HomeMy WebLinkAbout3702 AMUR MAPLE 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 theprovisions 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 . . . . . 13-30000041 Date 6/10/13
Property Address 3702 AM[RE MAPLE DR
Application type description PW - ENCROACHMENTS PERMIT
owner contractor
__________________ ________________________
FUJIWARA FREI OWNER
.3702 AMUR MAPLE DR
BAKERSFIELD CA 93311
____________________________________________________________________________
Permit . . _ ENCROACHMENT PERMIT
Additional des. . .
Phone Access Code . 1335108
Permit Fee . . . . 208.00
Issue Date . . . . 6/10/13 Valuation 0
Qty Unit Cbarge Per Extension
1.00 208.0000 EA PW ENCFOACFPH:NT 208.00
__________________________________________________________: _____
Special Note. and Comments
June 10, 2013 10:39:03 AM ssandeah.1.
4' high fence behind sidewalk. Fence i
currently G' high. Will be removing top
2' of fence. Contact person. Keri
Fujiwaza (661) 432-0598
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Fee summary Charged Paid Credited Due
Permit Fee Total 206.00 208.00 00 .00
Grand Total. 208.00 208.00 .00 .00
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to
revoke the permit at a e_
Jif' i Fv�l !� pit di-.
Signature of Appli wrier/Agent) Print Name JJ
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) Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
E A K E R S F I E L O
Public Works Department
1501 Truxtun Avenue
Bakersfield, Caidomla 93301
(661)32(f-3724
APPLICATION FOR ENCROACHMENT PERMIT
Permit Fee $208.00
To the City Engineer of the City of Bakersfield, California:
Pursuant to the provisions of Chapter 12.2q 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.
9. PUH name of applicant and complete address including phone number:iVAE r
2. t Nature or description of the encroachment for
fence, concrete block wall, raised planter, etc...)
Wood or wrought iron
a Location of proposed encroachment (Example: Side yard at back of sidewalk or front yard at back of sidewalk)
4. Period of time for which the encroachment is to be
5. Is property part of a Homeowner's Association Yes
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, quasiyudicial, orjudicfal tribunals of any kind whatsoever, arising out
sof, 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
ni or ndht of wav where the same is located, and restored said public property or right of way 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 evideri
ing the insurance required. The type(s) and amounts) of insurance coverage is:
Applicant acknowledges the right of rile City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permii at
any time.
StEncroacnmentPermimWppliwtbnforEncroacnment
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KA 4E6 A x> rrS a_cE L o
Public Works Department
1501 Twxtun Avenue
Bakersfield, California 93301
(661)326.3724
rO WHOM IT MAY CONCERN
We the unde-signed, have no objection to the construction of a fence beside the sidewalk within the
public right-of-way.
A w �Ar l� thl 17r „�
(Sr el orrp�roposed encro� menp (�wncrs�/xmr` , �t
nL_3 / 6 Z. � 1'/ ! phone,
(Addr= or proposed eneroadwen)
1)Name ,
Address
RQu)
r
2-) Name;
Address:
?.) Name:
1000.Y1
Address:
4.) Name:
IM -
Address:
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5) Name.
Address:
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"o.) Name:
Address:
Date: (--7— 1
.pate: Is /I -L-,_
Date'. (01 /0 1 1--3
Date: �l�l (3
Date: 3,3( ',
Declaration. Number: 001
Effective Date; 03/12/2013
Page 3
Policy Number: X110213187-1
Keri Fujiwara
COVERAGE DECLARATIONS
Location Address: 3702 Amur Maple Drive Bakersfield, CA 93311
$ 300;000
Basic Coverages:
Limit
Deductible
Section I Coverages:
Cov A - Dwelling
$ 211,000
$ 1,000
Cov B - Detached Structures
$ 21,100
$ 1,000
Cov C - Personal Property
$ 147,700
$ 1,000
Cov D - Loss of Use
$ 42,200
Section 11 Coverages
Cov E - Personal Liability
$ 300;000
Cov F -.Medical Payments
Each Person
$ 1,000
Each Accident
$ 25,000
Property Insurance Disclosure:.
This location Includes Specified Additional Amount of Insurance
for Coverage A - Dwelling.
This location Does Not Include Earthquake Coverage.
This location Includes Building Code Upgrade (Ordinance or Law) Coverage, per Form PH0041009.
This location Includes an Annual Inflation Guard of 4%.
Additional Coverages
Form
Limit Premium
Personal Property Replacement Cost
H004901000
Refer to Farm
$ 0
Specifed Add'1 Amt Insurance Cov'A'
PHOO81009
Refer to Form
$ 10
H.O. Plus
PHO011012
Refer to Form
$ 25
Identity Theft Coverage
PH061761009
.Refer to Form
$ 25
Ordinance or Law
PH0041009
$ 211,000
$ 42
Workers Compensation
H024900801
$ 100,000
$ 5
Date Printed 03/21/2013 INSURED xo�.w..n rxu peva
B A h E R S F I E L SJ
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer II 1
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: June 14, 2013
SUBJECT: Encroachment Permit Application for: 3702 Amur Maple Dr
Name of Applicant., Keri Fujiwara
Description of Encroachment: 4' high fence behind sidewalk.
Please review the attached encroachment permit and return to me at your earliest convenience.
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E A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager -�c
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: June 14, 2013
SUBJECT: Encroachment Permit Application for: 3702 Amur Maple Dr
Name of Applicant: Ken Fujiwara
Description of Encroachment: 4' high fence behind sidewalk
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
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