MEMORANDUM FOR TRAFFIC REGULATIONS
OVERRIDE
PROHIBITION AGAINST PARKING (Except for the Handicapped):
Street, etc:
South Hemitage Avenue
Location, etc:
No. 8610
(Permit No. 71058)
Distance or extent:
Hours:
at all times
Days:
no exceptions
WILLIAM S. SHEETS
LONA LANE Alderman, 18th Ward
APPLICATION FOR DISABLED PARKING SIGNS 71058 PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
An application will not be considered complete unless;
• All lines of the application have been completed in full.
• A check or money order lor $70 00 made payable to the City oi 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 lhe 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 of Birth I 2. State Identification Number MO _ OK* - YEA* _ _ / I 2 \Q I*. IV I I I I I I I I I I I * 3. Drivers License Number S'2 |o~4, Applicant Last Name £\Hi\Z\etf[S \ i i i i i i i m i Ml P First Name U>\ l|/ |i |/ |A|A?| | | II
5. Home Address (primary residence) CX STREET NUMBEP I OB- | STREET NAMlj » II CODE C>\l\/\o\ r...
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