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HomeMy WebLinkAbout7801 KROLL WAYBA E ENCROACHMENT PERMIT oFr.��a�. CRs men CITY OF BAKERSFIELD o PUBLIC WORKS DEPARTMENT 4� 1501 TRUXTUN AVE .V"n® BAKERSFIELD CA 93301 CA 1F0 (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 . . . . . 12-30000027 Date 7/26/12 Property Address 7801 MOLL WAY Application type description PW - ENCROACHMENT PERMIT Owner contractor ________________________ __________ PANAMA UNION SCHOOL mST OWNER 4200 ASHE RD BAYIRSPIELD CA 93313 ------------------------------------------------- ______________ Permit . . . ENCROACHMENT PERMIT Additional dead . . Phone Access Code . 1224872 Permit Fee . . . . 208.00 issue Date . . . . 7/26/12 Valuation . . . . Qty Unit Charge Per 1.00 208.0000 EA PW ENCROACHMENT ------------------------------------------------- Special Notes and Comments Only 26, 2012 10:41:20 AM mmendenhal. Stockdale Elementary School - Chain Linc fence along Kroll Way - 5' behind sidewalk. Contact person: Mike Euckey 742-7165 _________________________________________________ Fee summary Charged Paid Permit Fee Total 208.00 208.09 Grand Total 208.00 209.00 Extension 209.00 ------------- Credited Due _________ ---------- .00 .00 .00 00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 tc re ce the permit at any time. `� J• 1F ignature 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 IE THEREFORE (GRANTED) (DENIED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back an ENCROACHMENT PERMIT F . APPLICATION FORM v o CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT ,yyaV` ♦ 1501 TRUXTUN AVE C L1F0 11 BAKERSFIELD CA 93301 (661) 326-3724 Fax: (661) 852-7012 LOCATION OF ENCROACHMENT(Address required where available): Stockdale Elementary School 7801 Kroll way Bakersfield, CA 93309 Southeast corner of Kro11 way & Camino If there is no address adjacent to work describe limits of workibo distamwo koro nearest existing street intersection. APPLICANT INFORMATION FULL NAME OF APPLICANT Panama Bueptai Vista Union School Distric7— COMPLETE ADDRESS: 4200 Ashe Road PHONE: (661) 397 -2200 -Ext 6437 �atieu'�i<).� (fn� 933)3 FAX: (661) 831-1484 CELL: (661) 742-7165 DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): Chain Link Fence along Kroll Wav and Camino Del Oeste. PERIOD OF TIME FOR ENCROACHMENT: INDEFINATE or OTHER: INDEFINATE (Please Circle) CONTACT PERSON Nike 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, orjudicial 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 noun the 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 famish the City Risk Manager with a Certificate of Insurance evidencing sufficient coverage for bodily injuryor property damage liability or both and required endorsements evidencing the insurance required. The type(s) and amounts) 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 Encroachment Permit Fee: $208.00 S:\PERMITS\ENCROACH\Encroachment Permit Req Fonr.DOC January 2009 CERTIFICATE OF LIABILITY INSURANCE BELOW, THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTEA CONTRACT BETWEEN PIE ISSUING INSURITHS), AUTHORREO REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: it the comfu ate holder m an ADDITIONAL INSURED, the pellil lesl must he endomed. If SUBROGATION IS WAIVED, subject to tee terms antl conditions of the policy, certain polidas may reouire an endamamant Aslatement on this certificate does not center rights to file THIS IS TO CERTIFY THAT T He RUMORS OF INSURANCE Clu lihmis holder in lieu of such endoreement(sl. INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITHRESPECT 10ATICH THIS CERTIFICATE EWY BE ISSUED OR MY PERTAIN. THENSURANCE APF IUEO BY THE POLICIES DESCRIBED HEREIN IS SUWHrT TO ALL THETERMS. PPoldto. xeue INiR•__.. "-ADetands Self Insured Schools of CA Vim, N,{ml 661.636 4495lumen xp>: 661.636.4418 POUCY NUNBEN MMOOMYYY4 Non.aFt Y"1 UM1Ine PO Box 1847 Aoexeae X GO,A.1fAC'A( C NA( .InY Bakersfield, CA 93303-1847 IXNVPE J AFEO.N.0 Ce.Mgc NAICtl - A 'as ... A! Self Insured Schools Calif. AVTIOR. PEPPESEMATNE rosin v_ Self Insured Schools of CA SISC II- _- _of_ SURERB /[ 1300 17th Street_-- - - - INNVRExC "O(ICY P'EOT ILO. PO Box 1847 INSUPER O: _.. _.. •__• SAP 7112 13'07101,2012 anx t 1,]50,00 Bakersfield, CA 93303-1847 $1.000 DEDUCTIBLE] All ONNEO steam"CD A SISC I & II Member Districts (See attached) nSevPExF ,. PFOPEW5 E CA9}tE CIt\(CGAOFC D PIPTIFIOBTF NIIMRFP� 17-11 Woh rMv T R TT RFV,Sx1N.11 NI THIS IS TO CERTIFY THAT T He RUMORS OF INSURANCE LISTED BELOW HAVE BEEN ISSUCU TO THE INSURED NAFALb ABOVE FOR IHE POUGY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITHRESPECT 10ATICH THIS CERTIFICATE EWY BE ISSUED OR MY PERTAIN. THENSURANCE APF IUEO BY THE POLICIES DESCRIBED HEREIN IS SUWHrT TO ALL THETERMS. E%CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAT HAVE BEEN REDUCED 2Y PAID CLAIMS INiR•__.. "-ADetands PCIIDYPFr--PaC1CY FSP •. _. ! ;'—,' Lp, NSYIUNGE Nam q POUCY NUNBEN MMOOMYYY4 Non.aFt Y"1 UM1Ine �YNDi ee ERPt R4J ry SLP ]112 13:OLOf12012:0710Yt20131 , RRfNLC 5 1,750,000 ' X GO,A.1fAC'A( C NA( .InY n,WfiG" t,n[N2C VryEM SCB `-feT 5 O.s.. , I_X OtFuN A wsoe.ALa e _. AVTIOR. PEPPESEMATNE bON l RAL ACInD,GAFE 5 /[ C N 6fHE(iAtt"(IMn APRIEeI EH � i }20P N E N AUG S "O(ICY P'EOT ILO. 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PEPPESEMATNE SISC I & II. MEMBER DISTRICTS /[ (See Attached List) � E ©1908-2010 ACOVD CORPORATION. All rights reserved. ACORD 26 12010105) The ACORD name and logo are registered marlin of ACORD B A K E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Raul M. Rojas, Public Works Director FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: October 10, 2012 SUBJECT: Encroachment Permit Application for: 7801 Kroll Way Name of Applicant: Panama Union School District Description of Encroachment: Chain link fence along Kroll Way 5' behind sidewalk around Stockdale Elementary School. Engineering and Traffic staff has reviewed the attached encroachment permit to allow the applicant to install fence as described above. The applicant has provided proof of appropriate insurance coverage to Risk Management. Based on their review, staff recommends approval of the permit. SAPERMITSENCROACN12011 Approval LaRer511901 Kroll Way.doc Y _A- h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor Il, Subdivisions DATE: August 22, 2012 SUBJECT: Encroachment Permit Application for: 7801 Kroll Way Name of Applicant: Panama Buena Vista School District Description of Encroachment: Stockdale Elementary School— Chain link fence along Kroll Way— 5' behind sidewalk Please review the attached encroachment permit and return to me at your earliest convenience. g(� l ZUl2 �(-L1gE FENGE SLI(gklllt`� ENG�O/7cSASl6ftT gr 7VE sour /��sT COILNER OF 71f5 I0-67rS"'r4VC'efwt Wqr � c.,r}�vIfND (JEL O��TG,� $�tT j70E5 NOT cmrrlTG17E Plu j{�i'RcG[ffF 6 VISug�L- �5T-�V&-rIDN. nv ars S:\PERMITS\ENCROACH\TRAFFIC\7801 Kroll Way.dw 1f 'wL #t -C ho 41 Js/s�y,� A �v • P> A h E R S F I E L L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor ll, Subdivisions DATE: August 22, 2012 SUBJECT: Encroachment Permit Application for: 7801 Kroll Way Name of Applicant: Panama Buena Vista School District Description of Encroachment: Stockdale Elementary School— Chain link fence along Kroll Way— 5' behind sidewalk. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCROACH\INSURANCE\7801 Kroll way.doc