Ordinance O2011-61
Passed
Handicapped Parking Permit No. 75946
Sponsors
| Sponsor | Ward | |
|---|---|---|
|
Burnett, Jr., WalterPrimary Sponsor | Ward 27 |
History
Legislation Text
City Council Meeting January 13,2010
MEMORANDUM FOR T fcA ?F1C REGULATION
PROHIBITION AGAINS f P. IRKING (es i:epl for the disable)
NAME APPLICANT:
PRIMARY STREET ADDRESS: LOCAT ION SIGNS TO BI POSTED: PERMIT: HOURS:
DAYS:
CAROLYN CALHOUN
951 N. AVERS 951 N.A VERS 75946 ALL
ALL
Walter Burnett Jr, Alderman, 27th ward
1
APP1JCA10 M FOR DISAEJIi-D PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BE :OUE COMPLETING THE FORM
75946
An application will not be considered a
• All lines ol the application heve bei
• A check or money order lor S70 00 Please note' The application fee st
• Disability must be permanent as e\ submitted at the lime of appiicatior
• Proof ol residency, in the form of a ~x>p) of your drivers license, state identification, or utility bills are submitted at in* time of application.
mpii ite unless: n cc mpleted in full:
mace payable to the City ol Cnicago is submitted as payment ol the application fee: all b? waived for any person holding a valid, current disabled veterans c-iate iden:ed by a copy of /our valid disabled placard and/or current vend* regisddOon
Completed application forms may be r< facility, or via mail at P.O. Box 8C3100. fee will be billed to you annually Shou 744-PARK (72751
lurn. id lo: the offici! ol your alderman, any City of Chicago Department ol Mevenuu ^hieigo, IL60680-31'H3, ATTN: Disabled Permitting Section. A $25 00 maintenance d yc j have question;; or concerns, please call Oui permit processing division at 312'
i. Date ot Binh
4, Applicant La«;t Name
Oir\iuui-;m \h\ i
late identification Numl; ar
' . I ■:
:v Dnvors License Number
..i.....:•• .:...)..!
Ml
5. Home Address (primary rcsidoncrl
STKEf NUWOL" :» I MHtETN»»IC
6. Address wrier© signs will bo posted
.r'.flMtmg. ■ i
7 Phone Numbers
7 O • ^ "
...l... i j.....
iLil_._Ll_.L_ 1.1.....L
|0:QO
First Name
._._i_iL.._._^ _L
i : I
Home
LL
8 Current Permanent Disabled Placard Nu
......U..L
iber
9. Current Liconso Plaic Number
Hl-f<-/_,7_
______........I......I...
Bus nes_
-ILL...... "...
Registered in
.'. . . \____i.:j-4v-
Rogistci lid to ! Cily Slicker No
1
rtClflflO"SM;l* W. Apt1"!
10, Description ol Medical Condition nnd Dis ibilih.
iii. ^ ~-v. r*~ir........... _&ta_UUKi* \U.________LLh>_li_Vi..li:..:_i .
Alternative Parking: Please note youi applic: lion nay be oenisd il yi: .i haw alternative accessible oN-streoi aarkniq odik.i^
11 Is there off-street parking available at yoi (i.c garage, car port, driveway, erc.i'
12 it you answe'ed Ves to question 11. pi.a -I Garage: J Dnveway: .J Car F
• pm iary residence -J irES Z) NO
e de scribe.
>rl J Other
13 Is your otl-strpel parking acco-si-lo1 □ Ves: .21 No Plaaso axpl.vn
14 Aflirmation: I hereby affirm thai tf_ abov thai the oppiicam has laisoly represented or Si00 bul no more than $500. and the applic Revenue o< any changes in ina infonnaiion |
: mlt rmation is irue nn'.-a understand thai it'S my responsibility to notify the- Dop.vinicni rovi( ed
Signature ^ ,iTV~U^C^-^''
Date ... C
FOR OFFICE USE ONLY
_ ____JTL
fl I PL ACARO/PLATE
RESIDENCY J COMPLETE "?q