APPLICATION TO USE THE PUBLIC RIGHT OF WAY
APPLICANT INFORMATION
LEGAL NAME OF ENTITY: EL A _ /jsS&LlfiT£3 LLC._
PERMIT MAILING ADDRESS: ^ KuTTtGf td^ gp4r»
OVnOAtfP&bnU ~T7~.PBfk-{? STATE: IL_ZIP CODE: LOlHl
CONTACT PERSON: ~THp^A<, BloAP TITLE: foiy^TV HriiJ,
PHONE:3>^.«g/g^fc</</ FAX^Q. ,g£/ -3737 E-MAIL: jfe'"
BUILDING OWNER INFORMATION
NAME: <?AM£r AS 4JRnV£_
ADDRESS:
CITY: _STATE:_ZIP CODE:
PHONE: FAX: E-MAIL:
USE OF THE PUBLIC WAY
1. List the proposed or existing use below and complete the worksheet on page 3. Use only one application for all public way use type.
TYPE HOW MANY? BUILDING ADDRESS
2. Please enclose one sketch of each proposed use of the public way, which maps to scale the proposed use(s) and its relationship to surrounding right-of-way. All measurements must be indicated.
The prints should also accurately depict the location of the property line and public facilities (meters, light poles, sidewalks).
APPLICANT CERTIFICATION
I hereby certify that all statements made as part of the application, and the attachments herein, are true to the best of my knowledge and belief.
Rj&dl_ T'TLE: {LaX. /^L,^a_
ECIJRITY NUMBER: 3%1%H-~J 1 1 ' f
BY:cv
F.E.I.N*6r SOCIAL SECURITY
ALDERMAN'S APPROVAL
As part of this application process, you are required to notify/obtain approval from the Alderman in whose ward your proposed use ofjhe; public way is located
ALDERMAN'S SIGNATURE:
DATE: \ f\ TTi v i\ " WARD
CHIC A C O _
City of Chicago | Department of Business Affairs and Consumer Protection | Public Way Use Unit ■uswa5»FHws'i Business Assistance Center | City Halt, Room 800 | 121 North LaSalle Street I Chicago, Illinois 60602 commmnoTKnoN www.cityofchicago.org/bacp | 312.74.GOBIZ (744.6249) | 312.742.1974 (TTY)