Knoll Road Car Park Permit - Application Form

Knoll Road Car Park Permit - Application Form
1. Please complete all sections of the form. Your application may be delayed if sections are not completed.

2. Payment can be made online. Upon submission of this form you will be re-directed to our payment page on our website to make your payment.

3. You will not receive a physical permit to place in the windscreen of the vehicle. Your vehicle will be granted a virtual permit which provides entry and exit via the Automated Number Plate Recognition system.

4. This is an application for a single user Knoll Road Car Park permit only; however a permit can be applied to more than one vehicle registration. Please note that the permit will only allow free access to one vehicle at any one time. For example, if vehicle A entered the car park and then vehicle B entered before vehicle A had left, when vehicle A came to leave it would be granted free exit whereas vehicle B would be required to pay the standard car park tariff at the paystation before exiting.

5. A parking permit will not be issued until your application & payment have been processed and confirmation sent.

6. Permits are issued on a pro rata basis, valid from 1st April to 31st March the following year

Applicant Details
Company Name (if applicable)
Name*

TitleFirst NameLast Name
Address*

Street Address

Street Address Line 2

TownCounty

Post Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

Declaration

I declare that:
• the vehicle does not exceed 2.0 metres in height.
• the vehicle is a passenger vehicle for up to 8 people (including driver) or a goods vehicle up to 1.5 tonnes unladen weight, or a carriage adapted for the transportation of disabled passenger/s.
• I have read the instructions and guidance notes regarding the issue of parking permits.
• I will use it in accordance with the conditions of use for the Knoll Road Car Park.

I accept that:
• refunds will only be given for unused, remaining complete months left on the permit upon written request to the Council, less £15 admin fee.

I understand that:
• you will use the personal information I have given in line with the Data Protection Act 1998. You will use the information I have given to issue parking permits. I accept that you may pass this information to other council departments and the DVLA, as allowed by law.
• you have to protect the public funds you handle, so you may use the information I have provided on this form to prevent and detect fraud. You may share this information with other bodies who handle public funds for these purposes only.
• if the permit is misused, duplicated or other fraudulent activity identified by Surrey Heath Borough Council then the permit will be withdrawn and penalties may apply.

For further information on Surrey Heath Borough Council's Privacy Policy, please click here
Declaration*

Please tick to confirm you understand and agree to the declaration above
Date*

DayMonthYear
Date
Vehicle Registration/s*
Please see instruction 4 on page 1
Additional Information

Permit Payment Options*

	Number of Permits Required	Total Cost
One off Annual Option - £1035.00
6 Month Option - £560.00
3 Month Option - £300.00
1 Month Option - £105.00

Total Cost
Please confirm Permit Start Date

DayMonthYear
The Council accepts the following debit / credit cards:-

Visa credit / debit card

Mastercard

Electron/SOLO/Maestro Domestic UK

If you wish to pay by Standing Order please email parking.services@surreyheath.gov.uk
Should be Empty:

Knoll Road Car Park Permit - Application Form

Applicant Details