1

Resident's Name

 *

Resident's Name

2

Resident's Address

 *

Resident's Address

3

Resident's Address 2

Resident's Address 2

4

City

 *

City

5

State

 *

State (Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

6

Zip

 *

Zip

7

Resident's Phone

 *

Resident's Phone ext.

8

Resident's Email

 *

Resident's Email

9

Date permit is being requested to begin & end (NOT to exceed 7 days)

 *

Date permit is being requested to begin & end (NOT to exceed 7 days)

Start Date

End Date

10

Make of vehicle

 *

Make of vehicle

11

Color of vehicle

 *

Color of vehicle

12

Model of vehicle

 *

Model of vehicle

13

Vehicle license tag number

 *

Vehicle license tag number

Submitting this request does NOT guarantee a permit will be issue.  If you do not receive a call and/or an email from Zoning & Code Compliance regarding your permit within 2 business days please call 941-575-3352 or email CodePermits@pgorda.us If you choose to provide information on this form, unless specifically exempted by Florida Statutes, such information is a public record under Florida's Government in the Sunshine Laws and available for public inspection upon demand. Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.

 

 

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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