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Parking Permit Application

Please complete this form and submit to start your permit application. Permit holders are entitled to have inserted on their Permit, the registration number of two vehicles. Both vehicles must be owned by the applicant or by members of the applicant’s family resident in the same household.  

First Name


Last Name


Address 1st Line






Email Address


Telephone Number


Car Details

Registration Number 1


Registration Number 2


Please note: a maximum of two registrations can be included on any one permit, although only one permit will be issued and this can only be used in one vehicle at any given time.

Car Park Required


Permit Required


Monthly Payment Option

Duration - 3 Months - Initial Payment £80 - Monthly Payment 2 x £60Duration - 6 Months - Initial Payment £80 - Monthly Payment 5 x £54 Duration - 12 Months - Initial Payment £80 - Monthly Payment 11 x £45

How would you like to pay?

  Cheque Credit/Debit Card (Telephone) Standing Order *  

Information on making payments

Standing Order: Should you require to pay by Standing Order please contact the parking office on 01283 508036 to make the initial payment. After we have received the initial payment of £80.00 via cheque or debit/credit card, you are responsible for setting up the standing order with your bank. They will need the following information: 

Our Bank is: The Royal Bank of Scotland, 38-41 Station Street, Burton upon Trent, DE14 1AX Our Bank Sort Code is: 16-14-70 Our Bank Account number is: 10028206 

You must also quote reference number, from the list below, followed by your registration number and surname/business name. 

Car Park Codes: Burton Place - CPSTSEB Coopers Square - CPSTCSS Fleet Street - CPSTSFS Library - CPSTLIB Meadowside Leisure Centre - CPSTSEM The Maltings - CPSTSMA Trinity Road - CPSTSTR Uttoxeter Leisure Centre - CPSTSLC 

Should the Standing Order be stopped at any time during the payment option period without the Council’s prior knowledge, you will be invoiced for the full amount. 

Cheques: Cheques should be made payable to East Staffordshire Borough Council. Your registration number and full name/business name should be written on the back. Then sent along with a cover note to East Staffordshire Borough Council, PO Box 8045, Burton upon Trent, DE14 9JG or taken to our Customer Services Centre in the Market Place, Burton upon Trent or at Uttoxeter Library. 

Debit and Credit Cards: You are able to pay via debit or credit card at our Customer Services Centre in the Market Place, Burton upon Trent or at Uttoxeter Library. Alternatively you can also pay for your permit over the phone by calling 01283 508036. Please note after your permit has been issued, any alterations to your permit will incur a £25.00 admin charge payable in full by debit/credit card or cheque.