i^^^ APPLICATION FOR DISABLED PARKING SIGNS 71057
l|fi PLEASE READ THE FOLLOWING CAREFULLY
^HBr BEFORE COMPLETING THE FORM
An application will not be considered complete unless: « All lines of the application have been completed in lull;
• A check or money order for $70.00 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 60680-3100. 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 312-744-PARK (7275).
1. Date ot Birth 2 Slate Identification Number 3. Drivers License Number MO _ 0»v _ *E4Q _ _ . — - l \-> 1 iAn It; \:\ 1 1 1 1 1 1 1 1 1 1 1 L 15 13 I o-l s-11 5l3lilH/
4. Applicant Last Name Lh Inldiil^.h MINI I I 1 1 Ml First Name V|A|T1i |
5. Home Addres9 (primary STREET NUMBER OIR. mm mi & "residence) STREET NAME II ZIP CODE Ullhh ileJ 1 1 1 1 1 1 1 1 1 1 1 \\Ud\b\S\Z
6. Address where signs w STREET NUMBER I 0IR OI4IM\H 1 Is II be posted 1 '...
Click here for full text