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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.