FEB-01-20" 12:12 From: ALP JOE MOORE ^49^7733385989
To:13127446824 ClTril IOH (MJMIN
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DISABLED PERMIT PARKING REMOVAL APPLICATION
FOR SIGN REMOVAL REGARDING PROHIBITF-D PARKING EXCEPT FOR DISABLJiD PERMIT NUMBER 9- Bl/'f
( Please print W type )
NAME OF DISABLED INDiVIDUAI.:/// C f<.Q> ■''<- /\r\,-\<?> '^ n REMOVAL LOCATION OF DISABLED PARKING SPACE REQUESTED:
_ /Vy^s k>, U r___
( Plr.asc print or type cm teat sign lourtwn ad<li«ss )
CHICAGO, LLUNOIS (£1? CODB)^f ^^ (PHONE NUMBER)___
REASON FOR REMOVAL: A'lfi t-^r eL _____
ILLINOIS VEHICLE LICENSE NUMBER._
( w or V pUtf s)
ILLINOIS DISABLED PLACARD NUMBER:^_________
{ Secretary of Sure Disabled l'bcanl)
CERTIFICATION: THE ABOVE INFORMATION IS CORRECT TO THE
BEST OF MY KNOWLEDGE:___________
( Signature nr Applicant)
FORWARD IHIS COMPLETED APPLICATION TO YOUR ALDERMAN APPIJCANT- DO NOT WRITE BELOW TH Ai .DERM ANIC CERTIFICATION:

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(nate)
ATTEP APPROVAL, THIS APPUCATION IS TO BE FORWARDED TO COUNCIL SERVICES, BY THE ALDERMAN, AT THE TIME THE DTS ABLED SKiN REMOVAL ORDINANCE IS INTRODUCED
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