Memorandum for Traffic Regulation Parking Prohibited Except for Disabled
Location: 11630 South Hale
Permit Number: 77012
Work Order Number:
Days: At all times
Hours: At all times
Other: Override denial
City Council January 13, 2011
City of Chicago Richard M. Daley, Mayor
December 7, 2010
Department of Revenue
Bea Reyna-Hickey Director
City Hall, Room 107A 121 North LaSalle Street Chicago, Illinois 60602-1288 (312) 747-4747 (IRIS) (312) 744-0471 (FAX) (312) 744-2975 (TTY)
ALDERMAN VIRGINIA RUGAI WARD 19
10400 S WESTERN AVE. CHICAGO, IL 60643
Dear ALDERMAN RUGAI:
The Department of Revenue received a request for disabled parking signs to be posted in your ward. The application has been reviewed and a survey of the location has been conducted. The Department cannot recommend the application.
Provided is the name and address of the applicant, the proposed location of the signs, and the Department's reason for not recommending the application.
Applicant's Name: GREGORY CHARLES Applicant's Address: 11630 S HALE
Reason Not-Recommended: ALTERNATIVE ACCESSIBLE PARKING Explanation: GARAGE AT LOCATION
Appeals must be filed within ten (10) days. Appeal requests must be made in writing and state reasons to support a request for a review. Appeals may be directed to the Mayor's Office for People with Disabilities (MOPD), Disabled Parking Signs Appeal, City Hall, Room 104, 121 N. LaSalle St., Chicago, IL 60602. A decision regarding an appeal will be made within thirty (30) days of the request. Applicants are notified by mail of the final decision.
Should you have any questions or require additional information, please contact our office at 312.742.7434.
Very truly yours,
Anthony Gambino Manager of Parking
cc: Mayor's Office for People with Disabilities
JWIW :?'?7.«>
APPLICATION FOR DISABLED PARKING SIGNS 77012 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 S70.00 made payable to the City of 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 the 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).
4. Applicant Last Name
^\h\Q\r\l leisi
1. Date of Birth
2. State Identification Number
i. Applicant Last Name Ml
3. Drivers License Number
I
FfJLrst Name
5
5. Home Address (primary residence)
S1REET NUMBER , I DIH. I iTHEET NAME .
/ilitd^in 37 \v\\(\\\\^
|| !jP CODE , _
6. Address where signs will be posted
, STREET.NUMBER ^ I OIH I STHEET NAME
\\\\{t>\%\0\ 1ST IfJMlllOJ
D NUMEEJ'
7. Phone Numbers
Home
Business
7i7i5T^i3 & -5\3,o \S
I ! I
8. Current Permanent Disabled Placard Number
Registered to
Relationship to Applicant
9. Current License Plate Number
, Registered to
/O 3'A ,3/ /_
Relationship to Applicant
matter and m+hzf
10. Description of Medical Condition and Disability . rnative Parking: Pleasernote your application may be der
Alternative Parking: Pleasernote your application may be denied it you have alternative accessible off-street parking options.
11. Is there off-street parking available at your primary residence J YES NO
(i.e garage, car port, driveway, etc.)?
12. If you answered Yes to question 11, please describe:
'_J Garage: J Driveway: _J Car Port: □ Other:
13.1s your oft-street parking accessible? □ Yes: ^No. Please explain:
14. Affirmation: I hereby affirm that the above information is true and correct. If Ihe City of Chicago Department of Revenue determines that the applicant has lalsely represented one or more of the above conditions, the applicant shall be subject to a fine ol not less than $100 but no more than $500, and the application shall be denied. I also understand thai it is my responsibility to notify Ihe Department ol Revenue of any changes in the information provided.
Signature
Date
Chech* 33fce.
□ RESIDENCY J COMPLETE^qoO
FOR OFFICE U^E ONLY
AFEE
J PLACARD/PLATE