§ 95.64 APPLICATION FOR HONORARY STREET NAME DESIGNATION.

Name of Honoree (as it would appear on street sign):

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Permanent Street Name:

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Intersecting streets at each end of the street segment to be designated:

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Please check all that apply, and give a brief explanation of the applicable criteria. A street can be named for an individual, place of event.

          Individual

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          Place

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          Event

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          Cultural Impact to the Village:

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          Historical Impact to the City:

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          Humanitarian efforts:

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          Close association with Channahon:

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          Geographical relationship of the street to the area of interest-of the nominee:

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          Responsible for an accomplishment of local, regional, national or international significance:

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          Other information (please attach additional sheets if necessary):

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I,                                                       , depose and say that the above statements are true and correct to the best of my knowledge and belief.
I agree to be present in person or by representation when this application is considered by the Village Board of the Village of Channahon.

Signature of Applicant:                                                                      Date:                                            

Applicant address: _______________________________________________________________________________________________________

Applicant Phone: ________________________________________________________________________________________________________

Applicant Email: _________________________________________________________________________________________________________

Submit all information to: ___________________________________________________________________________________________________

Village of Channahon
Attn: Michael Petrick
Department of Community Development
24555 Navajo Dr.
Channahon, IL 60410
Phone: [phone]
Fax: [phone]
[e-mail]

(Ord. 1871, passed 10-3-16)