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Home My WebLink About101 N CHESTER AVEENCROACHMENT 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 12-30000016 Data 5/23/12 Property Address 101 N CHESTER AVE Application type description PW - ENCROACHMENT PERMIT Owner Contractor North of the River Chamber OMEP of Commerce P.O. Box 5551 - _Bakersf3e1d.-LA-93388 Permit ENCROACHMENT PERMIT Additional dean . . Phone ACcese Code . 1194331 Permit Pee . . . . .00 Iesue Data . . . . 4/25/12 valuation . . . . 0 ---------------------------------------------------------------------------- Special Notes and Comments North of the River Chamber of Commerce - Welcome Sign located at the north end of o.tbbound bridge of cheater Avenue, east side Contact Stan Shires 633-4839 --..--------------------"_-------------------_._-_----_-------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- - --------- Permit Fee Total .00 .00 .00 .00 Grand Total .00 .00 .00 .00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 tc revoke the per it at any ti Signature of pplicant (Owned gen Print Name O oe-,. 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 I: THEREFORE (GRANTED) (DENIED) Said permit shall expire on date stated above. Signature of Ofty Engineer e Additional Terms on the Back oFa„ es ENCROACHMENT PERMIT APPLICATION FORM v o CITY OF BAKERSFIELD �'�} PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE FIFO �P BAKERSFIELD CA 93301 (661)326-3724 Fax: (661) 852-2012 .TION OF ENCROACHMENT(Address required where available): /ZY6 -'AD Lt" N"Ier"e'cw 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 /1/0/zrH 4Ffi/c AWF-9 0,7172ea elf 61.fyr_Kce COMPLETE ADDRESS: i10. &,x 555 G/ PHONE:(d/)971- ASY, 941erSI/7/cr cPA 93SSS7 FAX: (641 ff7/- 4SS-4 CELL: PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): 12 71.11 ri+.c Ri✓p,e /unrmu.�� rJ ,>14�t,_2to�%f �<a ��>i �o ct//e�✓ PERIOD OF �TIME FOR ENCROACHMENT: EFINATE o OTHER: CONT (4G/)41S3 q�3y 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, m any of then, 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 !y or right of way where the same is located, and restore said public property or right of way to the condition as M 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 J vv Encroachment Permit Fee: $208.00 Wp1J lyglyslt. S:\ PERMITMENCROACMEncroachment Permit Req Form.DOC January 2009 A�CORDM CERTIFICATE OF LIABILITY INSURANCEoalaz INBR W571 42.2 o12 PRODucsa Dawn E. Woltz Insurance Services 2020 North Chester Ave., Suite A Bakersfield, CA 93306 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND .CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POLICYESURKTM dew imumnce@yahm.com 661-392.7290 fax 392.7294 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Mount Vernon Fire and Casualty North of The River Chamber of Commerce 3128 Edwards Bakersfield, CA 93306 INsuREae: INBORBN c: wsuREN v: NsuaEN E 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 CERTIFICATE MAY BE ISSUED OR HWY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR W571 POLICY NUMBER POLIOYEFFEGTIVE POLICYESURKTM LIMIT A X GBaNAL.R.G, EACHOCCURRENCE $1000Ooo 00 X COMMERCIAL GENERI�AL LIABILITY EI CLAIMB MgvE I..CUR NPP2104660B 02.12-2012 02-12-2013 PREMISESLES$. 100000.09 MED E% (ArM Dna um S 6000.00 PERSOWLLBAOVINURY $1000000.00 GENERALAGGNEGNTE 52000000.00 GEN'L AGGREGATE LIMIT ALRUES P0.1CY PRO- PER: LOC PRODUCTS-COMPIOPAGG slncluded AUTOMOBILELN&LITY ANYAUTO. COMBINED SINGLE LIMIT (Ea—dM l) s ALL OWNED MRCS SCHEDULEDAUTOS BOO Bhp rspwnl) S HMEDAUTOS NON-0WNEO AUTO. BODILY INJURY S (PN emden0 (POOFENBMGAMAGE $ GARAGELIINUTY AUTO ONLY -EA ACCIDENT $ ANYAU O OTHERTH9N EA ALC $ AUTOONLY: AGO $ EXCES.NIMaRELLALAMLM OCCUR CLAIM. MAGE EACH OCCURRENCE $ AGGREGATE $ S DEDUCTIBLE S RETENTION 5 S WORNERSCOMPmIUknONANO EMPLOYERS' LIABILRY WC STAT OTH- EL FACHACCIDENT $ PHY PROPRIUQRS`ANTNERIE%ECUrVE 0' ICERIMFAISER7CLUDEO7 ELDISEASE-EAEMPLOYEE S d: _EN_. _ Nry .PE LIALPROVI.IONSO._ E.L. DISEASE -POLICY LIMIT S O XER DESCRIPTION OF OPERATORS I LOCATIONS I VESCLESI..SIMS ADDED BY ENDORSEMENT I SPECIAL M MIONS Named as Additional Insured, County end County'S Board mem be re, officials, off(cers 8geTie and employees me Ing out of this Agreement and Deny operations related thereto. To be listed as Additional Insured for the tern of this policy or up to October 31, 2012 Additional Insured: $"W. ANYOFTHEABDYEDC---PDLILIESBECANCELLEDBEFORETHEE ,—ON County of Kem, its Officers, Agents and Employees DATE THEREOF, THE ISSUING INSURER WD.L ENDEAVOR To NAIL 10 DAYS WNIII. 2101 Oak Street NOTILETO THE CENTI =TE HOLDER NAMED TOTHE LEFT, BNT FAILURE TD DO SO SNALL Bakersfield], CA 93301 WOW NO OBLIGATION OR NABILDY OF ANY No UPON THE INSURER, ITS AGFXTs OR IMPORTANT If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certifimte holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer fights to the certificate holder in lieu of such endomement(s). DISCLAIMER The Certificate of Insurance on the. reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,extend or alter the coverage. afforded by the policies listed thereon. Chester Avenue.- Google Maps Google Address Chester Avenue near::: k........ Page 1 of 1 http://maps.google.com/maps?fes&source=s_q&hl=en&geocodc=&q=101+Chester+Aven... 4/25/2012 • Y, .4 K E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor II, Subdivisions DATE: May 1, 2012 SUBJECT: Encroachment Permit Application for: 101 N Chester Name of Applicant: North of River Chamber of Commerce Description of Encroachment: Welcome sign located at the north end of northbound bridge on Chester Avenue on the east side. Please review the attached encroachment permit and return to me at your earliest convenience. 5�r�ialy 411pl (Z S:TERMIMENCROACMTRAFFIMNOR Chamber of Commerm.doo • B A k: E R S F I F L LJ PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: May 1, 2012 SUBJECT: Encroachment Permit Application for: 101 N Chester Ave Name of Applicant North of the River Chamber of Commerce Description of Encroachment: Welcome sign located at the north and of northbound bridge on Chester Avenue on the east side. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S: PERMITS\ENCROACMINSURANCE\NOR Chamber of Commerce.doc