MEMORANDUM FOR TRAFFIC REGULATIONS
OVERRIDE
PROHIBITION AGAINST PARKING (Except for the Handicapped):
Street, etc:_South Central Park Avenue_
Location, etc:_No. 1251_(Permit No. 67467)
Distance or extent:_
Hours: at all times
Days:_no exceptions
REBECCA SANDERS
SHARON DENISE DIXON Alderman, 24th Ward
PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
b/4b/
An application will not be considered complete unless:
All lines of the application have 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 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/br 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 2. State Identification Number MO _ DAY_ _--fEAR _ _ C o n ia id \3 n sisit^eioBRKweis: |
3. Drivers License Number 5iSi3ifc7ra K>i3Riftoi8 |
4. Aopjicant Last Name ■ ■ ■ ■ iSiaintlkiiriSi I I I I I I I I |
Ml |
First Name iKieibir-.r.rjai i f i |
5. Home Address (primary residence) STREET NUMBER DIR. STREET NAME it ZIP CODE Il IAISK SClelolV-Irtoll I iPlalrlKJ I I I I I I IfeloifeaiS |
6. Address where signs will be posted STREET NUMBER DIR. STREET NAME _ 1/ «1511 5 Clelnl+lrkali 1 iP |
. WARD NUMBER nlrlKl 1 1 I 1 1 1 1 1 lart-l |
7. Phone Numbers Home -> n i3T5" is iaT3io |
n is |
Business I i T 1 i "T 1 I 1 |
8. Current Permanent Disabled Placard Number |
Registered to |
Relationship to Applicant |
|
|
|
9. Current License Plate Number |
/i Registered to Y.tK>eccx- |
City Sticker No. |
Relationship to Applicant U61O |
|
|
|
|
10. Description of Medical Condition and Disability * /P. rs^7 /ttrvAjrMr |
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 ^NO (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; □ No. Please explain: |
|
|
|
|
|
|
14. Affirmation: l hereby affirm thai the above inlormation is true and correct. If the City of Chicago Department of Revenue determines that the applicant has falsely represented one or more of the above conditions, the applicant shall be subject to a fine of not less than $100 but no more than $500, and the application shall be denied.' I also understand that it is my responsibility to notify the Department of Revenue of any changes in the information provided.
Signature
Date.
6-3.3-/0
a rr\t.fSi etc J__-
FOR OFFICE USEJJ^LY
a o a Dnrai atc
DCCinCM^V
City of Chicago Richard M. Daley, Mayor
Department of Revenue
Bea Reyna-Hickey Director
City Hall, Room 107A 121 North LaSalle Street Chicago, Illinois 60602-1288 (312) 747-4747 (IRIS) (312) 744-047) (FAX) (312) 744-2975 CITY)
July 1,2010
REBECCA SANDERS 1251 S CENTRAL PARK CHICAGO, IL 60623
Dear Applicant:
The Department of Revenue has received your application for disabled parking signs. A parking study will be conducted and the application will be reviewed for compliance with Chapter 9-64-50 of the Municipal Code of Chicago. The Department will make its recommendation within thirty (30) days of the receipt of the completed application and fee.
Should you have any questions or require additional information, please contact our office at 312.742.7434.
Very truly yours,
Department of Revenue Permitting Section
NEIGHBORHOODS
City of Chicago Richard M. Daley, Mayor
November 18,2010
Department of Revenue
Bea Reyna-Hickey Director
City Hall, Room 107A 121 North LaSalle Street Chicago, Illinois 60602-1288 (312) 747-4747 (IRIS) (312) 744-0471 (FAX) (312) 744-2975 (TTY)
REBECCA SANDERS 1251 S CENTRAL PARK CHICAGO, IL 60623
Dear Applicant:
The Department of Revenue has received a response from the Mayor's Office for People with Disabilities (MOPD) regarding the denial of your application for disabled narking signs. The origin?' decision *o not rBcomrriend your application has been upheld.
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
Copy: ALDERMAN DIXON
NE]