Committee on Traffic Control and Safety January 13, 2011 Council Meeting
MEMORANDUM FOR TRAFFIC REGULATION Prohibition Against Parking (Except for the Disabled)
Applicant Name: Wilbert S. Peterson
Primary Street Address: 5407 North Bernard Street, Chicago, IL 60625 Location Signs to be Posted: 5407 North Bernard Street Permit Number: 76998 Hours: At all times Days: No exceptions
MARGARET LAURINO Alderman, 39th Ward
--12/I'd/2810' 14:42 7737362333
APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
PAGE 02/83
76998
An apphcalion will not be considered complete unless.
• All lines of the application nave 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 appiicalion 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 oti^otyQ)i¥^&ifoht:&fty~ City of Chicago Department of Revenue facility, or via mall at P.O. Box 803100, Chicago, IL eoeB^aiO&iWniMcpisiWed'-Pdrniitting 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
MO _ DAY _ vg»H
/ I / 1 Q 1 fe I 2. I h
2. State Identification Number.
A. Applicant Last Name
PlElTfElfrlSlOlMI
3. Drivers License Number
P!3 I* \2 }S |q|7!2|fe|3i/ \6
Ml 1 First Name
L ISIF5 |*|T
5. Home Address (primary residence)
STREET NUMBER DIR. STREET NAME
I ZIP CODE
BlElKNlAlRlP
6. Address where signs will be posted
STREET NUMBER CHP. STREET NAME|104-|G|...
Click here for full text