Committee on Pedestrian and Traffic Safety Introduction to Gity Council October 7,2020
MEMORANDUM FOR TRAFFIC REGULATION
Applicant Name: Primary Street Address; Location Sign to be Posted: Permit Number: Hours: Days:
Raul Guzman 1117 W3 Is' St 1117 W 31st St 92795
At all times j NO Exceptions
DISABLED PERMIT PARKING REMOVAL APPLICATION
FOR SIGN REMOVAL REGARDING PROHIBITED PARKING
EXCEPT FOR DISABLED PERMIT NUMBER ^A^t^S
(Please print or type)
NAME OF DISABLED INDIVIDUAL: $OmA. 6Lc£Kcvi
REMOVAL LOCATION OF DISABLED PARKING SPACE REQUESTED:
„., r''i MR.«*J Z\£+ S-l "
" " " ; l (Please print or type current sign location address) V
CHICAGO, ILLINOIS (ZIPCODE) 6obd8 (PHONENUMBER)
":"!:'* " - (W or V plates)
ILLINOIS DISABLED PLACARD NUMBER: - ...
REASON FOR REMOVAL: (p<*£SQo( OoXLL^
ILLINOIS VEHICLE LICENSE NUMBER: : ".■ ■
" (Secretary of State Disabled Placard)
CERTIFICATION: THE ABOVE INFORMATION IS CORRECT TO THE BEST OF
MY KNOWLEDGE: ■ -^J:., . . . ■
* (Signature of Applicant)
FORWARD THIS COMPLETED APPLICATION TO YOUR ALDERMAN.
ALDERMANIC CERTIFICATION:
(Aldermanic Signature)
DO NOT WRITE BELOWlrfrlS LINE
(Ward) (Date)
AFTER APPROVAL, THIS APPLICATION IS TO BE FORWARDED TO COUNCIL SERVICES BY
THE ALDERMAN. AT THE TIME THE DISABLED SIGN REMOVAL ORDINANCE IS
INTRODUCED. ' 5 " " ""'
The City of Chicago - Department of Revenue
P.O. Box 803100
ATTN: Disabled Permitting Section
Chicago, IL. 60680-3100
. Phone: 312.744.PARK. (7275)
■ ":" " " Revised: 4/24/2019