72-Hour Ordinance Application CONTACT INFORMATION Question Title * First Name: Question Title * Last Name: Question Title * Home Address (house number, street, city, state, zip): Question Title * Email Address: Question Title * Telephone Number: Question Title * Vehicle Plate State: Question Title * Vehicle Plate Number: Question Title * Vehicle Make: Question Title * Vehicle Model: Question Title * All exemptions are granted for a duration of two weeks. If granted, the exemption will expire fourteen calendar days after the start date (counting/including the start date). Please specify the exemption start date. Start Date Date Question Title * Is the vehicle properly registered with the City of Alexandria? Yes No Question Title * Does the vehicle owner reside in a Residential Parking Permit District? Yes No Question Title * Does the vehicle owner have an up-to-date Residential Parking Permit decal? Yes No Question Title * Which Residential Parking Permit District does the vehicle owner reside? Not Applicable 1 2 3 4 5 6 7 8 8A 9 10 11 12 12A 13 14 Question Title * All vehicles granted an exemption remain subject to on-street parking restrictions. This means a vehicle can only park on a restricted block if it has the appropriate residential parking permit decal. Do you acknowledge this statement? Yes No Question Title * All vehicles granted an exemption must park within 1/8 mile of their place of residence. For reference, this is between 1.5 and 2 blocks in Old Town. Vehicles found beyond the 1/8 mile radius that have been granted an exemption are subject to enforcement. Do you acknowledge this statement? Yes No Question Title * Leaving one’s car parked on-street is a decision made purely at the discretion of the vehicle owner. The City is neither responsible nor liable in the event a vehicle is damaged while parked on-street. The City encourages the applicant to consider alternative solutions for vehicle storage rather than leaving the vehicle on-street. Do you acknowledge this statement? Yes No Question Title * The City retains the right to move and store vehicles when necessary due to street maintenance, in cases of emergency, or as otherwise provided by law. Do you acknowledge this statement? Yes No Question Title * Per code, vehicles may be granted a maximum of five exemptions per calendar year. Has your vehicle been approved for less than five exemptions in the current calendar year? Yes No DONE
