HomeMy WebLinkAbout5118 Coxwold Abbey CtENCROACHMENT PERMIT
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
(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- 30000022 Date 6/01/17
Property Address . . . . . . 5118 COXWOLD ABBEY CT
Application type description PW - ENCROACHMENT PERMIT
Owner
------------------------
ARELLANO ANGELICA M
5118 COXWOLD ABBEY CT
BAKERSFIELD CA 93307
Contractor
------------------ - - - - --
OWNER
----------------------------------------------------------------------------
Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 2026151
Permit Fee . . . . 213.00
Issue Date . . . . 6/01/17 Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 213.00
----------------------------------------------------------------------------
Special Notes and Comments
June 1, 2017 3:15:27 PM mmendenhal. MUST FOLLOW SIGHT DISTANCE REQUIREMENTS
Place 6' block wall at back of sidewalk PER ATTACHED PROPOSED CITY STANDARD T -11
on side street, Oswell Point Ln. Will
leave 4 ^clearance from mailboxes. DATED 12 -2015
wu�fww�►
Contact person: Maria Govea 661 - 556 -1747
----------------------------------------------------------------------------
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 at any time.
Sigg ature of Applicant (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) (p.E�NIED) Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
Applicant agrees that if this application is granted, applicant shall indemnify, defend, and hold harmless 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 or judicial tribunals of any kind whatsoever, arising out of connected with, or caused by applicant,
or in any way arising from, the terms and provision of this permit or the placement, use (by applicant or any other person or
entity) or maintenance of said encroachment, whether or not caused in part by a party indemnified hereunder, except for CITY's
sole active negligence or willful misconduct. The applicant further agrees to maintain the aforesaid encroachment, including, but
not limited to, repairing or replacing the encroachment at Applicant's cost even if CITY inadvertently damages or destroys the
encroachment in the ordinary course of CITY's business, during the life of the 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 revocation
thereof by the 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 must contact Dig -Alert at 811 at least 2 full working days prior to all excavating.
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 issuance evidencing sufficient
coverage for bodily injury or property damage liability of both and required endorsements evidencing the insurance required.
I have read and acknowledge the above.
7_ Applicant's Initials
U
2.
A = 6' Without Parking (Always used on Arteriols & Collectors)
A = 12' Kth Parking
O =Sight Distance
D =Sx10'
S = Critical Speed (65th Percentile) or ff not known,
use Design Speed on thru street.
A
1
Maximum
Encroachment
Design Speeds
60' R/W 25 MPH
90' R/W 55 MPH (i/ not multi —lane)
90'RIW 65 MPH
I 110' " 65 MPH
a- rri-r_
D
_L
3' off centerline or
median edge
D
Rowline
15'
7�jl— I— re oint
I
CONTROLLED INTERSECTION
Clear sight area at olleys or driveways, is determined by
measuring 10' along bock of sidewalk and 10' along edge of
alley or driveway. Anyfhing within this triangle must be no I
taller than 3' above Nowlin. ff there is no sidewalk,
measurement will be taken from and along R/W line. See
Municipof Code Section 1708..175
I }
Rowline 60'
No Obstruction to Motor &ic /e
Oriw view in Excess of Three
Feet Higher than flowline in Mis
Area.
Rowline UNCONTROLLED IN TERSEC T1 ON
Rowline
110,1 1 10' !0'
!0' 10' 10' !0'
Drimwoy Alley
Clear Sight Area for Driveway or Alle y
N. T.S.
STANDARD "12i2015
NOIFS SIGHT DISTANCE oRA s,1D cEc
Both criteria govem at on uncontrolled T— Warsectia?. REQUIREMENTS FOR CRDCM RJS
All sight line requirements ore per Sec 17.08.175 INTERSECTIONS SCALE NTS
of the Municipal Code APPROVED SNE£T ND.
CfTY OF BAKER8FIELD
CALIFORNIA T -1 1
CCTV ENGINEER PUBLIC WORKS DEPARTMENT
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 �pj"l W ieo etrl
COMPLETE ADDRESS: 5 i iq, noxwo H hk PHONE:((-&I- Q Q 5 7 ffy
FAX:
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT ( Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.): �� zn � �� 1AY1- t
b
PEIZIOD OF TIME FOR ENCROACHMENT INDEFINITE r OTHER:
CONTACT PERSON I �� r x / a PHONE: �� �— 5S:5 tli °1
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 by the City Engineer, applicant will at his own cost and expense remove the same from the public
grope , 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: $: 2-13'=
S :IPERMITSIENCROACMF- ncroachment Permit Req Form.DOC Aug. 2016
U1
.000� 0 MROMMP
SAKE RS FIELD
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. t
C/(N'Wdd ( ellwjBy: �6-kAALJ.'G( (Street ` o+r� proposed encroachment) jV (� t f (Owners Name) �% Z,
5 11 if �nY, 1 A^ I A 11 h,- 1L U l_ 1� Phone- I Kl L— l 6 ) D 36 1+
Addrdss-of pro ed n oachme t) ,
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SIGNED:
1.) Name: Date: �017
Address: 'X Xuip — n
2.) Name: , ., �L mac( k-�kci Date: Z�a / l z
Address: 611
3.) Name: G /�., l/ ✓ �S i Z• Date:
A
4.) Name:
N., WON
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IF APPLICANT IS UNABLE TO OBTAIN A REOUIRED SIGNATURE
PLEASE SUBMIT A LETTER STATING REASON FOR OMISSION.
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K E R S F I E L L)
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ed Murphy, Engineer III
FROM: Michelle Mendenhall, Engineering Tech I
DATE: June 14, 2017
SUBJECT: Encroachment Permit Application for: 5118 Coxwold Abbey Ct
Name of Applicant: Hortencia Mata & Angelica Arellano
Description of Encroachment: 6' block wall on side yard (Oswell Point Ln)
at back of sidewalk.
-fit'
Please review the attached encroachment permit and return to me at your earliest convenience.
S: \PERMITS \ENCROACH \TRAFFIC \5118 COXWOLD ABBEY CT.doc
B _A- K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager l
FROM: Michelle Mendenhall, Engineering Technician I
DATE: June 14, 2017
SUBJECT: Encroachment Permit Application for: 5118 Coxwold Abbey Court
Name of Applicant: Hortencia Mata & Angelica Arellano
Description of Encroachment. 6' block wall located on the side yard
(Oswell Point Ln) at back of sidewalk
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S: \PERMITS \ENCROACH \INSURANCE \5118 COXWOLD ABBEY CT.doc
ENCROACHMENT PERMIT
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
(661) 326 -3724
*O THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA:
'ursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place,
rect, use and maintain an encroachment on public property or right of way as therein defined.
Application Number . . . . . 17- 30000022 Date 6/01/17
Property Address . . . . . . 5118 COXWOLD ABBEY CT
Application type description PW - ENCROACHMENT PERMIT
Owner
------------------------
ARELLANO ANGELICA M
5118 COXWOLD ABBEY CT
BAKERSFIELD CA 93307
Contractor
------------------ - - - - --
OWNER
----------------------------------------------------------------------------
Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 2026151
Permit Fee . . . . 213.00
Issue Date . . . . 6/01/17 Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 213.00
----------------------------------------------------------------------------
Special Notes and Comments
June 1, 2017 3:15:27 PM mmendenhal.
Place 6' block wall at back of sidewalk
on side street, Oswell Point Ln. Will
leave 4' clearance from mailboxes.
Contact person: Maria Govea 661 -556 -1747
----------------------------------------------------------------------------
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 tc
evoke the permit at any time.
3ig ature of Applicant (Owner /Agent) Print Name
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;
3UBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2
NILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION I�c
THEREFORE (GRANTED) (DENIED) Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
aax
ENCROACHMENT PERMIT �y
APPLICATION FORM
r CITY OF BAKERSFIELD
0
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
QLI F F 0 (661) 326 -3724 Fax: (661) 852 -2012
LOCATION OF.ENCROACHMENT(Address required where available): Nil LoKlO d M G U^
If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
FULL NAME OF APPLICANT
COMPLETE ADDRESS: v j i
DESCRIPTION OF ENCRO
planter, etc.):
AP
M1a
IM
FAX: Z
CELL: Q `)
PROJECT INFORMATION
MpENT (Example: Wood or wrought iron fence, concrete block wall, raised
f -kIq
PERIOD OF TIME FOR ENCROACHMENT INDEFINITE r OTHER: r
CONTACT PERSON I v� ✓ -
PHONE: [G �— 5 6; -I 7Z
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 by the City Engineer, applicant will at his own cost and expense remove the same from the public
1
ropeMor 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:
Au
e 2016
SAPE?RMrrSU ?NCROACI I \Eaicroachment Permit Req Form.DOC `
Issued: 12105/2016
Universal North America Insurance Company
Homeowners
P.O. Box 901036 Fort Worth, TX 76101 -2036
New Business Declarations Page
Policy Service: 1- 866- 458 -4262
DECLARATION EFFECTIVE: 11/30/2016
Claims Service: 1- 866- 999 -0898
DIRECT BILL
www.universalnorthamerica.com
$20.00
Policy Number
From Policy Period
To
Agent Code
GAVH0000079752 -0
11/39116
11/30/17 12:01 AM STANDARD TIME
11474
NAMED INSURED AND ADDRESS:
AGENT: 661 396 -3660
ANGELICA M ARELLANO
HORTENCIA F MATA
5118 COXWOLD ABBEY CT
BAKERSFIELD CA 93307 -2996
IVANTAGE SELECT INS AGENCY INC
GAMAL AHMED
218 SOUTH H STREET
SUITE 103
BAKERSFIELD CA 93304
PREMIUM SUMMARY
Basic
Coverages
Premium
Attached
Endorsements
Premium
Scheduled
Property
Premium
Fees
Total Policy
Premium
& Fees
$496.00
$43.00
$.00
$20.00
$559.00
LOCATION
FORM
CONST
YEAR
USE
NUM FAM
I OCCUP
PROT CLASS
TERRITORY
HO -3
FR
1997
Primary
Owner
02
44
EARTHQUAKE
INCLUDED
COUNTY
CODE
PERSONAL PROPERTY
REPLACEMENT COST
N
Kern
Y
Coverage is provided where premium and nmii of na4nhry is stww11.
Important Notices:
Coverage for flood damage is not provided by this policy.
Coverage for earthquake damage is not provided by this policy.
Loss Assessment for Earthquake is NOT covered by this policy.
Contact your agent for additional information on how to obtain these coverages.
THIS POLICY INCLUDES ORDINANCE OR LAW COVERAGE = 25%
COVERAGES -SECTION I LIMITS PREMIUMS
Coverage A. Dwelling Liability $190,000 $ 4 7 5
Coverage B. Other Structures $19,000 1 NCL
Coverage C. Personal Property $142,500 1 NC L
Coverage D. Loss of Use $38,000 1 NC L
SECTION I COVERAGES ARE SUBJECT TO A $1000 ALL PERU, DEDUCTIBLE PER LOSS.
COVERAGES — SECTION 11
Coverage E. Personal Liability
Coverage F. Medical Payments
LIMITS PREMIUMS
$300,000 $21
$5,000 INCL
LOCATION(S) OF PROPERTY INSURED
5118 COXWOLD ABBEY CT, BAKERSFIELD CA 93307
Countersignature '
UNA HOP CA DEC OS 09
Insured Copy Continued on Next Page... PAGE 1
Issued: 12/05/2016
Policy Number From Policy Period To I Agent Code
CAVH0000079752 -0 11 30 16 11/30117 12:01 AM STANDARD TIME J 11474
ADDITIONAL INTERESTS MORTGAGEE(S)
FIRST MORTGAGEE
GUILD MORTGAGE COMPANY
AND /OR ISAOA
PO BOX 85304
SAN DIEGO, CA 92186 -5304
LOAN NUMBER: 177 - 2002307
POLICY FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY
NUMBER
EDITION
DESCRIPTION LIMITS
PREMIUMS
HO 00 03
10 -00
Homeowners 3 Special
I NCL
HO 04 10
10 -00
Additional Interests
I NCL
HO 04 96
10 -00
No Sect H Liab Cov for Home Day Care
I NCL
UI 101
10 -12
Animal Liability Exclusion
I NCL
UI 108
02 -07
Trampoline Liability Exclusion
I NCL
UI GLB
03 -15
Privacy Notice
I NCL
UN 09 74
02 -08
Intentional Loss Exclusion
I NCL
UN 09 96
03 -08
Pollution Exclusion
I NCL
UN 10 07
03 -14
Special Sublimit - Late Wildfire Claim Reporting
I NCL
UN 10 08
09 -15
Special Provisions - California
I NCL
UN 32 85
06 -08
CA DOI Consumer Affairs Div Notification
I NCL
UN 32 86
06-08
CA Residential Prop Ins Disclosure
I NCL
UN 32 87
07 -11
CA Residential Prop Ins - Bill of Rights
I NCL
UN 30 32
01 -16
Notice of Extension of Communication to Third Parties
I NCL
HO 04 16
10 -00
Premises Alarm or Fire Protection
$
—24
Type of Device: Smoke /Fire Alarm/Fire Ext, DBolts
HO 24 90
08 -01
Workers'Compensation for Private Res Employees
$
5
UI EBEE
01 -14
Equipment Breakdown Enhancement
$
25
Limit: $50,000 per occurrence and $100,000 aggregate
UN 09 56
04 -09
Executive Homeowners Coverage F o r m
$
1 1 3
UN 09 80
09 -15
Fungus, Wet or Dry Rot or Bacteria (1103)
1 NCL
UN 30 30
01 -16
Earthquake Insurance Offer
I NCL
Affinity Discount
$
—24
Deductible Adjustment
$
—52
Policy Fees
$
20
THE LIMIT OF LIABILITY FOR THIS STRUCTURE (COVERAGE A) IS BASED ON AN
ESTIMATE OF THE COST TO REBUILD YOUR HOME, INCLUDING AN
APPROXIMATE COST FOR LABOR AND MATERIALS IN YOUR AREA AND
SPECIFIC INFORMATION THAT YOU HAVE PROVIDED ABOUT YOUk HOME-
This replaces all previously issued policy declarations, if any. This policy applies only to accidents, occurrences, or losses which happen during
the policy period shown above. In case of loss under Section I, only that part of lass over the stated deductible applies. This declarations page
together with all policy provisions and any other applicable endorsements completes your policy.
Please contact your agent if there are any questions pertaining to your policy. If you are unable to
contact your agent, you may reach us at: 8664584262 for Customer Service and 866 -999 -0898 for
Claims.
UNA HOP CA DEC 05 09
Insured Copy PAGE 2