From:
03/01/201115:51 8870 P.002/002
PARKING RESTRICTION SIGN APPLICATION
QUESTOR DRESS
ISINESS NAME
DATE: o(/o5/i 1
^Url Ce^-yrvaK phone no. Ots) ^^^^t/g^
r& V«VMi>r A sLLa,. \ Up HRS OF OPERATION A AM To *t p ^
__ ZIP CtoQa?,
JS1NESS ADDRESS <2n% ^ ^waVr
JStNESS PHONE ffosV £^3- S^S^ MAIL ADDRESS
_ ' FAX NO.
XACT ADDRESS OF INSTALL 0- H % VM C Wl ft C o JL7~ £
EiN: %k-X£-5.23-±SL or ss# SsJ__-252_-_JgLX(
"YPE OF BUSINESS circle)
NON FOR PROFIT
YES
OR
10/ (If yes. attach tax except letter)
CONDITIONS
This request is valid for 60 days, if payment is not received within that time frame the ordinance will be repealed. After orgtnal cost of signage, you are responsible for yearly malnaintance fee. If you move, relocate, and/or change businesses you must notify the Ctty^ Chicago. _.
SIGNATURE
FOR OFFICAL USE ONLY
SIGNAGE
TYPE OF RESTRICTIONS REQUEST
INSTALL _
RELOCATE _
CHANGING _
DAYS
HRS.
TRAFFIC SIGNS @ S100.00/SIGN TRAFFIC SIGNS @ $ 50.00/SIGN
TRAFFIC SIGNS @S 50.00/SIGN.
5. $.
$.
Temporary removal of traffic signs during construction
REMOVE & REINSTALL ■ TRAFFIC SIGNS @ S100.00/S1GN.
PERMIT NO. _
ANNUAL SURCHARGE
REMOVE RELOCATE
NUMBER OF FEET OF CURS SPACE (Chargeable) MORE THAN 25 FT Q $14.00 per FT
PARKING METERS
PARKING METERS @ $150.00/METER PARKING METERS @ S150.00/METER