HomeMy WebLinkAbout10301 BAY COLONY DRA [{
ENCROACHMENT PERMIT
-� CITY OF BAKERSFIELD
v PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
IFO (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 . . . . . 13-30000080 Date 12/13/13
Property Address 10301 BAY COLONY DR
Application type description M - ENCROACHMGNT PERMIT
owner contractor
RUNGE MARCO A ZAMORA OWNER
10301 BAY COLONY DR
BAKERSFIELD CA 93312
( 66) 589-0032
Permit . . . ENCROACHMENT PERMIT
Additional deeo . .
Phone Access Code . 1407220
PErmit Fee . . . . 208.00
Issue Date . . . . 12/13/13 valuation 0
Qty Unit Cnarge Per
Extension
EASE FEE
208.00
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Special Notes and Comments
Allow pillars at end of driveway
as
existing. 26"x26"x96" high.
Marco Zamora
444-5579
Fee Charged
Paid
Credited
i
--------
Due
Perm't Fee Total 208.00
208.00
.Do
.00
Grand Total 208.00
208.00
.00
.00
Applicant acknowledges the right of the 'ty Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to
revoke the permit at anpmejm�r. ,
i
•+n r , n y-16aD�9f�
Signature o pp scan ffr7Agent) 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) COII,TE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE ( RANTE (DENIED) Said permit shall expire on date stated above.
Signature City Engineer
Additional Terms on the Back
BA�ERs ENCROACHMENT PERMIT
APPLICATION FORM
v o CITY OF BAKERSFIELD
�, PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
IFO BAKERSFIELD CA 93301
(661)326-3724 Fax: (661) 852-2012
LOCATION OF ENCROACHMENT(Address required where available): umj\ yxl�A dda -u,
P-m11�.�cSF°xL �\ CCA 0 �SQ,
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 2..atvint-tA
E'@MPLETEADDRESS: PHONE: (C(GI_'B7-033�
\0ac1 apk�j 1 -t-,f FAX:
CLI 0Q9Q CELL: rGlo 1 - LI LI LI - S' 5 71
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wroughtiron fence, concrete block wall, raised
planter, etc.): "1430 ( cyy ve-V or- wviik i:Bk\afti eArlo y(LVl Lr4c ln-k . �n.EhnlyS
IotaAQX 0APt1CV $,\e `�A *\,o &1W1A,)M49,n Cut .plow -01v .
PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE or OTHER:
/n� /AI (Please Circle)
CONTACT PERSON / I/ ofd 1u[8 PHONE: (p?& J - Ll qq
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
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. 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 m amount of at least $1,000,000.00
The Commercial Liability policy must identify City and City's mayor, council, officers, agents, employees, and designated
volunteers as Additional Insureds.
Encroachment Permit Fee: $208.00
S TERMITSTNCROACH�,c h.me , Ne A Req FovnD SepL 2013
B A K E R S F i E L D
Public Works Department
1501 Truxtun Avenue
Bakersfield, California 83301
(661) 326-3724
TO WHOM IT MAY CONCERN
We the undersigned, have no objection to the Construction of a fence beside the sidewalk w0in Ine
Public fight -of -way.
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or \�» f�Y� 11! �tS3I� ei= COSI - Uu U —SS 75
(Add.. of pmppxed encroachmenp
Name: X�
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? Date: �„�t /G /-j
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Declaration Number: 001
Effective Date: 12/14/2013
Page 3
Policy Number: XH0211588-3
Marco A. Zamora Manic
COVERAGE DECLARATIONS
Date Printed 12/10/2013 INSURED imnN--PHC,—V[,1
Location Address: 10301 Bay Colony Drive Bakersfield, CA 93372
-
Basic Coverages:
Limit
Deductible
Section I Coverages:
Cov A - Dwelling
$ 304,000
$ 500
Cov B - Detached Structures
$ 30,400
$ 500
Cov, C - Personal Property
$ 212,800
$ 500.
Cov D - Loss of Use
$60,800
Section 11 Coverages:
Co, E - Personal Liability
$ 300,000
Cov F - Medical Payments
Each Person
$ 1,000
Each Accident
$25,000
i
Property Insurance Disclosure:
j This location Includes Specified Additional Amount of Insurance
for Coverage.A - Dwelling.
This location Does Not Include Earthquake Coverage.
This location Does Not Include Building Code Upgrade
(Ordinance or Law) Coverage - Form PH0041009 Not Purchased.
This location Includes an Annual Inflation Guard of 4%.
Additional Coverages
i
Form Limit
Premium I
Personal Property Replacement Cost
H00490I000 Refer to Form
$ 0
Specifed Add'l Amt Insurance Cov'A'
PHOO81009 Refer to Form
$ 10
H.O. Plus
PH0011012 Refer to Form
$ 36
Workers Compensation
I
i
i
H024900801 $ 100,000
$ 5
�
i
Date Printed 12/10/2013 INSURED imnN--PHC,—V[,1
•
B _A- K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: January 7, 2014
SUBJECT: Encroachment Permit Application for: 10301 Bay Colony Dr
Name of Applicant: Marco Zamora Monje
Description of Encroachment: Allow pillars at end of driveway as existing.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:TERMITSENCROACMNSURANCEM 0301 Bay Colony Drdoo
•
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: January 7, 2014
SUBJECT: Encroachment Permit Application for: 10301 Bay Colony Dr
Name of Applicant: Marco Zamora Monje
Description of Encroachment: Allow pillars at end of driveway as existing.
Please review the attached encroachment permit and return to me at your earliest convenience.
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