JANUARY 13, 2011 CITY COUNCIL
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. PROHIBITION AGAINST PARKING (EXCEPT FOR DISABLED)
NAME OF APPLICANT: HIRMIZ 0. HIRMIZ
PRIMARY STREET ADDRESS: 6082 N. ALBANY, 2nd FLOOR
LOCATIONS OF SIGNS TO BE POSTED: 6082 N. ALBANY, 2nd FLOOR
PERMIT NUMBER: 73510
HOURS: AT ALL TIMES
DAYS: NO EXCEPTIONS
SECTION 2. This ordinance shall take effect upon its passage and publication.
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City of Chicago Richard M. Daley, Mayor
December 8, 2010
Department of Revenue
Bea Reyna-Hickey Director
Chicago, Illinois 60602-1288
City Hall, Room 107A 121 North LaSalle Street
(312) 747-4747 (IRIS) (312) 744-0471 (FAX) (312) 744-2975 (TTY)
ALDERMAN BERNARD STONE WARD 50
121 N LA SALLE STREET - 203 CHICAGO, IL 60602
Dear ALDERMAN STONE:
Please see the attached application for disabled parking signs. The applicant is requesting a restricted parking space within your ward.
The Department of Revenue will conduct a parking study and review the application for compliance with Chapter 9-64-50 of the Municipal Code of Chicago. The Department will make its recommendation to you within thirty (30) days of the receipt of the application fee.
Should you have any questions or require additional information, please contact our office at 312.742.7434.
Very truly yours,
Deputy Director Department of Revenue
Enclosure: Disabled Signs Application
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APPLICATION FOR DISABLED PARKING fft5NS ^^r^rp^lOi PLEASE READ THE FOLLOWING CAREF^LL^I/5^ A V' ^m 1 BEFORE COMPLETING THE FORM PIT'
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An application .will not 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 p^jt^^^ffff-^plication 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 a'^d/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).
1. Date of Birth
MO _ PAY
2. State Identification Number
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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
STREET NUMBER DIR. STREET NAME
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| ZIP CODE
6. Address where signs will be posted
STREET NUMBER DIR. STREET NAME
, WARD NUMBER
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7. Phone Numbers
Home
Business
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8. Current Permanent Disabled Placard Number
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Relationship to Applicant
9. Current License Plate Number
Registered to
City Sticker No.
Relationship to Applicant
10. Description of Medical Condition and Disability .
Alternative Parking: Please note your application may be denied if you have alternative accessible off-street parking options.
11. Is there off-street parking available at your primary residence '□ YES . (i.e., garage, car port, driveway, etc.)? _ .- ■
12. If you answered Yes to question 11, please describe: . □ Garage; □ Driveway; □ Car Port; . □ Other:
13.1s your off-street parking accessible? □ Yes; 3hlo. Please explain:
14. Affirmation: I hereby affirm that the above information is true and correct. If the City of Chicago Department of .Revenue determines that the applicant has falsely repj^ssntettTjne-T^f^-mrye of the above conditions, the applicant shall be subject to a fine of nof less than $100 but no more than $500<a"fid the application shaiTbe denied. I also understand thai it is my responsibility to notify the Department of Revenue of any changes/n the information provided. \
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Signature
Date l(; 1\( ID
FOR OFFICE US^tfLY
□ PLACARD/PLATE /m RESIDENCY
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□ COMPLETE