA BEACH
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CIry OF DANIA BEACH
APPLICATION FOR
BEACH PARKING PERMIT
95,1-924-6800 x3,Ol
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NAi'E:
ADDRESS:
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2DR 4DR VAN MC}( suv TRK ( sw
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<w ELECTRIc PHONE CABLE VOrER's REGISTRATIoN
For Office Use OnlYi
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PERI'IT
VIN #:
PROOF OF RESIDENCY/OWNERSHIP: PLEASE SHOWTo CASHTERWTH AUTOMoBILE REGISTRATION oNE oF THE FOLLOWNG:
CURRENT UTILITY BILL SHOWING DANIA BEACH AODRESS
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VEHICLE INFORMATION (No campe6 permitted)
LICENSE PLATE *:
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STATE TAG ISSUED BY:
ROPERTY OWNE
JEA II.
LIVE IT.€,q For paperless
ebillin& ch.nge of
aoor€s'or
automatic
bankdr.ft, s€€
backofcoupon.
LOVE IT.
CIW OF DANIA BEACH
1OO W DANIA BEACH BOULEVARD
DANIA BEACH, FL 33004
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871 1 AV 0.455
TRACEY KURILLA
1029 SE 6TH CT
DANIA BEACH FL 33004-5407
Please do not send cash throughthe mailordrop box. We are not
responsible for lostcash. Make checks gavable to:
ATTN: City of Dania Beach Lockbox # 919789
P. O. Box 919789
Orlando, FL 92891-0001
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FLORIDA VEHICLE REGISTRATION
co/AGY l0 / l1
lf ldnlght Sun 21111m24
T# 1575693479Br 5353032
PLATE HXJY58 DECAL OOI3OO38
YRA,{K 2014'[AZD BODY UTVIN JX3KE2CY2E039/878
PlateTyp€ RGS NETWT 3375
DUFETD K5408t8595510
Date lssucd 12n1,2O21 Platc Issucd 2r3r20l?
TRACEY RAE KURILLA
1029 SE 6TH COURI
DANIA BEACH, FL 33004.5403
6q
LOVE IT.
Expires
COLOR
TITLE
BLU
113552710
Reg TEr
Iril. Rcg.
Conoty F€e
Mail Fe€
S.lcs Thx
rr'ohotry Fceg
Grmd Total
66.20 Class Code
Trx MordN
6.00 Back Tax Mos
0.75 Crcdit Class
CYedir Mooths
72.95
Iu
0
0
L
IMPORTANT INFORMAIION
ThE Flodda liccose platr must rcdrin with the rrgisfalt upo! sale ofvehicle.
The lrgistratioo Eust bc dcliv.rcd to a Tax Collcotor or T8g Aged for tratrrfcr to
a replacemeDt v€hiclc.
Yout registsation Eust bc updalcd to your ncw address witbi! 30 days ofdoving.
Registratiotr rcrcwals ar€ thc rcspoNibility ofthe rEgisbanl aDd shsll occur dring
thc 30-dry p6iod prior to thc c4riration dat! sho*'a oa this regisfation. Rcnewal
uotices are prcvid€d 8s a courtagy and arc lot t€quied for rcncwal l'urpos.s.
I udersted thst my driver licctrse snd rEgfutratiotrs will be suspcnd.d
iDmediately ifthc insurcr dcnics ftc insEalc! ilforEatiotr subditted
for this recistsation.
5.
RGS . SUNSHII{E STATE
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SEA IT.
LIVE IT.
CITY OF DANIA BEACH
1OO W DANIA BEACH BOULEVARD
Forpaperless
ebillln& change of
aoor65, or
automatra
bankdraft, see
back of coupon.
2
so.0o
s85.37 DUE By 09/2912022
s85.37