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Home My WebLink About5126 BLUE BROOK DRENCROACHMEF-= CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENTr1 TRUXTUN AVE' v5BAKERSFIELD CA 93301 ar tl�I NiM10N\\\ ``(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 . . . . . 13-30000017 Date 3/27/13 Property Address 5126 BLUE BROOK DR Application type description PW - ENCROACHMENT PERMIT Owner Contractor STANDARD PAC CORP OWNER 15360 BARRANCA PW IRVINE CA 92618 ___________________ _ Permit . . . ENCROACHMENT PERMIT Additional dear . . Phone Access Code 1306877 Permit Fee 208.00 Issue Data 3/27/13 valuation 0 Qty Unit Charge Per Extem ion 1.00 208.0000 EA PK BNCROACNMENT 208.00 Special Notes and Comments March 27, 2013 11:26:13 AM mmendso al. Place 4' white vinyl fence at back of sidewalk along Blue Brook Drive and part of Polished Rock Lane. These are to be temporary until model homes are closed. Contact person: Jake Persons - 805-760-5341 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due FA eeTotal 208.00 208.00 .00 .00 Applicantedges the righ6ao6Jhe CityoEngineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke that any time. r Pttt (SSI Signatur 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 =DENIED) Said permit shall expire on date stated above. Signature of Cit Engineer Additional Terms on the Back 13 3vww1-7 BA ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD � PUBLIC WORKS DEPARTMENT I501 TRUXTUN AVE FO BAKERSFIELD CA 93301 (661)326-3724 Fm:(661)852-2012 LOCATION OF ENCROACHMENT(Addrcss required where available): Ln 5jo-_�9 _ .,��3 of cc `rrz� (e -65-Z- I . ry 40o2Esr� vtft-Sg- saw A,r,&CbLb vim. 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 - %'r4M NZ0 PP -Ci Flc (7 Nl Ef COMPLETE ADDRESS: -X-7AlILF i(IV,59 02• PHONF,: IeO.�-• 71oU'S �I AlAED t CA, 9303Q, FA -X— o c. Ctwl 7(PO' ,j7 / PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter,etc.):!i�'brr, �fra/d 1 I{(r1F VINYL- FEWCF IN TPIAEO rJE'{flnlQ 07Y �irJGW,w,(L. To IMyYt ,INODEL CO& Oi Fx AREA Ar'FGT "D TIDY W4�IL� WET VI �CnF W6)czs PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE mr THER• Aaf rernd " 56LE 14,) p (Please Circle) CONTACT PERSON J Ioz SdNS PHONE: S -K, 70•5-3W 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 N or right of way where the same is heated, and restore said public property or right of wav to the condition as 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 arc: Residences: Homeowners General Liability coverage in an amount of at least $300,000.00 Commercial: Commercial Liability coverage in at amount oral least $1,000,000.00 Encroachment Permit Fee: $208.00 S:\PERMII'S\ENCROACMEnetoachment Permit Req Fonm.DOC January 2009 [ORO ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM19DOIYYYYf B3rifinD,a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXPEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED, the p.IiCyfl.S) must b, endorsed. 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 rights to the ceHlficateholder in lieu of such endoomment(s). PROOOCE0. Am Risk insurance Services Best, Inc. Newport aeach CA office 100 Bayvi Ew Circle Newport Beach CA 92660 OSA CONTACT P NE Lgdg) 600-6300 FNI 0949) fi00-6451 INDNO.EVI A¢.No.: Ea LLA.ss: GENERALOIBILITY INSUREENG AFFORDING OWERAGE NNC# INSURED INFIRED, Steadfast insurance Company 2638] Standard Pacific Corp. Ventura Division ]5] Nile River Drive INSURERS INELDER Oxnard CA 93036. USA NSVRERO: INSURER E: s & cord, INSURER F: $100:000 11 ancV:eTC NIIMRPR SYD4a:i504'i1 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested ITT Or INBVRAN.E 8R a0 µy cY NUMBERLPYEFF F UQYGXP LIMis GENERALOIBILITY HBP PerN OCC LURENGE $25.000,000 SIR applies. per policy ter s & cord, s $100:000 % COFOAERONLGENERALLIABILGY PREMISES XPLAny One Pin") AIM9MAOE ❑% OCCUR PERYONAL A FLY INJURY 825,000,000 GENERALAGGPEGATE $30,000,000 GEN L TE AGGREGATE LIMIT APnIES FEE ROPAGG $30,000,000 XPRO OLICY LOC AUTOMOBILE LWBRY NIT R COMBINED SINGLE LIMIT AGOILLYIEVRYIPo,pevcn) ALI BOOILYI NIVRYIr.r-II-O ALLOWNEO BCHEOVLED NITOS PROPERTY DAMAGE EOAEO AIWH O R09 B CUREACH OCCURRENCE AGGREGAIE EXCE98 L)A0� CLAIMe MADE WORNERBOOMPENSATONANG WC OTH EMPLOYERSLIABILITY Y❑ EL EmoryACCIDENT .JIM ETOR �IX JLI %o en. EL DISEASEEAUNFLOYEE nEabyln 1OE9CRIPiIONOF V.-GER—SER OPERATIONS nelmv ABEPOLICYLIMIT NS/VENT owhfte sidewalk o theon Lots 6-18, 12] and 12] of Trans 6329-1, vi yl fence tl behind the City sidewalk Lots Re anon GF a vinyllocatedbehind ation The city of Bakersfield, its mayer, council, mployees, ct Location: Bakersfield' Ci Project No. 16]3,. Project Name: jest No.l in the of t e cenEral Liability ed as Ad, an. policy provisions accordance w'0 insured for agents. and volunteers are included a occurrence COV A & B Each occurrence, -COV C, D & E $7,500,00; Policy. Self tonsured Each occurrence STR SCSI Third Party Action Over Claims - 82,000,000; Annual Aggregate Self Insured 0.etention - $15,000,000. r Claims ggr CERTIFICATE HOLDER xoum All or THE ABOVE o POLICIES BE CANCELLER BEFORE M. x DATE THEREOF, NOTICECWILL eE DEwERED IH. ACCOXIMNCE Wne THE eORGIONS. The cityf Bakersfield ORGEO RREFFAN1mATNE Attn: Public works Department 1501 TrUKF n Avenue ^� / Dakersfield GA. 93301 LISA e�O» .rdh v�n��»[¢ Y,f.#�, 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD C d U B 4, K E R S F I F L L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager -4-- v!a' FROM: Bob Wilson, Supervisor II, Subdivisions DATE: April 10, 2013 SUBJECT: Encroachment Permit Application for: 5126 Blue Brook Dr Name of Applicant: Standard Pac Corp Description of Encroachment: Place temporary 4' white vinyl fence at back of sidewalk along Blue Brook Dr and part of Polished Rock Lane. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. I S'.\PERMITS\ENCROACH\INSURANCE\5126 Blue Brook Dr.doo • E A I�: E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor ll, Subdivisions DATE: April 10, 2013 SUBJECT: Encroachment Permit Application for: 5126 Blue Brook Dr Name of Applicant: Standard Pao Corp Description of Encroachment: Place temporary 4' white vinyl fence at back of sidewalk along Blue Brook Dr and part of Polished Rock Lane. Please review the attached encroachment permit and return to me at your earliest convenience. S:WERMITSS ENCROACH\TRAFFIC15126 Blue Brook Dr.doo