MEMORANDUM FOR TRAFFIC REGULATIONS
OVERRIDE
PROHIBITION AGAINST PARKING (Except for the Handicapped):
Street, etc:
North Panama Avenue
Location, etc:
No. 3430
(Permit No. 73110)
Distance or extent:
Hours:
at all times
Days:
no exceptions
CHRISTINE W. JASTRZEMBOWSKI
JOHN A. RICE (iderman, 36th Ward
. ^'APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORIVKrg^
/"application will no) be considered complete unless: All lines of the application have been completed in full; « A check or money order for $70.00 made payable to the City of. Chicago is .submitted as payment ot the application fee
¦ Please note: TheapplicationTee shall be waived for anyperson 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 S25.00 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 _ YEAR
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2. State Identification Number
3. Drivers License Number
4. Applicant Last Name
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First Name
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5. Home Address (primary residence)
STREET NUMBER
DIR. | STREET NAME
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6. Address where signs will be posted
STREET NUMBER
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STREET NAME
. WARD NUMBER
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7. Phone Numbers
Home
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8. Current Permanent Disabled Placard Number
Registered to
Relationship to Applica...
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