DISABLED PERMIT PARKING
REMOVAL APPLICATION
FOR SIGN REMOVAL REGARDING PROHIBITED PARKING
EXCEPT FOR DISABLED PERMIT NUMBER _
( Please print or type.)
NAME OF DISABLED INDIVIDUAL: VtuUA^usVA REMOVAL LOCATION OF DISABLED PARKING SPACE REQUESTED:
( Please print or type current sign location address. ) CHICAGO, ILLINOIS (ZIP CODE) Lp^ '^~ (PHONE NUMBER)_
REASON FOR REMOVAL: Mo fep^se A/cTt^iT 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 ALDERMANKTcERTTnCATlON^"""""
'{.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