Jan"»14 2011 1:24PM
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773-769-3804
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AppucaaTON mm omsim parking signs
PLEASEREAD THE POUJQWIW C^EFUUY BffORECOMPt^rTOTHEFOfW
77298
An appfeeSon win not be considered complete unless:
AS ftw$ ot 9s application have been completed in full;
A Check or money order for $70.00 made payable to the City ol Chicago is submitted as payment of the app^p&tjon fee; Pteese rate: The atppilcatjan tee shafl be waived for ot^
DtsaMtty rm»t be permanent as evidenced by a copy ot your valid disabled placard and/or current vatTtc* regpttreGdn. eubmSed at the fime of appKcatton;
Pmcf of njriooncy, in tite form oi a copy ot your drivers ttoense, state identtfkation, or utttty bats are ©Ararfte* at the time of appfcation.
Completed appfeaSofl forms may be returned to: the ofdoe of your atderman, any City of Chicago Department of Revenue fecffity, or vfa nal at P.O. Bom 803100, Chicago, fL 60680.3100. ATTN: Disabled Perrnttring Section. A S2S.O0 matnteratnoe fee wtt-be bled to you annually. Should you nave questions or concerns, please call our permit processing division at 312-(727S).
1. Date of Kith MD _ OM - «*B- c\% \ / i e i vi? |
2. State Identification Number 1 1 1 T 1 1 Ml 1 1 i |
3. Drivers License Number |
4 ApptatttAetNane Ao\*>\*)\£\\\ I I l I l I l l l l |
Ml |
Pint Name /T^fiAei/^i/i/?} iM |
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6. Adriief* where efgrtewBf be posted |
.MSinoMuMBan 1^1^ 1 I 1 1 1 1 1 1 |
r. H^Nurobere Home |
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8usiness JUoK)£ ! 1 1 1 1 1 1 i ! |
$. Current Peitnanent Disabled Placard Number |
Registered to |
ffteiarlonship lo Appfcant |
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9. Currant License Plate Number |
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Ctty Sticker No. |
Ratattomhip to AppftcBnt |
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10. Description ol Medical Condition and DtoabBlty _ |
Alternative Psrlcng: Please note your application may be denied tf you have altemative accessible off-street panting options. |
11 Is there off-streot pa/king available at your primary rsatctenca □ YES QftlO (i.e garage, car port, driveway, eta)7 |
12. rf you answered Yes to question 11, phase describe: □ Garage; □Driveway; □ Car Port; □Other |
13.1s yom oA-etmat pactdng aoeeeafjMe? □ YM: □ Mo. Please aoqjtaJn: |
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14. Affirmation: I hereby aflrm that the above Information is true and correct If the City of Chicago Department ol Revenue dstorminae tut Ihe apptieart tat* lettoiy represented one or more of the above oondBtons. the applicant shaft t» subject to a fine ol not tees then 1100 but no more then $500, end the oppVc&con ehsfi be denied. I atac understand that He my responsMfty to natty the Department ot Revenue ot any enenges the information provided
Sgneture
Data
4/fO
□ COMPLETE <A~?0
FOR OFFICE US
Ml
NLY
FEE
□ PLACARD/PLATE □ RESIDENCY
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2011 1:2
4PM
uiarcKO
773-769-3804
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BeiReyna-Hickey Difktor
Cit|jHall,Room 107 A l2|Norlh LaSalle Street Chl^, Illinois 60602-1288 l3l|b 747-4747 (THIS) <3l|i 744-0471 (FAX)
<3l|) 744-2975 (TTY)
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January 5, 2011
ALDERMAN PATRICK OCONNOR WARD 40
5850 N LINCOLN AVENUE CHICAGO, IL 60659
Dear ALDERMAN OCONNOR:
The Department of Revenue recommends installation of disabled parking signs as described below. The application has been reviewed and a survey of the location has been conducted. Since the applicant has met the requirements outlined in the Municipal Code, the signs will be installed.
Provided is the name and address of the applicant, the exact location proposed for the signs, and the permit number assigned Please introduce an ordinance to post residential disabled parking signs at the location recommended, if one has not yet been introduced.
Applicant's Name: PATRICIA E LOWNEY
Applicant's Address: 5654 N ARTESIAN AVE
Address/Location of Signs: 5654 N ARTESIAN AVE
Permit Number: 77298
Work Order Number: H10-1492
If the proposed ordinance is not passed within four months after its introduction, the permit shall be revoked and the restricted parking signs removed. Should you have any questions or require additional information, please contact our office at 312.742.7434.
Very truly yours,
Manager of Parking
Enclosure: Disabled Signs Application