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HomeMy WebLinkAbout10117 Revere Beach DrENCROACHMENT 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. i Application Number . . . . . 17- 30000028 Date 8/02/17 Property Address . . . . . . 10117 REVERE BEACH DR Application type description PW - ENCROACHMENT PERMIT Owner ------------------ - - - - -- HAMPTON JOHN P & COURTNEY D A 10117 REVERE BEACH DR BAKERSFIELD CA 93314 Contractor ----------------- -- - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2058014 Permit Fee . . . . 420.00 Issue Date . . . . 8/02/17 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments August 2, 2017 12:10:15 PM mmendenhal. Move existing 6' wooden fence at side of house to back of sidewalk. Keep 4' away from side of mailbox. MUST FOLLOW SIGHT DISTANCE REQUIREMENTS PER ATTACHED PROPOSED CITY STANDARD T -11 DATED 12 -2015. Contact person: John Hampton 331 -1444 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- --- - - - - - -- ---- - - - - -- Permit Fee Total 420.00 420.00 .00 .00 Applicant arGow�e ges the righf�o��he City Engineer, pursuant to thg °Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. o--m �'� c Si natu P6 kf A p scant (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) Sam 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, agent: and employees against any and all liability, claims, actions, causes of action or demands whatsoever against them, or any o 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 o entity) or maintenance of said encroachment, whether or not caused in part by a party indemnified hereunder, except for CITY': sole active negligence or willful misconduct. The applicant further agrees to maintain the aforesaid encroachment, including, bu not limited to, repairing or replacing the encroachment at Applicant's cost even if CITY inadvertently damages or destroys thf encroachment in the ordinary course of CITY's business, during the life of the said encroachment or until such time that thi: permit is revoked. Applicant further agrees that upon the expiration of the permit for which this application is made, if granted, or upon revocatioi thereof by the City Engineer, applicant will at his own cost and expense remove the same from the public property or right of wa where the same is located, and restore said public property or right of way to the condition as nearly as that in which it wa 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 howeve long the encroachment remains. Applicant shall furnish the City Risk Manager with a certificate of issuance evidencing sufficier coverage for bodily injury or property damage liability of both and required endorsements evidencing the insurance required. I (nave read and acknowledge the above. �• Applicant's Initials ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where available): /Qd 7 Jeey,, - ] l If there is no address adjacent to work descri FULL NAME OF APPLICANT limits of work by distances from nearest existing street intersection. PPLICANT INFORMATION V1 COMPLETE ADDRESS: / O I / 7 i0r^!�e re ►3 c -1�cL� �t. 2�r i, --e,4- ;c 1d, moo. 1��3 %�f PHONE: FAX: CELL: (�&./- 33 % / /jf q PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): P10 v '✓�i Fri • E�)I,.5,'119 eEA PERIOD OF TIME FOR ENCROACHMENT: DEFINI or OTHER: (Please Circle) e CONTACT PERSON \Fi b. -I /L AO^ PHONE: 60- w J "Iyq 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 Ci 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: $: 213 S: \PliRMI'I'S \I ?NCROACI I \I?neroachment Permit Req Fonn.DOC Aug. 2016 Revere Beach Dr r *f ✓,�+� i'�;. : kevel E: bunk -1 i li; Q1 Cr 0 I O Z- C �• • G� Nt _. - � r N �J 10117 Revere Beach Drive 0- 0 Ur a Cl /I Imagery 02017 Google, Map data rr2017 Google Google Y m W a I � � Q O O •wN• ;+�•� ;"4s z� = ,09 -• ; ;ro PUD 4+rlo J / � Q Cr- 3rd � O Zf � 3No m n' It Google Maps GO, ,gle Maps 10117 Revere Beach Dr Page 1 of 1 Imagery 02017 Google, Map data ©2017 Google United States 20 ft https: / /www.google.com /maps / @3 5.4355295, - 119.1157829,61 m /data =! 3m 1 ! 1 e3 ?hl= en &au... 8/2/2017 Talbot Port Way - Google Maps GO gle Maps Talbot Port Way Page 1 of 1 image capture: Feb 2012 © 2017 Google United States Bakersfield, California Street View - Feb 2012 ro n 9e Dr https://www.google.com/maps/@35.4355788,-119.1161204,3a,75y,l 28.14h,89.54t /data =! 3... 8/2/2017 • BAKERSFIELD 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. U6 28A W B: P 4 Co o qefflohd (Street for proposed jepnccrooachmenn� r �/ ^ (Owners Name) l�IG�I�( /►�) �`�I� Wye, c Vi. 101 111' �C' _ Phone- um —M4 — 1 (.d (Address of proposed encroachment) SIGNED: 1.) Name: �`� �G��Y� 1�"' Date: T1 Ito l Address: 2.) Name: 1" ad WaLlt 1 Date: Address: 1624 ItM I I, 3.) Name: Address 4.) Name: Address: 5.) Name: cA 006-ez <;.- LANk5;t6 Address: iRt-,-E c m hfZ - 6.) Name: --VOLe Address: V �--q,, t'ut C \L. VAC"," • See Signatures needed for approval page Date: 1 L)I I /7 Date: % I%l �I�l T Date: 7 I ;? --:11 l-7 Date: c d - _ R W IF - N s '1 v - - m _ - = N O 0 0 U -a co L _ (6 m F zm _ Z rc _ x .r�.rM.11- vIf1- MY-m-- Q I 0 N _ N Q MINIMUM SIGNATURES NEEDED FOR APPROVAL OF APPLICATION, IF APPLICANT IS UNABLE TO OBTAIN A REOUIRED SIGNATURE PLEASE SUBMIT A LETTER STATING REASON FOR OMISSION. Street Centerline ►q�q�q 1.t. ♦ggl•q�qqqqqjqq, gjgj��qqqqqq�qqqq� ggqqGqqqqqq�qqqlq•� ��q�q�j►�i�j�q�q�q� FO BLOC LOT ---------------- -------------------------------- - — — — — — — — Lxistin __ _ 9gosed Sidewolk Curb and Gutter Street Centerline A�COR °® EVIDENCE OF PROPERTY INSURANCE DATE(MMlDD/YYYY) THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 7 UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPR . ESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. —. AGENCY PHONE — -- 6615891991 COMPANY SU Na Ca NAIC 111 25143 r.,,.,.< STATE FARM INSURANCE _! TOM SMETHURST State Farm Fire and Casualty Company 13061 ROSEDALE HWY STE A BAKERSFIELD, CA 93314 FAX E-0A eG ,— WC. N.I. - 6615891833 I tnm smolhnrct h7con�• • .. __ CODE: INSURED JOHN & COURTNEY HAMPTON 10117 REVERE BEACH DR BAKERSFIELD, CA 93314 FKUPERTY INFORMATION LOCATIONIDESCRIPTI ON 10117 REVERE BEACH DR BAKERSFIELD, CA 93314 LOAN NUMBER 0488599341 EFFECTIVE DATE EXPIRATION DATE 03/3012017 03/30/2018 THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER 87- CR- F947 -6 CONTINUED UNTIL TERMINATED IF CHECKED THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE / PERILS rFORMS A- DWELLING — - – AMOUNT OF INSURANCE _ DEDUCTIBLE DWELL EXT 341400 1000 ALL PER B -PERS PROP 34140 C -LOSS USE ACT LOSS 256050 L -PERS LIAB DMG TO PROP 300000 M -MED /PERS 500 1000 S ANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NAME AND ADDRESS WELLS FARGO BANK NA #936 ITS SUCCESSORS AND /OR ASSIGNS PO BOX 100515 FLORENCE SC 29502 -0515 ACORD 27 ADDITIONAL INSURED LENDER'S LOSS PAYABLE X MORTGAGEE LOAN a 0488599341 AUTHORIZED REPRESENTATIVE ©1993 -2015 ACORD The ACORD name and logo are registered marks of ACORD LOSS PAYEE TION. All rights reserved. 1004363 142988.2 01 -21 -2016 "00e Y A K E R S F I E L L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager 4Q--/ FROM: Michelle Mendenhall, Engineering Technician I DATE: August 16, 2017 SUBJECT: Encroachment Permit Application for: 10117 Revere Beach Dr Name of Applicant: John & Courtney Hampton Description of Encroachment: Move existing 6' wooden fence at side of house to back of sidewalk. Keep 4' away from side of mailbox Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\ PERMITS \ENCROACH \INSURANCE \10117 REVERE BEACH DRAM TO: FROM: DATE: SUBJECT: "Ooe P, _- K E h ti F I E L L) PUBLIC WORKS DEPARTMENT MEMORANDUM Ed Murphy, Engineer III Michelle Mendenhall, Engineering Tech I August 16, 2017 Encroachment Permit Application for: 10117 Revere Beach Dr. Name of Applicant: John & Courtney Hampton Description of Encroachment., Move existing 6' wooden fence at side of house to back of sidewalk. Keep 4' away from side of mailbox Please review the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS \ENCROACH \TRAFFIC \10117 REVERE BEACH DR.doc