Committee on Traffic Control and Safety January 13, 2011 Council Meeting
MEMORANDUM FOR TRAFFIC REGULATION Prohibition Against Parking (Except for the Disabled)
Applicant Name: Dona Petrakis
Primary Street Address: 6248 North Keeler Avenue, Chicago, IL 60646 Location Signs to be Posted: 6248 North Keeler Avenue Permit Number: 72905 Hours: At all times Days: No exceptions
MARGARET LAURINO Alderman, 39th Ward
12/14/^2010 TUE 14:35 FAX
12)002/006
SOW
APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
Ari application will not r>e considered complete unless
• All lines ol the. application nave been completed m iuil.
A check or money order (of $70.00 made payable to the City of Cnicaoi, -u: Please note: The application fee shati be waived for any person holding ;-. .-.d!-.:
• Disability must be permanent as evidenced by a copy of your valid disa&*o pi suunntled at the time of application:
• Proof of residency, in Ihe form of a copy of your drivers license, state d-=--t ¦¦ woe ot application.
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Completer) application fonns may be returned to tne office of your alderma- aiv. facility, or via mail at P.O. Box 803100. Chicago. IL 60680-3100. ATTN". Disaftlt:: p fee will be billed to you annually. Should you have auestions or concerns p'*><;'Dale :;i Siflh , *': ") ~ /'"' r.'/ "
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t; AcJci;0S5 where siyr.5 will r.:o posictd
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8. Curium i^rrniariRr.t Disabled Placard Number
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9 Ci.''i:oi LicO'"-so Plate Number
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10 Description oi Mfidica CdiuJiiio;'! ana Disabilnv
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Alternative Parking" Picas.© noto your application may be tienrra •'¦ you nave oitemMvi
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