Tow Authorization Form - City Of Perris Department Of Development Services

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C
P
ITY OF
ERRIS
D
D
S
EPARTMENT OF
EVELOPMENT
ERVICES
C
OMMUNITY PRESERVATION DIVISION
135 NORTH ‘D’ STREET, PERRIS, CA 92570-2200
TEL.: (951) 943-1029 FAX: (951) 943-8379
R
A
, B
A
D
ENE
VILA
UILDING
SSISTANT
IRECTOR
TOW AUTHORIZATION FORM
_______________
DATE:
_____________________________________________________
LOCATION OF VEHICLE (S):
___________
___________
___________
_________
LICENSE No.:
MAKE:
MODEL:
COLOR:
__________________________________________________________
OTHER DESCRIPTION:
_______________________________________________________________________________
_______________________________________________________________________________________
REQUEST IS HEREBY MADE FOR THE REMOVAL OF INOPERATIVE/DISMANTLED OR
ABANDONED VEHICLE (S) LOCATED AT THE ABOVE LOCATION.
I, ____________________________ request that the vehicle(s) be removed from my property. In
requesting this removal, I understand and agree that I am relieving the abating agency from all liability,
also that the removal of the vehicle (s) will be made at no cost to me nor will I receive any monetary or
other compensation.
Can the vehicle (s) be towed:
YES ______ NO ______
____________________________________
Property Owners Name (please print)
____________________________________
Property Owner/Representative Signature
____________________________________
Contact Number

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