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Home My WebLink About4511 POLO VIEW 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 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 . . . . . 15-30000014 Date 4/20/15 Property Address 4511 POLO VIEW DR Application type description PW - ENCROACHNENT PERMIT Owner Contractor ____________ ________________________ GLAVIN MICHAEL & JULIE REVOCAE OWNER 4511 POLO VIEW DR BAKERSFIELD CA 93312 --------------------------------------------------------------------------- Permit . . . ENCROACHMENT PERMIT Additional dexo . . Phone Access Code . 1626829 Permit Fee . . . . 200.00 Ienue Ddte . . . . 4/20/15 Valuation . . . . 0 Qty Unit Charge Per Extension .EASE FEE 208.00 --------------------------------------------------------------------------- Special Notes and Comments place 37" wroght iron fence at .back of sidewalk along front and side of property on comer lot. Julie Glavin 331-5381 _________________________________________________________________ Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 208.00 206.00 .00. .00 Grand Total 208.00 208.00 .00 .00 Applicant a owledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the pe it at any time. J/�[�rL Sign f nt (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) COgNSTRTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFOR 7G) (DEy`\IEE\\D11) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back Bo.,,Rs ENCROACHMENT PERMIT APPLICATION FORM u e CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE LIFO BAKERSFIELD CA 93301 (661)326-3724 Fax: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where If there is no address adjacent to work describelimits of work by distances from nearest existing street intersection. FULL NAME OF COMPLETE ADDRESS.i21 pol'o V 1FL11 bg- PHONE: Ioloi'`J -%slli' OkLZ.6 P t Ej-0 C,k Gl331,% FAX: 1.J�A CELL: L�3I-331-5?0 PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): In poo Lit wr rpC t �� 1-I C-� .�71 t 1-}IC� t -t I Yl6`�0.i �r� ,Irl Z0� 1 : 3z"atP r�t� PERIOD OF TIME FOR ENCROACHMENT: �INDEFINITE o OTHER: ,.J/ / (Pleas CONTACT PERSON !-/UI-LF- C7 L VIN' PHONE:. &61- 33 I —s 3 & / 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 noon the revocation 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 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 amount(s) 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 The Commercial Liability policy must. identify City and City's mayor, council, officers, agents, employees, and designated volunteers as Additional Insureds. Encroachment Permit Fee: $205.00 Se0t S THRM ITSNCNCROACDT..c,ach.unt Penni[ Rcq Fmm DOC 2013 B A K E R S F I E L D Public Works Department 1501 Trumun Avenue Bakersfield, California 93301 (661)326-3724 TO WHOM IT MAY CONCERN: We the undersigned, have no objection t0 the Construction of a fence beside the sidewalk within the public righbot-way. 20so til — f.J� 'rrem or propose encroac a I or fid// PCY�6 vie'llf Da (Address of proposed encmachmem) SIGNED: 1.) Name: Address: 2.) Name: Address: 3.) Name: Address, 4.) Name: Address: Br:-.JUGiU� 4uU x wners//NIame / PRnne(Gfol v�� — (dr�l� Ud4a2 &IVDate: Date: 4 &z5 -d A. Date' ANw, ck pylie� Date: Uof rav ,w- 5 ) Name: 'p�C' /9 v, k 4j Address: 1 S.) Name. Address: Date: moi` /d -/S Date: e-1 (`yam/) { E C O Public Works Department 1501 TruxWn Avenue Bakersnaid, Calikmle 93301 (561)326 3724 ENCROACHMENT PERMIT REQUIREMENTS 'i Application 2. Permit Fee of $208.00 3 Drawing; Minimum 8 112 x Y1 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 ano any additional information that may assist the City in making a determination as to your request. a. TypeandAmount of Insurance Coverage for fence installation or construction for A. Residences Homeowners General Liability coverage in an amount of at least $300,000,00 S o er 'al C� mere I General Liabif oven an amo of al —IeElst $1,000,000.00 A.\k'he Ci f akersfeid, its mayor, c pl area d additional insured' ith respect I.e. th insta tion of a c Ink fence at 1501 s LL rnvoacumtrnPermisOnSoraueP.apmremtms a`oeo CERTIFICATE OF LIABILITY INSURANCEo 1712M 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, EXTEND 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 Policy(les) must be 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 certificate holder in lieu of such endorsement(s). MooucEa TOM SMETHURST STATE FARM INSURANCE 51atc-!:Rrm 13061 ROSEDALE HWY. STE. A 04 BAKERSFIELD,CA. 93314 CONTACT NAME: TOMSMETHURST PNOXE 'SS1�589-1991 1 I'M. xe: 13094 833 :TOM SMETHURST.BT STATEFARM.COM MswE BAFFOPMNGCOVFUTAGE MCA INSURER1; SIeta -81111 ('ia11e0In311rH11ee C0 8fl IMS'now GLAVIN, MICHAEL & JULIE 4511 POLO VIEW DR BAKERSFIELD CA 93312$605 INSURERB: INSURERG: IxwRER °' IMURERE: INSURER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED MAMED AROVE FOR THE POLICY PERIOD INDICATED. NOTNATHSTANDING 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 SHO_NM MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR ry CA INSUMXEE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4511 POLO VIEW DR POIJCY NVMOFA POIICYEFF POUmIlon YMIDI GENERAL. DAMAUI TC07-ERC1AL GENERAL L-LRY C_.Z-OE n OCCUR ❑ EACH OCCURRENCE S PREMISES Ea ,Agug S MEDEXP(NymaP ) $ PERSONAL&ADVINJURY f GENERALAGGREOATE b OEN'LPAGOREGATELIMITAPPLIE8PER OLICY P1io LOC PRODUCTS-COMPWAGG i S AUTOMOBILE UAMUTY —AUTO OV ALLMED SCHEDULED ALL OB AUTOS HIRED AUTOS NOKONNEO MTOS Eaaru6wl S BODILYWUIY(Pap) S BODILYWURY(Perss ) S _ py" f S VMBREW WM "CESS UAB OCCUR CIAIMEIMoE EACH OCCURRENCE s AGGREGATE S DED RETENTION$ S ADMTEK C°MPENMTON VIN ANY ANY PROPRIETORIPARTNERTXECWIYE OD"CF/MEMBER E%CWOEm RYMa4ry4NH) xr-.,:-w.uma, NIA NCeTgTU- ION - Y EEACM gC410ENi S EL DISEASE EA EMPLOYEES E.L DISEASE-POLICYLMn E A HO-HCMEOVMERS ❑ 87 -SE -M907•1 p 71MIS 0611012016 L -PERSONAL LUBRDY S aII.. DESCRIPIpN OF OPEMTXINBILOCATWXSI VMIKIEB IAMSM1 AO°10 tot, AtipMmtl Ram�Ms SCI4MMRn,wF q,eas4rtptllaM 1'(-111-149 GLAVIN, MICHAEL & JULIE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4511 POLO VIEW DR ACCORDANCE WITH THE POLICY PROVISIONS. BAKERSFIELD CA 93312-8605 THORREDRE AT11� ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010186) The ACORD name and logo are mgfatered marks of ACORD 1001488 132849.8 01-23-2013 E =1 h E R S P' I E L L> PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer III FROM: Bob Wilson, Supervisor II, Subdivisions DATE: May 11, 2015 SUBJECT: Encroachment Permit Application for: 4511 Polo View Dr Name of Applicant: Michael & Julie Glavin Description of Encroachment: Place a 37" wrought iron fence at back of sidewalk along front and side of property. Please review the attached encroachment permit and return to me at your earliest convenience. Mpr S]PERMITS\ENCROACH\TRAFFIC\4511 Polo View Dr.doc B I� E R S E I E_ L V) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: May 11, 2015 SUBJECT: Encroachment Permit Application for: 4511 Polo View Dr Name of Applicant: Michael & Julie Glavin Description of Encroachment: Place a 37" wrought iron fence at back of sidewalk along front and side of property. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S \PERMITS\ENCROACH\INSURANCE`A511 Polo View D1,doc F I F, T, D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer III FROM: Bob Wilson, Supervisor II, Subdivisions DATE: April 7, 2015 SUBJECT: Encroachment Permit Application for: 21001V St Name of Applicant: D & S Electric Description of Encroachment: Will install and maintain 6 decorative street lights — 3 in front of building and 3 on the east side of building in the grass area. Please review the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCRCACKTRAFFIC\2100 19th Sltloc Y, A h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager & FROM: Bob Wilson, Supervisor ll, Subdivisions DATE: April 7, 2015 SUBJECT: Encroachment Permit Application for: 2100 19� St Name of Applicant: D & S Electric Description of Encroachment: Will install and maintain 6 decorative street lights — 3 in front of building and 3 on the east side of building in the grass area. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. IM sc.doc