Transcription of APPLICATION FOR MOBILITY-IMPAIRED PARKING PERMIT ND …
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APPLICATION FOR MOBILITY-IMPAIRED PARKING PERMIT ND …
APPLICATION FOR MOBILITY-IMPAIRED PARKING PERMIT North Dakota Department of Transportation, Motor Vehicle SFN 2886 (6-2021)MOTOR VEHICLE DIVISION ND DEPT OF TRANSPORTATION 608 E BOULEVARD AVE BISMARCK ND 58505-0780 Telephone (701) 328-2725 Website: MOBILITY-IMPAIRED License Plates - $5 fee required for EACH vehicle listed below - DO NOT SEND CASHThis option requires ONE current PARKING PERMIT . **Complete ONLY if you are requesting MOBILITY-IMPAIRED license BE COMPLETED BY APPLICANT (please print)Placard Number(s)For Motor Vehicle Use OnlyApplicant's Legal NameMailing AddressCity StateZip CodeTelephone NumberDriver's License NumberPermanent MOBILITY-IMPAIRED PARKING PERMIT ONLY - no fee requiredNumber of permits requested (maximum amount 2)License Plate NumberYear and Make of VehicleLicense Plate NumberYear and Make of VehicleDuplicate Permanent MOBILITY-IMPAIRED Parki
less than 60 millimeters of mercury on room air while at rest and is classified III or IV by standards for cardiac disease set by the American Heart Association. Address of Clinic City State ZIP Code Name of Clinic Telephone Number. I certify that the above applicant is mobility impaired as defined in NDCC 39-01-15. Please check . ONE. of the ...
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