City Council Meeting January 13,2010
MEMORANDUM FOR T RAFFIC REGULATION
PROHIBITION AGAINST PARKING (esi:ep< for tbe disable)
NAME APPLICANT:
PRIMARY STREET ADDRESS: LOCATION SIGNS 10 BE POSTED: PERMIT: HOURS:
BETTY F.TABBWALKER
343 W. OLD TOWN COURT 1211 N.SEDGWICK 73«36 ALL
DAYS:
ALL
Walter Burnett Jr, Alderman, 27th ward
APPLICATIDN FOR DIS/.BLED PARKING SIGNS PLEASE HEAD THE FOLLOWING CAREFULLY BEF< )R E COMPLETING THE FORM
73636
An application will not be considered corr 5let> unless.
• All lines of the application have been :orr pleted in full;
• A check or money order for S70.00 rr ade payable to the Please note; The application feu shal be waived for any
• . Disability must be permanent a:; evid >nc< o by a copy of submitted at the time of application;
Proof of residency, in (he form of a c< py < f your drivers Ii::ens2, state identification, or utility bills ai'e.:$ubrnitted.a! the time of applicalion.
Z'ny of Chicago is submitted as payment of the application fee; aerson holding a valid, current disabled veterans plate, /our valid disabled placard and/or current vehicle regislration
Completed application forms may be retu nec to: the ofdc« o facility, or via mail at P.O. Box 8031 DO, C licaijo, IL 60680-31 fee will be billed to you annually. Siould /ou have question:; 744-PARK (7275).
your alderman, any City of Chicago Department of Revenue :>0, PTTN' Disabled Permitting Section. A $25.00 maintenance or cjncerns, please call our permit processing division at 312-
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Date of Birth
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