ANTIETAM SQUARE
PARKING PERMIT APPLICATION

Please complete and sign this application to request visitor parking permit(s).

OWNER INFORMATION

Owner Name:

Antietam Square Address:

Billing Address, if different from above:

Owner's Email:

Owner's Phone:

Is this unit a rental property?
Yes No

OCCUPANT INFORMATION - If your unit is rented, a valid lease is required in order for a parking permit to be issued. Please upload your lease here. 

Upload Tenant's Lease HERE

The Board of Directors passed a resolution requiring the Lot Owner(s) to provide the names and contact information of the tenants, authorized occupants under the lease, authorized agents and vehicle information in accordance with VA Code Ann. § 55-79.87:1 B. Please provide the following information.

Include everyone who lives in the house, including the person completing this form, if applicable, and all children.

Occupant 1 Name: Owner Tenant Resident

Occupant 1 Email:

Occupant 1 Phone: cell work home

Occupant 2 Name: Owner Tenant Resident Child

Occupant 2 Email:

Occupant 2 Phone: cell work home

Occupant 3 Name: Owner Tenant Resident Child

Occupant 4 Name: Owner Tenant Resident Child

Occupant 5 Name: Owner Tenant Resident Child

Occupant 6 Name: Owner Tenant Resident Child

List any additional names in the box at the bottom of this form.

Authorized Agent, if any:

Name:

Telephone:

Email:

Mailing Address:

Vehicle 1 Information:
Make:
 
Model:

Color:   Year:

License Plate Number: License Plate State:

Vehicle 2 Information:

Make: Model:

Color: Year:

License Plate Number: License Plate State:

VISTOR PARKING HANGTAGS ARE $50 EACH. SELECT THE TYPE AND QTY BELOW.

Only two permits max will be issued per unit.  

I am requesting:1 NEW visitor parking hangtag1 NEW resident parking decal1 each NEW visitor hangtag and resident decal1 REPLACEMENT visitor parking hangtag ($50)1 REPLACEMENT resident parking decal ($50)1 each REPLACEMENT visitor hangtag AND resident decal ($100)

PLEASE INITIAL TO CONSENT.

Visitor parking passes are to be used for visitors only.

Residents parking in visitor parking spaces will be towed at the vehicle owner’s expense.

Visitor parking permits are valid for a maximum of 75 hours, after which cars will be towed at the vehicle owner’s expense.

IMPORTANT: *There is a $50.00 processing fee due each time new tenants move into the property. This form and payment of the $50.00 processing fee must be received by the Association before your tenant(s) can get the amenities passes or stickers. All tenants, including children, and authorized occupants must be listed above. To submit your payment, login to your Connect resident portal at https://antietamsquare.connectresident.com/. Once logged in, click 'Make Payment' to access ClickPay. As the charge may not yet appear on your account, select the 'Edit' button next to the balance, then select 'Alternative Amount' to manually enter the charge. 

I am a/an:
Owner Tenant