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Golf Cart Permit Application

  1. Application Type*
  2. Address where golf cart is stored, if different from address above:
  3. Golf Cart Information
  4. Do Not Write Below This Line-Office Use ONLY
  5. Required Inspection Items:
  6. Pass ______/Fail______
  7. Inspected By:_____________________________________________ Date: _____________________
  8. Circle One
  9. Fee: (Personal Check or Exact Cash ONLY)
  10. Initial Inspection $25.00
  11. Re-Inspection $10.00
  12. Received By:_____________________________________________ Date: _____________________
  13. PERMIT NO. ___________________________________EXPIRATION DATE_________________________
  14. Leave This Blank:

  15. This field is not part of the form submission.