MEMORANDUM FOR TRAFFIC REGULATIONS
PROHIBITION AGAINST PARKING (Except for the Handicapped):
Street, etc:_West Pierce Avenue_
Location, etc:_No. 3314_(Permit No. 77283 )_
Distance or extent:_
Hours:_at all times_
Days:_:_no exceptions_
FLORENTINO GARCIA
ROBERTO MALDONADO Alderman, 26th Ward
Jan 03 2011 2:48PM HP LASERJET FAX
APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
An application will not be considered complete unless: • All Unas of the application have been completed in full;
page 3
7728
• A check or money order for S70.00 made payable to the City of Chicago is submitted as payment of the application fee; Please note: The application fee shall be waived for any person holding a valid, current disabled veterans plate.
• Disability must be permanent as evidenced by a copy of your valid disabled placard and/or current vehicle registration submitted at the time of application;
• Proof of residency, in the form of a copy of your drivers license, state identification, or utility bills are submitted at the time of application.
Completed application forms may be returned to: the office of your alderman, any City of Chicago Department of Revenue facility, or via mail at P.O. Box 803100, Chicago, IL 60880-3100, ATTN: Disabled Permitting Section. A $25.00 maintenance fee will be billed to you annually. Should you have questions or concerns, please call our permit processing division at 312-j_Z44-PARK (727S). _ -"
1. Date erf Birth
MO ___ 0AV
J MO 0AV ___ YEAR
J 4 ISIQ 1 3.1*
2. State Identification Number
11
3. Drivers License Number
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4. Applicant Last Name
Mil
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First Name
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5. Home Address (primary residence)
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STREET NUMBER I ML I STREET N
aainTi Nl ip
1 1 1 1 1 1 1
Izip axe b|PS-|/
6. Address where signs will be posted
STREET NUMBER I OW. I STREET NAME
I I I I I. I I
I I I I I
WARD NUMBER
7. Phone Numbers
Home
Business
8. Current Permanent Disabled Placard Number |
Registered to Flo rCrviiAD €ftfHtet |
Relationship to Applicant |
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9. Current License Plate Number |
Registered to , |
City Sticker No. |
Relationship to Applicant Sel-C |
|
|
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|
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|
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10. Description of Medical Condition and Disability / _
Alternative Parking. Please note your application may be denied if you have alternative accessible off-street parking options.
11. Is there off-street parking available at your primary residence (i.e garage, carport, driveway, etc.)?_ _
3 YES □<rto"
12 . It you answered Ves to question 11, please describe: □ Garage; □Driveway; □Car Port; □Other
13.1s your off-street parking accessible? □ Yes; □ No. Piaase explain:
'44. Affirmation: I hereby a
formation is Irue and correct. If theuity of Chicago Department of Revenue deterni
hereby affirm that the above information is irue and correct. If tne"City of Chicago Department of Revenue'deterrnirtes that the applicant has falsely represented one or more ol the above oondHions. the applicant shall be subject to a fine ol not less than £100 but no more than $500. and the application shall be denied. I also understand thai it is my responsibility to notify the Department of Revenue of any changes In the information provided.
Signature.
Date.
ia(t i>Pia
FOR OFFICE USE ONLY
□ FEE
□ PLACARD/PLATE □ RESIDENCY
□ COMPLETE
Jan 03 2011 2:48PM HP LASERJET FAX
page 4
Page1ol2
Account Number 6321726010
Noma FL OMEN UNO GARCIA
SaivleaLOoaion 3323 W LE MOYNE ST UMT 2.01
CHICAGO Plans Nwfca 77Me8-8B43
Prevtoua i Total PeyiiMWis
26.2016
$1! 1
in
luue Date
NtmmiMf 24. 2010
(jtepeyinentchergMwiBooiMMwintiblltta
Rwl Matar
Mb • Nintw j Tppe L103.J. 2420MO27 |Ganwal Samee
Reatknu
T»" Total KWh
Mater rhudwc
Pravtoua Mao Actual I 5829 Estimate
DJfrawnoo
Service from 11/472010 to 11/23/2010 -10 Days Electricity Supply Service*
Elactrioity Supply Charge 27S~kWh X
TiimnHeion Sanaaaa Cnarga 275kWh X
Purchased Eledricrty Adjustment
Delivery Service* • ComEo)
Custonnsr Charge Standard Metering Charts
OMribuUoii FaciMna Charge 279 kWh X
Taxes and Other Smart Motor Pragnm
Environment* Co* Recovery Aoj 275 WVh X
Energy Efltoiency Program* 27S kWrt x
Franc hMe Coal State Tax Municipal Tax
Total Current Charges
Residential - Mul
ti
0.07653 0.00730
S1
0.02463
-0.00007 0.00156
An E«ton Company
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R«kait oa* IHi poffen nth yow ohack made payafcla k>Co«^ Pta^w^ your aecouilnuT«w oii your olwok
To pay by phona call 1 WO IU 6477. A convenience fie wtfl apply.
23S771 SP 0.440 aa«7joa*77inTiw» 07p o. ojuhof \ im*»ii> FLORENT1 NO GARCIA 3314 W PIERCE *UNIT 2 CHICAGO. IL 60651
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Account Number 6321726010
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CemEd PO Box 6111
Carat Stream; IL 60107-6111
aittountby 12/2O/2O10 $1M
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10 15 S&Bk'
Jan 03 2011 2:48PM
HP LASERJET FAX
page 2
December 29, 2010
To whom it may concern:
We, Aida and Virginio Gonzalez are the owners of property: 3314 .W Pierce Ave, Chicago, IL 60651. We are requesting handicap parking signs and/or poles be installed in front of our building for a tenant who lives in the second floor of our building. Our tenant, Florentino Garcia is handicap and it makes it difficult for him to get from the building to his car and vice versa. The garage is unavailable as it's already occupied with other tenants from our building. Please feel free to contact us with any questions or concerns.
Thank you,
Aida and Virginio Gonzalez 3314 W. Pierce Ave Chicago, IL 60651 773-387-7576