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HomeMy WebLinkAbout1105 WHITE LNBAKg�SENCROACHMENT PERMIT .n CITY OF BAKERSFIELD o PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE C -gyp BAKERSFIELD CA 93301 LIFO (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 . . . . . 13-30000039 Date 6/04/13 Property Address 1105 WHITE IN Application type description PW - ENCROACHMENT PERMIT owner Contractor COATS EDNA NAE TRUST OWNER 1105 WHITE LN BAKERSFIELD CA 93307 _____________________________ Permit ENCROACHMENT PERMIT Additional desc . . Phone Access Cade 1332485 Pernit Fee 208.00 Issue Date . . . . 6/04/13 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 208.00 -------------------------------------------------------------------------- Special Notes andComments 4r Nigh concrete block and wrought iron fence in front of house behind sidewalk. West side of house from sidewalk to back of house will be solid concrete wall. Fee 1 summary Charged Paid Credited Due Permit Fee Total 208.00 208.00 .00 .00 Grand Total 200.00 209.00 .00 .00 Appli nt acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revo the permit at any time. Signature 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) CO UTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE GRANT D (DENIED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back I;-S00Do031 B A K E R 5 F I E L D Public Works Deparbnent 1501 Truxtun Avenue Bakersfield, California 93301 (661)326-3724 APPLICATION FOR ENCROACHMENT PERMIT Permit Fee $208.00 To the City Engineer of the City of Bakersfield, California: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, e place, erect, use and maintain an encroachment on public property or right -o as 1. (Full name of applicant and complete address including phone n / i 2. Nature or description of the encroachment for which this appfl i e: fence, concrete block wall, raised planter, etc...) ` c YLbca of proposed encroachment (Example., ,(Let, /I . i ..-, 4. Pertoo of time for which the croachr t is to be 5. is property part of a Homeowner's Association Ined applies for a permit to defined. / yard at back of sidewalk or front yard of back of sidewalk) A — LA t Yes V N No 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, quasHudicial, 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 revQmtIon 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 restored 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 Applicantfurther 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 evildoing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidenc- g file insurance required. The type(s),Gd apount(s) of insuranrgle coveral V Z Applicant acknowledges the right or the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. 5'\EncroachmentPmmits W ppikaflonforEnoroaahment a� 6 A K E R S F I E L D Public Works Department 1501 Truxtun Avenue Bakersfield, California 93301 (661)326.3724 rG WHOM IT MAY CONCERN We the undersigned, have no objection to the construction of a fence beside the sidewalk within the public dyhl-of.way, /{74&�c�o- �,STcF"dor propose ens oa mens) wners ame) (Address of proposed encroa0rmen0 SIGNED: 1 ) Name'. Address. 2.) Name: Address: 3.) Name: -K rp ✓1 iP S Aacress: �/I6� 4.) Name : rr lit) Address: 'limn "��kA 11 {., ,Jre k ,/ '"r'a) Name: �Ssler>,D Address. \\ 1\ i\.r1e- f-er. 5:) Name, Address. Date: e -- a — ., 3 Date. / - 3 - i f Date: /- S-Aj Date: 1.3- )3 Date: Lo -_q, --A3 Date: HOMEOWNER DECLARATION California Capital Insurance Company — NAIC Code 13544 Homeowners Policy— HO-3—Special Form INSURED COPY Name and Address of Insured Servicing Agency - 58440 Coats, Edna M Cal -Kern Insurance Agency 1105 White Ln Station A Bakersfield, CA 93307 P.O. Box 3644 Bakersfield, CA 93385 Telephone: (661) 324-6468 Policy. #: 8 -HOC -1-280274 Declaration Type: Extension Effective Date: 01/31/2013 Policy Period: From 0113112013 To 011311201412:01a.m. standard time at the address of the Named Insured asstated herein. Property Location: 1105 White Ln,. Bakersfield, CA 93307 This is Declaration 4:21 and when attached to the applicable forms, it completes the policy. Transaction Description: Extension Policy Summary Total Premium .$521.00 Total $521.00 This is not a Bill. Any premium due will be applied to the Account Bill. This is a replacement Declaration, counter signature is not required. TO REPORT A CLAIM, CONTACT THE CLAIM SERVICE CENTER: (800) 986-9974 Process date: 12/10/2012 Named Insured: Coats, Edna M Homeowner Declaration Policy #: 8 -HOC -1-280274 Declaration Type: Extension Effective: 01/31/2013 Coverage Form — 3 Property Location: 1105 White Ln, Bakersfield, CA 93307 Description: Construction: Fmme; Year Built: 1963; Territory: 55; Protection Class: 3 Basic Coverage . Limits and Premium Limit Premium A Dwelling $195,388 $678,00 B Other Structures 19,539 C Unscheduled Personal Property 136,772 D Additional Living Expense 39,078 E Personal Liability 300,000 25.00 F Medical Payments Each Person 1,000 Each Accident 25,000 The limit of liability for this stmcture.(Coverage A) is based. on an estimate for the cost to rebuild your home, incuding an approximate cost for labor and materials in your area, and specific information that you have provided about your home. As a Company, we will make property evaluations from information provided by you in assessing the value of your home. As mentioned in thestatement above, it is an estimate of the cost to rebuild your home; however, your home may cost more to rebuild. - It remains your sole responsibility to maintain a limit of liability for the described dwelling (Coverage A) that adequately corresponds to the amount it would cost to reconstruct your entire dwelling at current prices. Optional Coverages & Mandatory Fees Extended Dwelling Replacement Cost Coverage (Up to 200% of Coverage A— Dwelling limit) 10.00 Contents Replacement Cost 68.00 Cal -Pak Coverage (Includes $19,539; 10% limit for Ordinance or Law Coverage) Included Identity Fraud Expense Coverage Included Worker's Compensation (Mandatory) - Included Other Premium 5.00 Subtotal for Basic and Optional Coverages 786.00 Premium Credits and Surcharges $500 Deductible Credit -81.00 Multi -Policy Discount -60.00 Renewal Credit -54.00 Protective Device Credit -48.00 Century Age Credit -22.00 Total Premium Credits and Surcharges -266.00 Total Annual Premium $521.00 Annual Inflation Guard: 2 % This policy contains a $500. Deductible. Process data: 12/10/2012 B A K E A S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer 111 FROM: Bob Wilson, Supervisor II, Subdivisions DATE: June 14, 2013 SUBJECT: Encroachment Permit Application for: 1105 White Ln Name of Applicant: Edna Mae Coats Description of Encroachment: 4' high concrete block and wrought iron fence in front of house behind sidewalk. West side of house from sidewalk to back of house will be solid concrete. Please review the attached encroachment permit and return to me at your earliest convenience. &iPERMITS\ENCROACR\TRAFFIC\1105 White Ln.doc E A IS E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager �—*. FROM: Bob Wilson, Supervisor II, Subdivisions DATE: June 14, 2013 SUBJECT: Encroachment Permit Application for: 1105 White Ln Name of Applicant: Edna Mae Coats Description of Encroachment: 4' high concrete block and wrought iron fence in front of house behind sidewalk. West side of house from sidewalk to back of house will be solid concrete. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. 5:\RERMITS\ENCROACH\INSURANCE\1105 Whke Ln.doc 5 F L E L D Public works Department 1501 Tmxtun Avenue Bakersfield, California 93301 1661) 326.3725 ENCROACHMENT PERMIT REQUIREMENTS t Application 2. Permit Fee of $208.00 3.. Drawing; Minimum 8 112 x 11 showing encroachment on lot in relation to the existing curb, gutter and sidewalk, along with distances from curb, gutter and sidewalk to the encroachment.. Drawing to include curb, gutter and sidewalk and any additional information that may assist the City in making a determinationas to your request. 4. Type and Amount of Insurance Coverage for fence installation or construction for A. Residences Homeowners General Liability coverage in an amount of at le st 5300,000.00 6. Commercial Commercial General Liability coverage in an amount of at leas; 51,000.000.00 Additional Insured Verbiage (For Commercial) A. The City of Bakersfield, its mayor, council, employees, agents and volunteers are added as additional. insured's with respect to. (i. e. the installation of a chain link fence at 15C1 Truxtun P.ve.), 5 LL w.onn,meiiPertnl!eynsuranceP.egviremems 4 �-- — -� , o � $ / 0 �-- — --� ! ® 2 e % _ .�■ o K / e ©. ( is / /tail JUS $ . \ \} \ or � \ �------ %$ 0 � �-- — -� , o � $ / 0 �-- — --� ! ® 2 e % _ .�■ o K / e ©. ( is / /tail JUS $