APPLICATION TO USE THE PUBLIC RIGHT OF WAY APPLICANT INFORMATION
LEGAL NAME OF ENTITY: ft, fl. Flnrrsfr I Mercery Co-
PERMIT MAILING ADDRESS: innn -IO.O .^iW^lfrh Sir CITY: {~')f\frfliA f¦ STATE: ZIP: ^ ^
CONTACT PERSON) fflgfljIiC £flK/>r ______ TITLE: President ,
PHONE: /S^) ^/"-fe3;2^FAX: HU-V&<7 E-MAIL: jk^MtrfU^ k^nW'tty"
PROPERTY OWNER INFORAAATION
NAME: ffcPf RhOOOL-fH f%L&tA)AC L&C ADDRESS: /otfO «v/« llAr* Zni&iT
CITY: 6441 CA&D_STATE: IL-_ZIP: bObt>7
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 ADDRESS _
^'3^ * lOOfVfflrtiLO. gfln^ijiH
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 tnTB^o the best ofjim knowledge and belief.
BY: S-C-Jft**^ y /ju^a^_ _TTTLE: Vfl^.tOtT^'l
F.E.I.N or SOCIAVSECURITY NUMBER: ^U" W700 6S""
ALDERMAN'S APPROVAL
As part of this application process, you are required to notify/obtain approval from the Alderman
in whose ward your propose^ ALDERMAN'S. SIGNATURE: i use btthe public way is. lot ated. 1 -i A
DATE: Ui- ^1 I 1 WARD:'?>/
\\S \\ (I /
C H C AGO
City of Chicago I Department of Business Affairs and Consumer Protection | Public Way Use Unit Business Assistance Center I City Hall, Room 800 (121 North LaSalle Street | Chicago, Illinois 60602|1010|ORDINANCE
B.A. FLORIST & NURSERY CO Acct. No. 221...
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