MEMORANDUM FOR TRAFFIC REGULATIONS
PROHIBITION AGAINST PARKING (Except for the Handicapped):
North Campbell Avenue
No. 6738 (Permit No. 117243)
Distance or extent:
at all times
DOLORES A. RICCARDO
Alderman, 50th Ward
APPLICATION FOR DISABLED PARKING SIGNS 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 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 lor 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, state issued medical card,
or the following utility bills: Peoples Gas, ComEd, or City of Chicago water bill 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 Finance 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
MC DAY YEAR
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4 Applicant Last Name
3. Drivers License Number
First Name
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5 Home Address (primary residence) *
STREET NUMBER DIR STREET NAME
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7 Address where signs will be posted
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3 Phcr.3 Numbers
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9. Current Permanent Disabled Placard Number
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Relationship to Applicant
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10 Current Licens...
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