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Record #: O2011-1585   
Type: Ordinance Status: Passed
Intro date: 3/9/2011 Current Controlling Legislative Body: Committee on Traffic Control and Safety
Final action: 4/13/2011
Title: Handicapped Parking Permit No. 77514
Sponsors: Thompson, JoAnn
Topic: PARKING - Handicapped
Attachments: 1. O2011-1585.pdf
Related files: SO2011-3566
03-03-1 1; 01 :29PM;
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APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
An appficallon not be cor^lderad. ,,. !'¦;;
• All lines of the application have been completed in full;
¦ •: A check or, ;mohey order forS7p.00 ;mad9 pa>^We; to the Gity ot Chicago issuomitted a> payment pt. the; application lee;
"' .PleasehotaiTho applied ;• .- Disability must be permanent as evidenced by -a copy of yoocyaiiiddisabled, ptaea^anc^rcu'rrenl Vehicle;registration
¦; submitted at the lima or application; - . ' ¦'¦ '.¦!;: '
> Proof of residency, in the lorm of a cop/ of your drivers license, stale jdentificatiph; ;cir: iuiitUy:.b|ll5 are submitted atthe
.' time of application. ' \ ' i'-j":' i!,!"!'' '• | '. . '
' Completed application forms may be returned to: the'office of your'aldoirnan, any City of'Chicago Dec*rtmo!nr of; Revenue faalily.br Wama^
fee will be billed to you annually.1 Should ybu have question's or concerns, pfoase call our permit processing division at 312-744-PARK (7275).
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1: Oato 61 Btrth
2. Siato Identification Number -
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3. Drivers License Number
1 0
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4. Applicant Last Namo
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first Namo
5 Home Address (primary residence)
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6. Addrasa whore signs will bopostod
STREET NUWB5K,
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7. Phono Numbers.
Home
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8. Currant Pbrmanont Disabled Placard Number
Registered to
Relationship ic-Applicant
8. Currant L'eorise Plate Number
Rogrstered to
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Relationship; to Applicant
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Altomauvo Parking: PJeaBenot»ypur,a'ppJtato^ .". (i.o.i oaragB.cnrpori, drr...

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