Parking dispensation application form

Please complete all sections before submitting your application.

We have a duty to protect the public funds we administer and may use the information you have provided on this form to prevent and detect fraud. We may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

For more information, go to www.dacorum.gov.uk/dataprotection.

Your details

* Please ensure you include an email address as the parking team will need to send you a confirmation email with details on how to pay

Vehicle details

For example, Renault, Vauxhall etc
For example, Megane, Corsa etc

Dispensation details

If the dispensation is for a skip, please state 'SKIP' as the reason.
Please state the exact road and location - for example, "High Street Green outside house number XX"
For example, 12/09/2016
For example, 13/09/2016
For example, 7.30am
For example, 4.30pm

Type of bays and restriction

Please tick relevant box(es)





Payment

If your application is approved, we will send a confirmation email to you within five to seven days, with details on how to pay.

Declaration

I declare that all the information I have given in this application is correct and understand that a false statement or any breach of the above may result in the withdrawal of the dispensation and render me liable for prosecution.

By submitting this form, you are in agreement with our parking dispensation terms and conditions.

 

Warning signWe will be collecting bins from roads where it is safe to do so. Please leave your bins out for collection. If your bins have not yet been collected, leave them on the boundary of your property and we will collect them as soon as conditions allow. ×