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Record #: O2011-1647   
Type: Ordinance Status: Failed to Pass
Intro date: 3/9/2011 Current Controlling Legislative Body: Committee on Traffic Control and Safety
Final action: 9/8/2011
Title: Handicapped Parking Permit No. 74578
Sponsors: Levar, Patrick
Topic: PARKING - Handicapped
Attachments: 1. O2011-1647.pdf
Related files: SO2011-7929
APPLICATION FOR DISABLED PARKING SIGNS 74578 PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
An 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 MO _ DAY _ YEAR / la I o\ l 2. State Identification Number L^I7Til^HT3|l|J 3. Drivers License Number 6\ip\snjip\ix>\o\^\e>f\\H\x
4. Applicant Last Name 6\ft\0\U)\rl\£\L\L\ | | | | | | | | Ml First Name f\/f\U.\L\T\ri\^\ | | | |
5. Home Address (primary residence) STREET NUMBER I DIR. I STREET NAME ( 1 . _ || ZIP CODE 4|fe|4lk| lN|L|E|aifVl|r|AJ|f>|T|<9|/\l| IfrlVltrl 1 1 1 1 \tc\0\U>\5\o
6. Address where signs will be posted WARD NUMBER STREET NUMBER 1 DIB. 1 STREET NAME \ ...

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