APPLICATION TO USE THE PUBUC RIGHT OF WAY
APPLICANT INFORMATION
LEGAL NAME OF ENTITY: 5k|rW& fa***' °jWtiWx6 LLC-_
PERMIT MAILING ADPRESS:
CITY: cWcoy STATE: ZIP: CoisSW
CONTACT PERSON: S\uk* rmUT TITLE: fWfcsa- _
PHONE: FAX: 3il -yifi^HK E-MAIL: tft d>fc uurtAbAlQrtiujfr*^
PROPERTY OWNER INFORMATION
NAME: <yWfcli AWl^- Tk^sMg,^__
ADDRESS: 3^ V f& SkfttU
CITY: CUTtjy>_STATE: _ZIP: fcflfcN_
USE OF THE PUBLIC WAY
1. List the proposed or existing use(s) below, and complete the worksheet on page 3. Use only one application for all public way use type.
TYPE_ HOW MANY? BUILDING APPRESS , _
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.
3. All "No Fee" Items require a $50 application fee. Please remit with application.
4. "No Fee" items are listed in the price list on page 4.
5. 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 begLofjrfy knowledge and belief.
BY:
F.E.I.N. or SOCIAI/SEgURITY NUMBER: $1- I >Of OS?-
Skfali Ait.tHtsfvs ULc TITLE:
ALDERMAN'S APPROVAL
As part of this application process, vou are required to notify/obtain approval from the Alderman in whose ward your proposed use ofithe public way is located. / ■
City of Chicago | Department of Business Affairs and Consumer Protection | Public Way Use Unit affairs* Business Assistance Center | City Hall, Room 800 | 121 North LaSalle Street | Chicago, Illinois 60602 --^on www.dtyofchicago.org/bacp | 312.74.GOBIZ (744.6249) | 312.742.1974 (TTY)