MEMORANDUM FOR TRAFFIC REGULATIONS
OVERRIDE
PROHIBITION AGAINST PARKING (Except for the Handicapped):
Street, etc:_West Hirsch Street
Location, etc:_No. 3535_(Permit No. 77267)
Distance or extent:_
Hours:_at all times
Days:_no exceptions
MARIA L. ACEVEDO
ROBERTO MALDONADO Alderman, 26th Ward
Jan 06 2011 2:37PM HP LASERJET FAX
page 2
Oty of Chicago Richard M. Daley, Mayor
Department pf Reveone
Bea Reyna-Hickey Director
City HalL Room 107 A 121 North LaSalle Street Chicago, Illinois 60602-1288 (312) 747-4747 (IRIS) (312) 744-0471 (FAX) (312) 744-2975 (TTY)
December 7, 2010
ALDERMAN ROBERTO MALDONADO WARD 26
2434 W DIVISION ST. CHICAGO, IL 60651
Dear ALDERMAN MALDONADO:
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: MARIA L ACEVEDO Applicant's Address: 3535 W HIRSCH ST
Reason Not-Recommended: ALTERNATIVE ACCESSIBLE PARKING Explanation:
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
Jan 06 2011 2:37PM HP LASERJET FAX
page 3
APPUCAT10N FOR DISABLED PARKING SIGNS 77267 PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
An applcation 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 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 Ihe form of a copy of your drivers license, state identification, or utility bills are submitted at the time ot 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).
I
t. Dai© ot Birth
MO _ DAT _ YEAR
M I Mi I H 13
2. State Identification Number
3. Drivers License Mumbor
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4. Appicant Last Name
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5. Home Address (primary residence)
STREET HLHJBEK I 1MB 1 STHEC1 NAM!
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6. Address where signs wiM be posted
STREET (HMOER IIMM. 1 STREET HAI*
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7. Phone Numbers
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Home
8. Current Permanent Disabled Placard Number
lb A*__________
9. Current License Plate Numbei
Business
J7ip cor*
.WWII H'JWE"
s^l______
-> Registered to
City Sticker No.
Relationship to Applicant
6£- W
Relationship 10 Applicant
10. Description ot Medical Condition and Disability 1 * >
Alternative Parking: Please note yoor application may be denied if you have alternative accessible off-street parking options
11.1s there off-street parking available at your primary residence □ YES
(i.e., garage, car port, driveway, etc,)?
ihvejcca
./no
12 If you answered Yes to question 11. please describe: J Garage: J Driveway: J Car Port; J Other.
13. Is your ofl-streef parking accessible? 3 Yes; □ No. Please explain:
_____________J
14. Afftrmation: I hereby affirm that the above information fs true and correct. H the City of Chicago Department of Revenue determines that the applicant has fateety represented one or more of the above conditions, lhe applicant shad be subject to a line of not less then $100 but no more than $500. and the application shall be denied. I also understand thai it is my responsibility to notify the Department of Revenue of any changes tn the Information provided.
Signature YAOrffL^A* O^^O....
Date
Chech * 1230 ~
RESIDENCY J COMPLETE ^~j£t£-
FOtt OFFICE USE ONLY
PLACARD/PLATE