HomeMy WebLinkAbout12203 Home Ranch DriveENCROACHMENT PERMIT
CITY OF BAKERSFIELD
ti PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
f,L��c. BAKERSFIELD CA 93301
4L�rO (661) 326 3724
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA:
Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place,
erect, use and maintain an encroachment on public property or right of way as therein defined.
Application Number . . . . . 17- 30000016 Date 3/29/17
Property Address . . . . . . 12203 HOME RANCH DR
Application type description PW - ENCROACHMENT PERMIT
Owner
------------------ - - - - --
HESS CHRISTOPHER & SABRINA
12203 HOME RANCH DR
BAKERSFIELD CA 93312
Contractor
------------------ - - - - --
OWNER
----------------------------------------------------------------------------
Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 1993187
Permit Fee . . . . 213.00
Issue Date . . . . 3/29/17 Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 213.00
-------------------------------------------------- --- --- -------------- - - -- -- /►
Special Notes and Comments �7 /� // 4"49?
6' Block wall behind sidewalk on Humbolt ��- C �� C-/}�-1_(J�/ d � K
Way to match existing block wall on a y�
Noriega Rd.
Christopher Hess 203 -1725 e ��/�NG ►�iJl /�(y�/� �fuy/'
---------------------------------------------------------------------- - - - - --
Fee summary Charged Paid Credited Due
----------- - - - - -- ---- - -- - -- ---- - - - - -- -- -- - - - - -- -- -- ---- --
Permit Fee Total 213.00 213.00 .00 .00
Grand Total 213.00 213.00 .00 .00
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to
revoke the permit any time.
Sig natur pplicant ?Owner/Agent) Print Name
I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING
APPLICATION AND FIND THAT THE MAINTENANCE OF SAID ENCROACHMENT (1) WILL (NOT)
SUBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2)
WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE (GRANTED) (DENIED) Said permit shall expire on date stated above.
r1 ..
Signature of City Engineer
Additional Terms on the Back
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FB —AR ERs� ENCROACHMENT PERMIT
�•► APPLICATION FORM
d CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
'+tivt� 1501 TRUXTUN AVE
qLl F 0 BAKERSFIELD CA 93301
(661) 326 -3724 Fax: (661) 852 -2012
LOCATION OF ENCROACHMENT(Address required where available):
RIO'S Nome Rich Or 84AKerS�r -elJ , cal 933/Z
If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
APPLICANT INFORMATION
FULL NAME OF APPLICANT Ci r;- S+oPKer He-SS
COMPLETE ADDRESS: �2Z03 Nawte Re-,r►« Dr PHONE: 44ol- 2.03- /72s
&YNer% -9ce Ic! xA 933IZ FAX:
CELL:
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.): (—cecr e—+e b I oLK
PERIOD OF TIME FOR ENCROACHMEN INDEFINITE dr OTHER:
(Please Circle) '
CONTACT PERSON Cf%,--S4eA cr IV5-s PHONE: C� & / " Z 03 -/
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, its
officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever
against them, or any of them, before administrative, quasi-judicial, or judicial tribunals of any kind whatsoever, arising out
of, connected with, or caused by applicant's placement, erection, use (by applicant or any other person or entity) or
maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of
said encroachment or until such time that this permit is revoked.
Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or upon the
revocation thereof b the he City Engineer, applicant will at his own cost and expense remove the same from the public
property or right of way where the same is located, and restore said public property or right of way to the condition as
nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment.
Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for
however long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of Insurance
evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidencing
the insurance required. The type(s) and amount(s) of insurance coverage required are:
Residences: Homeowners General Liability coverage in an amount of at least $300,000.00
Commercial: Commercial Liability coverage in an amount of at least $1,000,000.00
The Commercial Liability policy must identify City and City's mayor, council, officers, agents, employees, and designated
volunteers as Additional Insureds.
Encroachment Permit Fee: $: �t3.1
S:\ PERMITS \ENCROACH \Encroachment Permit Req Form.DOC Aug. 2016
$AKERSFIEILD
Public Works Department
1501 Truxtun Avenue
Bakersfield, California 93301
(661) 326 -3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fence beside the sidewalk within the
public right -of -way.
1 -1 umbo 18+ By:Ckr:S-b?ker' NC4J.'4 HeSs
(Street for proposed encroachment) (Owners Name)
12203 Hc)&%f. gcsnGh cl r &1YtrS%2C ICI 91312 Phone- LU l'Z Z-S--
(Address of proposed encroachment)
SIGNED:
1.) Name:
Address: 12,241 *% "d- 14,4W 04 98312
2.) Name: Z4�001
Address: 1z'7-1y N "At r A/s' cN Pt-
3.) Name: 7—)(g DQ ✓'V- "1
Address: I ZU L t (uvu
4.) Name: i y>4-
Address: C ! Jr.
5.) Name: �
Address:
6.) Name:
Address: ?��iY 1 �(.�u r 'Cf L ►/
• See Signatures needed for approval page
Date: Z`i l7
Date: 71Z Y10
Date:
Date:
Date: `
Date: Nag 117
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I F� E R F I 1 1. 1 =�
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ed Murphy, Engineer III
FROM: Kirk Boland, Engineering Tech I
DATE: April 7, 2017
SUBJECT: Encroachment Permit Application for: 12203 Home Ranch Dr
Name of Applicant: Christopher Hess
Description of Encroachment: 6' block wall behind the sidewalk on
Hurnbolt Way to match existing block wall
on Noriega Rd.
Please review the attached encroachment permit and return to me at your earliest convenience.
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FROM:
DATE:
SUBJECT:
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B _A� R S' F T E L L>
PUBLIC WORKS DEPARTMENT
MEMORANDUM
Jena Covey, Risk Manager
4C
Kirk Boland, Engineering Technician I
April 7, 2017
Encroachment Permit Application for 12203 Home Ranch Dr
Name of Applicant: Christopher Hess
Description of Encroachment: 6' block wall behind the sidewalk on
Humbolt Way to match existing block wall
on Noriega Rd.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S \PERMITS \ENCROACH\INSURANCE \12203 Home Ranch Dr.doc
Universal North America Ins. Co. D-BILL: PENNYMAC LOAN SERVICES LLC PAGE: 1
Processing Center
D n rt- anal rnrkhnd rA 92016 -9061 RENEWAL
GA: 1 PRODUCER: 58179 (951) 653 -2619
ARROWHEAD GENERAL INSURANCE STEVE NICHOLS INSURANCE SERVICES
AGENCY, INC. 14420 ELSWORTH STREET STE 111
P 0 BOX 9061 MORENO VALLEY, CA 92553
CARLSBAD, CA 92018 -9061
CHRISTOPHER HESS AND
SABRINA HESS
12203 HOME RANCH DR
BAKERSFIELD, CA 93312
12203 HOME RANCH DR
BAKERSFIELD, CA 93312
POLICY NO: HCA10 0 2 0 9 7 Policy Period: 4/18/2U16 to 4/ 1 d/ 2 U 17
HOMEOWNERS DECLARATIONS 12:01 A.M. Standard Time at the Address of the Named Insured as Stated Herein.
COVERAGE PROVIDED WHERE
PREMIUM OR
LIMIT OF LIABILITY SHOWN FOR THE COVERAGE:
I - - - - -
- - - SECTION
I - - - -
- - - - I - - - SECTION II - - -
COVERAGES A.DWELLING
B.OTHER
C.PERSONAL
D.LOSS E.PERSONAL F.MEDICAL
AND LIMITS
STRUCTURES
PROPERTY
OF USE LIABILITY PAYMENTS
OF LIABILITY 413,500
41,350
206,750
82,700 300,000 1,000
THIS POLICY INCLUDES BUILDING CODE UPGRADE COVERAGE OF 10%
FOR LOSS UNDER SECTION I, WE COVER ONLY THAT PART OF LOSS OVER THE DEDUCTIBLE
STATED: $1000 LOSS DEDUCTIBLE.
SUMMARY OF PREMIUM:
BASIC PREMIUM $1426
ADDITIONAL PREMIUM $400CR
TOTAL PREMIUM $1026
POLICY SUBJECT TO THE FOLLOWING SURCHARGES, CREDITS,
FORM NO
EDITION
DESCRIPTION
HO 00 03
4/91
SPECIAL FORM
AHHO -SP CA
6/15
SPEC PROVISIONS CA
AHHO -GRID
7/11
INSURANCE DISCLOSURE
CA PHMITV
6/09
DWELLNG LIMIT NOTICE
HO 04 95
11/92
WATER BACKUP
AHHO -7A CA
6/15
SPECIFIED ADDL INS
HO 04 90
4/91
REP COST -PERS PROP
AHHO -82 CA
6/15
PERSONAL INJURY
UI GLB
12/13
UNA PRIVACY POLICY
USP 00
9/11
UNA SIGNATURE PAGE
HO 04 16
4/91
PREM ALARM /FIRE PROT
AGE OF HOME ADJSTMNT
LOSS FREE CREDIT
TRANSFR /RENEWL CREDT
TILE ROOF CREDIT
DEDUCTIBLE $1000
CA BOR
7/11
INSUR DISCLOSURE BOR
AHHO -10
6/09
CA INS GUARANTEE ASN
AHHO -50 CA
6/15
LIMITED FUNGI COVG
AHHO -9
6/09
LENDERS LOSS PAY END
OCC: PRIMARY TERR: 050 BUILT: 2005 FRAME
* CONTINUED
Date Issued: 03/29/16
1 COPY
TOTAL PREMIUM $1026.00
POLICY FEE $45.00
TOTAL POLICY $1071.00
ENDORSEMENTS AND FORMS:
LIMITS PREMIUM
$5000 $20
50% $71
$141
$300000 $18
PRT CLS: 002
$99CR
$127CR
$71CR
$71CR
$42CR
$240CR
Universal North America Ins. Co. D- BILL : PENNYMAC LOAN SERVICES LLC PAGE: 2
Processing Center
n onni f,_a�h,a re agn1R_anaa ADDITIONAL INFORMATION
ARROWHEAD GENERAL INSURANCE
AGENCY, INC.
P 0 BOX 9061
CARLSBAD, CA 92018 -9061
AMED INSURED AND MAILING ADDRESS
CHRISTOPHER HESS AND
SABRINA HESS
12203 HOME RANCH DR
BAKERSFIELD, CA 93312
y Nerioa:
RODUCER: 58179 (951) 653 -2619
STEVE NICHOLS INSURANCE SERVICES
14420 ELSWORTH STREET STE 111
MORENO VALLEY, CA 92553
12203 HOME RANCH DR
BAKERSFIELD, CA 93312
to
HOMEOWNERS DECLARATIONS 12:01 A.M. Standard Time at the Address of the Named Insured as Stated Herein.
POLICY SUBJECT TO THE FOLLOWING SURCHARGES, CREDITS, ENDORSEMENTS AND FORMS:
FORM NO
EDITION
DESCRIPTION LIMITS PREMIUM
AHHO -90 CA
6/15
WILDFIRE SUBLIMIT
CA OOL
6/09
ORD OR LAW DISCLOSUR
CAHO3 -HPD
6/15
PREM DISC AVAILABLE
HO 24 90
1/93
WORKERS COMPENSATION
UG 105C
6/09
CONSUMER AFFAIRS
CA TPN
12/15
THIRD PARTY NOTICE
** IMPORTANT **
POLICY DOES
NOT PROVIDE EARTHQUAKE COVERAGE
** IMPORTANT **
THE LIMIT
OF LIABILITY FOR THIS STRUCTURE (COVERAGE A) IS
NON - SUFFICIENT FUND
BASED ON AN ESTIMATE OF THE COST TO REBUILD YOUR HOME,
$25.00
INCLUDING
AN APPROXIMATE COST FOR LABOR AND MATERIALS IN
YOUR AREA,
AND SPECIFIC INFORMATION THAT YOU HAVE PROVIDED
ABOUT YOUR
HOME.
1ST PENNYMAC LOAN SERVICES LLC
MTG PO BOX 690450
ATTN CUSTOMER SERVICE ISAOA ATIMA
SAN ANTONIO, TX 78269-0450
THE FOLLOWING FORMS HAVE BEEN ADDED OR UPDATED: AHHO -SP CA(06/15)
CA PHMITV (06/09) AHHO-7A CA(06/15) AHHO-82 CA(06/15) AHHO -50 CA(06/15)
AHHO-90 CA(06/15) CAHO3 -HPD (06/15) CA TPN(12/15)
*FEE SCHEDULE:
THIS POLICY IS SUBJECT
TO THE
FOLLOWING FEES WHEN APPLICABLE.
INSTALLMENT PAYMENT
FEE
$7.00
PER PAYMENT
IF FULL ANNUAL PAYMENT NOT ELECTED
REINSTATEMENT
FEE
$15.00
PER REINSTATEMENT
IF POLICY CANCELLED AND WE AGREE TO
REINSTATE THE POLICY
NON - SUFFICIENT FUND
FEE
$25.00
CHARGED ON EACH CHECK /DEBIT CARD/
CREDIT CARD PAYMENT RETURNED UNPAID
ALL FEES APPROVED BY THE CALIFORNIA DEPARTMENT OF INSURANCE.
THE POLICY FEE DISCLOSED ON THE FRONT PAGE OF YOUR DECLARATIONS PAGE AND
THE ADDITIONAL FEES DISCLOSED ABOVE ARE FULLY EARNED AND ARE NOT SUBJECT
TO REFUND IN THE EVENT THE POLICY IS CANCELLED.
Date Issued
1
03/29/16
* END OF POLICY DECLARATIONS *