APPLICATION TO USE THE PUBLIC RIGHT OF WAY
APPLICANT INFORMATION LEGAL NAME OF ENTITY: fiSlflft /WE NUC INC
PERMIT MAILING ADDRESS: iblA- W^&ELttOlNfT _AVg AWIs CITY frrUC^
STATE
It
ZIP CODE:
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CONTACT PERSON: f\Lf\tt d^MRO^TITLE WftNftGrt^
Dept. of Business Affairs & Consumer Protection Business Assistance Center
Public Way Use Unit 121 N LaSalle St., Room 800 Chicago, IL 60602
<E: W-^V^ FAX: W2> S^- ^r^MMi*-^ M -H & ^A Hn n. ffrM
Stan Adams (312)747-9035
or
Lisa Pusateri (312)747-9034
FAX
(312)745-2958
USE OF THE PUBLIC WAY
LTepartmeni ot Business Affairs and Consumer Protection
OCT 05 2010
ic way y;
1. List the proposed or existing use below and complete the attached worksheet, uniy application per public way use type.
use one
Type
How many?
Building Address
tfalq- W< flginoNT Avert uc
2. Please enclose one sketch of proposed use of the public way, which maps to scale
the proposed use and its relationship to surrounding right-of-way. All measurements must be indicated.
The prints should also accurately depict the location of the property line and public facilities ( meters, light poles, sidewalks).
i
3. Please provide a full sized 80 Acre map, with the adjacent property and portion of the public way clearly outlined.
The 80 Acre is available at Maps and Plat in Room 905 City Hall w/$5.00 fee. APPLICANT CERTIFICATION:
I hereby certify that all statements made as part of the application and the attachments herein, and true to the best of knowledge and belief.
By:_flLflf\J_Title: fWVOTfrgft_
F.E.I.N. or Social Security Number: _ 3$ - 1 1 H _
ALDERMAN'S APPROVAL:
As part of this application process, you are required to notify/obtain approval from the Alderman in whose wafll vour proposed use of the public way is located.
ALDERMAN'S SIGNATURE.
WARD
31
DATE