MEMORANDUM FOR TRAFFIC REGULATION
PROHIBITION AGAINST PARKING (Except for the Disabled) Applicant Name: TOD A WINKELMAN
Primary Street Address: 5233 W 64th PLACE, CHICAGO, IL 60638 Location Signs to be Posted: 5233 W 64™ PLACE Permit Number: 77748 Hours: At all times Days: No Exceptions
ALDERMAN FRANK OLIVO, Ward 13|1010|
APPUCAtlONFOR DISABLED PARKING SIGNS PLEASE READTHE FOLLOWING p^REPULLY BEFORE COMPLETliMG THE FdRM
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77748
An application will not be considered complete unless:
• AH Iines of the application have been completed in full;
• A check or money order for $70:00 made payable tp the City of Chicago is submitted as payment of the application fee; Please note: The application fee shall be waived for any person holding a valid, current disabled veterans plate.
• Disability must be permanent as evidenced by a copy of your valid disabled placard and/or current vehicle registration submitted at the time of application;
• Proof of residency, in the form of a copy of your drivers license, state identification, or utility bills are submitted at the time of application.
Completed application forms may be returned to: the office of your alderman, any City of Chicago Department of Revenue ¦¦]¦¦'.)'¦$ facility, or via mail at P.O. Box 803100, Chicago. IL 60680-3100, ATTN: Disabled Permitting Section. A$25.00 riftalnteTtance• '•'„•;$ fee will be billed to you annually. Should you have questions or concerns, please call our perrriit processing division: at 312- ' 744-PARK (7275).
1. Date of Birth 2. State Identification Number I I III I Ml I I 3. Drivers License Number Ki5i^iyT8i4. Applicant Last Name T Wli \h\X\e\Lwi\A\rl\
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5. Home Address (primary residence) f- STOEetMUiBEn |0(r]| STREET, NAME/ I a a CODE Auhbi...
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