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APPLICATION TO USE THE PUBLIC RIGHT OF WAY
Cily of Chicago Department or Business Affairs and Licensing Public Way Use Unit 333 S. State Street, Suite 310 Chicago, IL 60604-3977 Stan Adams (312)747-9035 or
Lisa Puiateri (312)747-9034
FAX
(312)745-2938
APPLICANT INFORMATION
LEGAL NAME OF ENTITY:^ ^ // I fY<-
PERMIT MAILING ADDRESS:
CITY ^ O^i f C#-<j?Q STATER ZIP CODE:
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CONTACT PERSON:
USE OF THE PUBLIC WAY
l. List the proposed or existing use below and complete the attached worksheet. Only use one application per public way use type.
Type
How many?
Mi
JfLn'i
£35
Building Address
2.3 iO- Me^Ult >Vg_
2. Please enclose one sketch of proposed use of the public way, which maps to scale'
the proposed use 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).
3. Please provide a full sized 80 Acre map, with the adjacent property and portion ofthe . public way clearly outlined.
The 80 Acre is available at Maps and Plat in Room 905 City Hall w/$5.00 fee. APPLICANT CERTIFICATION:
I hereby certify that all statements made as part of the application and the attachments herein, and true to the best of knowledge and belief.
Title:
F.E.I.N. or Social Security Number: ALDERMAN'S APPROVAL:
As part Of this application process, you arc required to notify/obtain approval from the Alderman in whose ward your proposed use ofthe public way is located.