"*" indicates required fields Collection Notice The information we are collecting is necessary to deal with or respond to your enquiry or service request. Your personal information has been collected in accordance with the Information Privacy Act 2009 (QLD) and will not be disclosed outside of Australia. We may not be able to deal with or respond to your request if you choose not to provide your name and contact details. Our Queensland Privacy Policy (QPP) Privacy Policy explains how you may request access to and/or correct your personal information. Our policy also explains how you can complain to us if you consider we have breached our obligations to manage your personal information in accordance with the QPP, and how we deal with privacy complaints.Acknowledgement* I have read and accept the collection notice above. Business nameName* First Last Phone*Email* Permit detailTime and date permit required from*Time and date permit required to*Reason for request*Number of parking bays required*Address*Adjacent to parking bays Street Address Address Line 2 Town Adjacent shop or landmark to the parking bay*Adjacent businesses must be notified once approval is granted.Declaration* I understand that this application does not apply to disabled parking bays. I will ensure appropriate barricades/witches hats are placed within the designated parking bays. I will not impede pedestrian movement. You must accept the conditions of the collection notice (top of form) and the above statement/s before you can submit this form.
