92 Ill. Adm. Code 550.APPENDIX D
D Access Agreement
Section 550
Section 550.APPENDIX D Access
Agreement
STATE
OF ILLINOIS
DEPARTMENT
OF TRANSPORTATION
ACCESS
AGREEMENT
This agreement
covers the entire property served by entrance(s) described in Highway Permit,
District Serial No. __________. The entrance(s) to be constructed (is) (are)
to proved access to the following described property.
The undersigned
applicant (whether one or more) represents that he (they) is (are) the sole and
only owner(s) of the above described land and does (do) hereby covenant and
agree that the above described driveway(s) shall be the sole and only ingress
from and egress to the State highway for any or all of the above described land
whether same may now or hereafter be subdivided or owned in separate tracts or
parcels. Applicants further agree that the Department or its successors or
assigns may enforce such covenant by any proceedings deemed desirable at law or
in equity in addition to any other rights or privileges the Department has or
may have.
This agreement is hereby
accepted and its provisions agreed to this day of _____________ 19____
Approved this ___________ day
of
, A.D. 19____
Signed
Applicant
STATE OF ILLINOIS
Department of Transportation
Mailing
Address
By
Regional
or District Engineer
City
State
STATE OF)
)
)
)SS
COUNTY OF)
)
I,
______________________________, a Notary Public in and for said County and
State
aforesaid, do hereby certify
that
who ______________ personally
known to me to be the same person ___________ whose name ________________ subscribed
to the foregoing instrument appeared before me this day in person and
acknowledged that ______ he ______ signed, sealed and delivered the said
instrument as ______________ free and voluntary act, for the uses and
purposes therein set forth, including the release and waiver of the rights of
homestead.
Given
under my hand and notarial seal this ______ day of _______________ A.D.
19____.
Notary
Public
(SEAL)
My Commission expires
, 19____.
BT 1363