APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
73484
7.
An application will not'be considered complete unless:
All lines of the application have been completed in full; :- '":
A check or money oraer for S70.00 made payable' to;the City of Chicago is submitted as payment of trie application fee; " Please' note: The appli'catfdhrfee-shall b'e'wa'iveti fbr;ahy persbn'hblding'"a:valid; ;eu '"Disability rriu's:t3'e'pe'rm^
submitted at .the time of application; ¦'¦'*'- ''¦ ¦;
Proof of residericy- in the fbrm W 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
(H
4. Applicant Last Name
2. State Identification Number1'
3. Drivers License Number
Ml
First Name
5. Home Address (primary residence)
' STREET NUMBER DIR.J STREETNAME
mi/irr \M ffitu \c\<*\oII ZIP.CODE
6. Address where signs will be posted
DIR. STREET NAME
STREET NUMBER DIR. STREETyAME
, WARD NUMBER
7. Phone Numbers
Home
Business
717 \3~7\6
1/
8. Current Permanent Disabled Placard Number
Registered to
Relationship to Applicant
9. Current License Plate' Number
Registered to ¦¦'
City'Sticker No. .¦
Relationship to Applicant
10. Description of Medical Condition and Disability
Alternative Parking:' Please note your application may be denied if you have'alternative accessible off-street parking options.
11. Is there off-street'parking available at your primary residence ¦(i.e., garage, car port, driveway, etc.)?
? YES 4-MCf
12. If yoU answered Yes to question 11, please describe:
? Garage: ?Driveway; ? Car Port; ?other:
13.1s your off-street parking acce...
Click here for full text