ALLEY SPEED HUMP PETITION - 50th Ward Chicago

1 STREET SPEED HUMP PETITION PRO: SPEED humps MAY SLOW TRAFFIC & DISCOURAGE TRAFFIC ON RESIDENTIAL STREETS CON: SPEED humps MAY CAUSE SERIOUS ACCIDENTS & INCREASE THE CITY S LIABILITY FOR THOSE ACCIDENTS. SPEED humps SLOW EMERGENCY VEHICLES & EQUIPMENT ---------------------------------------- ---------------------------------------- ---------------------------- 90% of the resident addresses on both sides of the designated Street must sign this PETITION (preferably the homeowner) before the Alderman will consider the installation of SPEED humps .

2 The circulator must be a resident of the designated street. THIS SECTION MUST BE COMPLETED BY THE CIRCULATOR We, the undersigned residents of the _____ block of _____ in the 50th Ward, request SPEED humps to be installed in the ALLEY behind our residence. Number of Resident Addresses on Side 1 of ALLEY _____ Number of Resident Addresses on Side 2 of ALLEY _____ Total Resident Addresses _____ Total Signatures _____ I, _____, residing at_____ in the 50th Ward, certify that the following signatures are genuine and signed in my presence.

3 I further certify that the numbers representing resident addresses filled in below are true and correct. _____, _____, _____ SIGNATURE DATE DAY TIME PHONE# Signed and sworn to (or affirmed) by _____ (Circulator) before me, on _____ (date). _____ (SEAL) (Notary Public s Signature) Resident address is defined as an occupied single family home, or an occupied unit in any multi-unit building. Below enter all resident addresses on both sides of the ALLEY where SPEED bumps are requested to be installed.

4 For each address enter whether or not that address has petitioner that signed the PETITION , and indicate signature number. Resident Address Signed PETITION Y/N Signature Number Resident address is defined as an occupied single family home, or an occupied unit in any multi-unit building. Below enter all resident addresses on both sides of the ALLEY where SPEED bumps are requested to be installed.

5 For each address enter whether or not that address has petitioner that signed the PETITION , and indicate signature number. Resident Address Signed PETITION Y/N Signature Number I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside.

6 Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside. Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside.

7 Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside. Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside.

8 Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside. Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside.

9 Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside. Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside.

10 Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside. Initial _____ Sig #_____ I, _____, _____, residing at_____ Signature Print Name PETITION that SPEED humps be installed on my street. I UNDERSTAND that the City of Chicago Department of Transportation might INSTALL A SPEED HUMP IN FRONT of the property of which I reside.