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Home My WebLink AboutUniversity Permit Application Form.pdf Office Use Only: Badge #: ___________ Method of Payment: _________ R EXBURG POLICE DEPAR T MENT CHIEF SHANE TURMAN 25 EAST MAIN ST, REXBURG Phone 208.359.3008 Fax 208.359.3009 Rexburg City “U” University Permit Application *Print Name: _________________________*Cell Phone Number: ___________________ *Parent’s Residential Mailing Address: _________________________________________ *City: _______________________________________*State: _________ *Zip: _________ *License Plate Number: _____________________________________ *State: __________ *Driver’s License Number: ___________________________________ *State: __________ *Car Make: ___________________________ *CAR Model: _________________________ I agree upon receiving the Rexburg City Permit that I will obey ALL rules and regulations as follows: 1. All of my permit must be visible; forward facing and hanging from rear view mirror in front window to be valid. If not visible I will be responsible for any tickets issued. 2. I understand that I must park only on the designated streets that are assigned to my permit. 3. If my permit is lost or stolen I understand a replacement fee will be charged. 4. My permit is only valid for the semester or the current year when purchased. PAYMENT OF CASH OR CARD ONLY Office Use Only “U” Rexburg City University Parking Permit $30.00-Semester $75.00-Annual Permit Number: ________ / ________ / ________ Signature: _________________________________________ Date: ______________ Office Use Only: Badge #: ___________ Method of Payment: _________ R EXBURG POLICE DEPAR T MENT CHIEF SHANE TURMAN 25 EAST MAIN ST, REXBURG Phone 208.359.3008 Fax 208.359.3009 Rexburg City “U” University Permit Application