APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
/4o30
'.An acplicaticn wiil not be considered complete unless:-' > '•:•'• M lines ol tne application have baen completed in full; - : ¦¦ , ,' -;
A check o" money order fp'$70.00 made payable to tne City of Chicago is submitted as'payhient cif-lh'e'applicaikjn tee: P>ease note: The application fee snail be waived lor- any peison holding a val.di'current disable* v^ic-'a.-i's plat*,. , inability must be permanent as evidenced by a copy of your valid disabled placard and/or current vehicle registration biiomiiteu at the time.-a', application; ... Proof ol residency, in the form of a copy of your drivers license, state identification, or utility bills 'aie; submitted at the time of application.
C-opipMrtcU app'.cation fouris may be returned to: the office of your aldennan. any City of Chicago Dep.ir:':i •' h;./!;.w- ¦ & , (ncilitv or via mat! at P.O. Box-803100. Chicago; IL 60680-3100. ATTN: Disabled Permitting Section; .A $25.00 maintenance: ¦ ee will be billed to you annually. Should you have questions or concerns, please cad nurperrhil pmccssinq.vi 'k- 3">2~ 74-1-PARK (7275). " ' .'v ' : '.'-. <
O.iU; oi Birth
2. State Identification Number
. o. 3 .....|.......in 8;5 j I....!......lIJJ
.; <«. A[::;iic£in: l;v,: ¦ •Jarr.'-
TT"l£ ^.fc. fXj^J^S_LJ__|__!_.L
; Homo Ac:d!CSS.Iprini;iry residence)
; i n.M:M JuiL r^ffiiil. it.
3. Drivers License. Number
s M
Firs! Name ¦: ¦ ¦: :" ; ; ,". J"S>; A;** j.......i j n'Vi'
I'--;.-1
A'.:-.: when, sign:- will t>.: pcsv-j-J
i 7. Pttsne fturnhcrs
Homo
1.......11 3 T5i8....j5~T%.......n_ J.....g iM-
Business
Cut rent • >o;:rv.nen! Oisat/.-d Ph.;arr.l Numhr
bfv s^sn _. _.......
RfriiK'.ored i
j I.
Boi;;ti-.:hsi-
3. C'„iien; Licon".-:: Piato Numoer
Re-nisioroa to
C-y ^lickur.N:
\AoVv
?0. D«:;cnptmn ol Mediryi Condition nnd Disability
iii-.'i: r.ir'-,' Plt.-.ise noiD yo'-.'f ;«:p!ica:i...
Click here for full text