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ALDERMAN FREDDRENNA LYLE WARD 06
May 10, 2010
406 E 75TH STREET CHICAGO, IL 60619
Dear ALDERMAN LYLE:
The Department of Revenue received a request for disabled parking signs to be posted in your ward. The application has been reviewed and a survey of the location has been conducted. The Department cannot recommend the application.
Provided is the name and address of the applicant, the proposed location of the signs, and the Department's reason for not recommending the application.
Applicant's Name: ANNE WILSON Applicant's Address: 9719 S FOREST
Reason Not-Recommended: ALTERNATIVE ACCESSIBLE PARKING Explanation: GARAGE AT LOCATION
Appeals must be filed within ten (10) days. Appeal requests must be made in writing and state reasons to support a request for a review. Appeals may be directed to the Mayor's Office for People with Disabilities (MOPD), Disabled Parking Signs Appeal, City Hall, Room 104, 121 N. LaSalle St., Chicago, IL 60602. A decision regarding an appeal will be made within thirty (30) days of the request. Applicants are notified by mail of the final decision.
Should you have any questions or require additional information, please contact our office at 312.742.7434.
Vefiy truly youcs,
Turranna Cochran-Person Deputy Director
cc: Mayor's Office for People with Disabilities
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APPLICATION FOR DISABLED PARKING SIGNS 67838 PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
application will not be considered complete unless:
All lines of the application have been completed in full;
A check or money order for $70.00 made payable to the City of Chicago is submitted as payment of the application fee; Please note: The application fee shall be waived for any person holding a valid, current disabled veterans plate.
Disability must be permanent as evidenced by a copy of your valid disabled placard and/or current vehicle registration submitted at the time of application;
Proof of residency, in the form of a copy of your drivers license, state identification, or utility bills are submitted at the time of application.
Completed application forms may be returned to: the office of your alderman, any City of Chicago Department of Revenue facility, or via mail at P.O. Box 803100, Chicago, IL 60680-3100, ATTN: Disabled Permitting Section. A $25.00 maintenance fee will be billed to you annually. Should you have questions or concerns, please call our permit processing division at 312-^ 744-PARK (7275).
1. Date of Birth
2. State Identification Number
JMO _ DAY YEAR y, _ _ / _ _
4. Applicant Last Name Ml First Name
3. Drivers License Number
4. Applicant Last Name
5. Home Address (primary residence)
/~\ STREET NUMBER DIR. STREET NAME
ZIP CODE
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6. Address where signs will be posted '
STREET NUMBER DIR. | STREET NAME
,. WARD NUMBER
7. Phone Numbers
Home
Business
)arm'ar»on+ Pi i o nhloH CD I onnrrl MumKnc *
8. Current Permanent Disabled Placard Number
Registered to
Relationship to Applicant
9. Current License Plate Number
Registered to
City Sticker No.
Relationship to Applicant
10. Description of Medical Condition and Disability
Alternative Parking: Please note your application may I
denied if you have? alternative accessible off-street parking options.
11. Is there off-street parking available at your primary residence (i.e., garage, car port, driveway, etc.)?
YES □ NO
12.lf^ou answered Yes to question 11, please describe:
"Garage; □ Driveway; □ Car Port; □ Other:
12.lt*fi
your off-street parking accessible? Yes] □ No. Please explain:
14. Affirmation: I hereby affirm that the above information is true and correct. If the City of Chicago Department of-Revenue determines that the applicant has falsely represented one or more of the above conditions, the applicant shall be subject to a fine of not less than $100 but no more than $500, and the application shall be denied. I also understand that it is my responsibility to notify the Department of Revenue of any changes in the information provided.
Signature
Date
QJULCJ^- S350
□ COMPLETE <t/,^sir.
FOR OFFICE USEOMLY
M FEE
ACARD/PLATE
RESIDENCY