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HomeMy WebLinkAbout9501 RIDGE OAK DRBAKE ENCROACHMENT PERMIT CITY OF BAKERSFIELD o PUBLIC WORKS DEPARTMENT .� 1501 TRUXTUN AVE .raa'V' BAKERSFIELD CA 93301 c`ILIFO (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 . . . . . 12-30000023 Date 6/04/12 Property Address 9501 RIDGE OAK DR Application type description PW - ENCROACHMENT PERMIT Owner contractor ------------------------ ry1 Nn'r^AA Pii.1F+�/�1i1`-�i`/\ OWNER ,+dueEtc) --(Mat-3------------------------------------------ Permi[ . . ENCROACHMENT PERMIT Additional desc . . Phone Accede Code 1207125 Permit Fee . . . . 208.00 Issue Data . . . . 6/04/12 Valuation . . . . 0 Oty Dnie Charge Per Extension 1.00 206.0000 EA PW ENCROACHMENT 208.00 ---------------------------------------------------------------------------- Special Notes and Comments Panama BV School Dist. 4200 Aahe Rd., 93313 - Location Hart Elementary School - 9501 Ridge Oak - Move existing Chain link fence to back of sidewalk on Mountain Oak Road. Contact: Michael Buckey 661-724-7165 .lune 4, 2012 10:11:06 AM mmendenhal. 1 Pee s dry charged Paid -------- ted Due Permit Fee Total 208.00 208.00 .00 .00 Applicarft`&+68ii&dges the rf6At°6f the (5* Vi-gineer, P9%uant to fie Bakersfield Municipal Code Chapter 12.20 tc revoke the permit at any time. 'iep �% 7 Cr9GaCcP .mac '7 e L ('/t 7��!^YG L Signature of Applicant (O el!Tq� /- — Print Name I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOINC 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) A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION I: THEREFORE (GRANTE (DENIED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back /� RA oqe� s ENCROACHMENT PERMIT APPLICATION FORM v o CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT ® 1501 TRUXTUN AVE yIFO BAKERSFIELD CA 93301 (661) 326-3724 Fm: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where available): Hart Elementary School 9501 Ridge Oak Drive. Bakersfield, CA 93311 If there is no address adjacent to work describe limits of work by distances from neatest existing street intersection. APPLICANT INFORMATION FULL NAME OF APPLICANT Panama -Buena Vista Union School District COMPLETE ADDRESS: 4200 Ashe Road PHONE: 661-397-2200 Bakersfield, CA 93313 FAX: 661-831-1484 CELL: 661-724-7165 PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): Install fence behind existing sidewalk, in city right of way, as per plan. PERIOD OF TIME FOR ENCROACHMENT: INDEFINATE or OTHER: (Please Circle) CONTACT PERSON Michael Buckey PHONE: 661-742-7165 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 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. Thetype(s) and amount(s) of insurance coverage required are: Residences: Homeowners General Liabilitycoverage in an amount of at least $300,000.00 Commercial: Commercial Liability coverage in an amount of at least $1,000,000.00 Encroachment Permit Fee: $208.00 S:\PERMITS\ENCROACH\Encroachment Permit Req Foma.DOC January 2009 ACORQ CERTIFICATE OF LIABILITY INSURANCE Self Insured Schools of CA PO Box. 1847 Bakersfield, CA 93303-1847 Self Insured Schools of CA SISCII 1300 17th Street PO Box 1847 Bakersfield, CA 93303-1847 SI$C I & II Member Districts (See atti RI S AFFORDING COVERAGE NAIC R Self Insured Schools of Calif. -- T !E POLICIE6Of INSURANCE LISTFO BELVAN HAVE BEEN IBSUFD TO THE INSURED NAMED ABONE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG ANUIHON ANY REOUIR@dENF. TERM OR OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY DERN E 65UE0 Ca MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED. HEREIN IS SUBJLCT TO ALL THE TERNS, EXCLUSIONS AND CONDITIONSE, POLICIES AGGREGATE LiMHS SHOWN MAY HAVE BEEN REDUCED BY RED CLAIMS . iia. VU, p TYPE OF GI PnNLL ICY.Uv Ipq EICYIFEI E P.'.ENXPII '—_ _ E ILO - ___ SLP 7109 10i 07/01/2009 07/01/2030 xoc CE ie 1500,000 r MNEacmL kM1r nA.i tE n : I EM..LTo.C! Lo xEnWa I :s I nnswv L I t o rO: v Fxr IA on r A _.. t F snx nr '3 aENOw, rcr TC S gEeiL AOOPFG- OMIT LPPLIE9PCRl T .... :PROTUOT4GOMf"OP nOG x 1 JCr T PRS TOG ''.. uiDM eeELuswY SAP 7109 10'', 07/01/20091-07/01/2010 rornmrmG G u1NT CY IIUI IS XIMr ro 51',000 DIED ACV COMP/COLD r I 1 500,000 L wmILIG9 ..•-.._ A k SG 1EOl t[DANOS. 1 ebur lnnav ' ' II'm Mrcnl IS I E uow __ . arrxeo AJT05 "HE PYw .M _ . GARAGE ENUOTY ALUDONLY CA .0 CIPfNi S t ;.. inrn nma ! I 'CIS •3 NP. ONLY UiG G,1_ AGG E%CE 5 ONrIRfLIAt Rlt _Y cnn ocw nucc a .. D H r/u Mn.]G A GNB; rF I _ _ j uc INErrnar I s t � 1 f -- rs wORNEns coxrexGAnox LANDEMPLOYERSLABILITY RIC 7109 10 0] O1 2009 ; 0710112010 "'- lv u — / / TS [t4 ANY F'EIOH:PARiNTW %ECJ Ivk A ''AFF FRnk c i I.� _QI ` EACH A[C ! -t 1 DDDr 000 YxaNO FL oavn covLEa I6PEfIALPHOVSRINGEI- _1,000,D00 _ _' 1.110, T!E 1,000.00 DsBLANKET .BLANKET BUILDINGS & '', SPP 7109 301 07/01/2009 07/01/2010 LIMIT 5250,000 A PERSONAL PROPERTY I, $2,500 DEDUCTIBLE —� oVRIYn4x OF OnEMi OHG LO gilOHS rvENI¢E9I CYCYe510N5 A0 ED BYENDOPSEMERDGPELM tIN.VDIpN9 �— — arious permits and use of various facilities, for whichthe City of Bakersfield, its mayor, Council, Officers, agents, employees and designated volunteers are listed as additional insureds, as respect$ attached list of school districts Covered under the 5ISC M1C. (See attached list) CERTIFICATE HOLDER CANCELLATION SNODLD Axl OF THE ACOVEOCSCWDEO PP.'OU. HEµ'r011L. BEFORE THE CXTINATION pgTE TNEREGq THE 155'JIx6 W5JRER W4' ?QuklSwRI City Of Bakersfield FOTCE TO THE CCN9FlCATE HOLDER RAMEDTO THE -EFT, OOi FMIEURE TO 00500HAL.L Risk Mandgenent IMPOSE NO ORDAT10N OR UNINUTY OR ANY Num JPON THE N DUR, ITS AOerns oR Attention: David Stricken Rn nLL 1501 Truxtun Avenue Auixowmo REP s u 7 _-"— Bakersfield, CA 93301 ACURD x5 (ZOUylotl v 1908-2009 ACORD CORPORf)'RCJN}ANfiBMS rceerved. The ACORD name and logo aro registered marks of ACORO / M '0 r-6 ft C,L,F with �I 1 ft wide rlowstrip I I 'er ove ode ne II �r 3.72 \ Fire Hydrant 5' clear zone Cmm� required 8 16 5,23 C c dewMk U u�p -yard Encroachment Sight Line Hart Elementary School 9501 Ridge Oak Or. Bakersfield, Ca. 93311 saofe r —8outr: 5/30/12 76' R of W str S = 35nph D = 350 feet Required sight dire i 76' R of W str S = 35nph D = 350 feet Required sight dire 2 B A I� E R S F I E L E) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager �i FROM: Bob Wilson, Supervisor II, Subdivisions DATE: June 7, 2012 SUBJECT: Encroachment Permit Application for: 9501 Ridge Oak Dr Name of Applicant: Panama Buena Vista School District Description of Encroachment: Move existing chain link fence to back of sidewalk on Mountain Oak Rd. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S'\PERMITS\ENCROACH\INSURANCE\9501 Ridge Oak or doe • B A, K E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor ll, Subdivisions DATE: June 7,2012 SUBJECT: Encroachment Permit Application for: 9501 Ridge Oak Dr Name of Applicant: Panama Buena Vista School District Description of Encroachment: Move existing chain link fence to back of sidewalk on Mountain Oak Rd. Please review the attached encroachment permit and return to me at your earliest convenience. ai 'Al sKE-o�) 12-2 S'APERMITSENCROACHITRAFFIC\9501 Ridge Oak or doc 0 T � ❑ a V 1 V 1 V A O V V 00 N J � O M V) T s a O o C) C: O y EL N EO; N U 0 m U W O U p C = W 00 N