DISABLED PERMIT PARKING
REMOVAL APPLICATION
FOR SIGN REMOVAL REGARDING PROHIBITED PARKING EXCEPT FOR DISABLED PERMIT NUMBER J (* 3 9^
NAME OF DISABLED INDIVIDUAL:.
( Please print or type.)
REMOVAL LOCATION OF DISABLED PARKING SPACE REQUESTED:
( Please print or type current sign location address.) CHICAGO, ILLINOIS (ZIP CODE) (pO^'S*- (PHONE NUMBER)_
REASON FOR REMOVAL: A/0 fesPntiSG TP A/QT'^ ILLINOIS VEHICLE LICENSE NUMBER:_
(W or V plates)
ILLINOIS DISABLED PLACARD NUMBER:_
( Secretary of State Disabled Placard) CERTIFICATION:'THE ABOVE INFORMATION IS CORRECT TO THE
BEST OF MY KNOWLEDGE: _ _
(Signature of Applicant) FORWARD THIS COMPLETED APPLICATION TO YOUR ALDERMAN. APPLICANT: DO NOT WRITE BELOW THIS LINE ALDERMANIC CERTIFICATION^ , . """"^"!^^"
'f Aldermanic Signature ) (Ward) (Date)
AFTER APPROVAL, THIS APPLICATION IS TO BE FORWARDED TO COUNCIL SERVICES, BY THE ALDERMAN, AT THE TIME THE DISABLED SIGN REMOVAL ORDINANCE IS INTRODUCED