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245 MAIN ST
CITY OF EDMONDS DATE RECEIVED -5-11 Z
COMMUNITY SERVICES DEPARTMENT
250 5th Ave N DATE ISSUED
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7
771-3202 -7
PERMIT NO.— Cq7 -3
APPLICATION FOR STREET USE PERMIT M V
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Name of Applicant: EDMONDS ARTS COMMISSION (Linda McCrystal)
Mailing Address: 7nn Main Strept Edmonds, WA 98020
Telephone Number: _ 77; --- 2525, ext- 969 Date: 5112.1,97
Description of Public Place or Portion thereof desired to be used: (exhibit
may be attached)
sirfi-walk and under canopy at The Main Place, 5th & Main Streets
Type of Use desired to be made of Public Place: free noontime concerts for
thiz 13ijh]Jr n'n' f-hoge dateso Kay 13. July 14, August 25 - 11:30 a.m. to 1:00 p.m.
If applicable, attach plans and specifications for any utility or structure to
be erected and/or maintained on the Public Place:
TEMPORARY PERMIT: Unless otherwise designated herein, this permit is understood
by applicant to be wholly of a temporary nature, that it vests no permanent right
whatsoever. If the permitted use becomes dangerous or such structure shall
become insecure or unsafe or shall not be constructed, maintained or used in
accordance with the provisions of this title, the same may be revoked and the
structure and obstructions ordered removed by order of the City Engineer. If this
application is for a specifi.ed Deriod of time, the terms of said application is:
INDEMNITY: Applicant understands and by. his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its department or employees,
including but not limited to the defense or any legal proceedings including defence
costs, court costs, and attorney fees' by reason of granting this permit. In
addition, applicant understands that the City shal.1-be provided a certificate of
insurance to indemnify and hold the City of Edmonds harmless from all claims
and/or property damage, naming the City of Edmonds as an also insured.
APPLICATION OF CHAPTER 18.70 OF THE COMMUNITY DEVELOPMENT CODE: Applicant warrants
that he has read, or had the opportunity to read, Chapter 18.70 of the Community
Development Code, attached herewith, and understands that all terms of that
Ordinance are incorporated h6rein as if set forth in full and this application
and permit therefore are subject to the terms of that Chapter of the Edmonds City
Code.
,Kpplic*'nt's Signature
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City of Edmonds, Community Services Department
,APPLICATION FOR STREET USE PERMIT - - Page 2
Approval (and Agreement, if applicable) of Abutting Property Owners:
SIGNATURE PRINTED NAME ADDRESS DATE
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
ty Council Approval (ff appl.icable)(Attach Minu�e Entry):
�1'1 Approval (if applicable)(Attach Minute Entry):'
Building Official Approval (if applicable): A14
Si�nature Date
Provision for Indemnity: City of Edmonds Insurance Pool
lle�lef R4011yd-T 4TY 6,oaetul /(,V� 64
Terms and Provision of Performance Bond, if applicable:
41114
PERMIT AUTHORIZATION BY: gg2�,g6 - .,& S-/.T - s-,;7
SigfMture Date
PERMIT NO. 6?17--5 Date Issued: 7 Permit Fee: ff46-W411110
RELEASED B RECEIPT NO. ,49�IL BUILDING PEFE-ITIf
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Remarks/C mments�:(,--j
FIRE DEPARTMENT APPROV
POLICE DEPARTMENT APPROVAL
ENGINEERING DEPARTMENT APPROVAL
PUBLIC WORKS DEPARTMENT APPROVAL
DATE
DATE C-1 2- 4--7
DATE
DATE