APPLICATION TO USE THE PUBLIC RIGHT OF WAY
APPLICANT INFORMATION
LEGAL NAME OF ENTITY: FRC Kinzie Jefferson, LLC_
PERMIT MAILING ADDRESS: 222 s. Riverside Plaza, ste. 600_
CITY: Chicago_STATE: Illinois_ ZIP: 60606_
CONTACT PERSON: Martin Walz_TITLE: Director of Construction
PHONE: 312-424-6203_FAX: 312-8S5-1719_E-MAIL: mwalz@fifieldco.com
PROPERTY OWNER INFORAAATION
NAME: FRC Kinzie Jefferson, LLC
ADDRESS: 222 s- Riverside Plaza, Ste. 600 , , ¦
CITY: Chicago_'_STATE: Illinois_ZIP: 60606__
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? J3UILDING ADDRESS
Caisson Bell 6 365 N. Halsted (Kinzie Streetl
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 trueto Jfie besfaf my knowledge and belief.
BY: C_^ W-^.V,__/ TITLE: Agent
F.E.I.N. or SOCIAL SECURITY NUMBER: 36-452i54s
ALDERMAN'S APPROVAL.
As part of this application process, you are required to notify/obtain approval from the Alderman in whose ward your proposedjuse,of the public way is located.
ALDERMAN'S^SIGNATURE: VJQJtM j^^H^^ ^r
H I C A G O
U5INE5S AFFAIRS ONSUMU ntoitciroi
City of Chicago | Department of Business Affairs and Consumer Protection | Public Way Use Unit Business Assistance Center | City Hall, Room 800 | 121 North LaSalle Street | Chicago, Illinois 60602 » www.cityofchi...
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