DISABLED PERMIT PARKING
REMOVAL APPLICATION
FOR SIGN REMOVAL REGARDING PROHIBITED PARKING^
EXCEPT FOR DISABLED PERMIT NUMBER
,(Please print or type.)
NAME OF DISABLED INDIVIDUAL:
REMOVAL LOCATION OF DISABLED PARKING SPACE REQUESTED:
(Please print or type current sign location address.)
CHICAGO, ILLINOIS (ZIP CODE) (jdh (PHONE NUMBER)_
REASON FOR REMOVAL:
ILLINOIS VEHICLE LICENSE NUMBER:
■ v,":'". -: - v;:;.- , y " ■■. ... ( W or V plates)
ILLINOIS DISABLED PLACARD NUMBER:
( Secretary of State Disabled Placard ) CERTIFICATION: THE ABOVE INFORMATION IS CORRECT TO THE
BEST OF MY KNOWLEDGE:
( Signature of Applicant) FORWARD THIS COMPLETED APPLICATION TO YOUR ALDERMAN. APPLICANT: DO NOT WRITE BELOW THIS LINE ALDEmANTcTSmFICATION
( Ward ) (Date)
AFTER APPROVAL, THIS APPLICATION IS TO BE FORWARDED TO COUNCIL SERVICES, BY THE ALDERMAN, ATTHE TIME THE DISABLED SIGN REMOVAL ORDINANCE IS INTRODUCED