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2. Applicant Name*
3. Email Address*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number*
12. Fax Number
14. Permit Description
    Farmer's Market Vendor Parking: Pursuant to Brunswick Town Ordinance Sec. 15-71 (15), a vendor who participates in the farmer’s market on the lower Mall may obtain a permit which entitles one (1) vehicle to park on Park Row between Green Street and Fitch Place, in a legal parking space, for so long as the farmer’s market is open. Food Truck Parking: Pursuant to Brunswick Town Ordinance Sec. 15-71 (16), A licensed Mall food vendor may obtain a permit which entitles one (1) vehicle to park on Park Row between Green Street and Fitch Place, in a legal parking space, for so long as the food vendor’s stand is open. The permit shall be for the calendar year and the fee for it is $25.00. The permit must be hung from the rear view mirror when the vehicle is parked in the permitted space.
16. Permit Requested*
    -- Select One --Farmers Market Vendor ParkingFood Truck Parking
18. Certification of Ownership*

    By checking the "I agree" box and typing my name below, I certify that I am a Mall Vendor (either Farmers Market or Food Truck) and that the vehicle on which the permit will be displayed is used to transport my goods and/or products.

    1. I agree.
20. Electronic Signature*
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

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