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Home My WebLink About6320 WHITE LNENCROACHMENT 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 . . . . 14-30Dp0o01 Date 1/02/14 Property Address 6320'kklTE IN Application type description PW - ENCROACHMENT PERMIT Owner Contractor ________________________ BI%BY COURT APARTMENTS LLC -______-__--____________ ARGONAUT FOOD PARTNERS, LLC 201 COVINA AV k 1 2650 WASHBURN WAY LONG BEACH CA 90803 LKAMATH FALLS, OR KLAMATH FALLS OR 97603 (541) 273-4639 Permit . . . ENCROACHMENT PERMIT Additional desc . . Phone ACCeas Code . 1412535 Permit Fee . . . . 208.00 Issue Date . . . . 1/02/14 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 209.0000 EA PW ENCROACCFENT 208.00 ---------------------------------------------------------------------------- Special Notes and Comments January 2, 2014 9:37:00 AN mmendenhal. Install handicap pathway up to property with rails and raised ramp. ___________________________---__________--__-_-___.___-_____._--__---_____ Fee summary Charged Paid Credited One _________________ __________ Permit Fee Total 208.00 __________ __________ ---- 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 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) CQN-=J TE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE WR ANTE (DENIED) Said permit shall expire on date stated above. L1 Signature of City Engin Additional Terms on the Back A ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT ei 1501 TRUXTUN AVE FO BAKERSFIELD CA 93301 ¢m. (661)326-3724 Fax:(661)852-2012 LQQccAA,,TION qQ�F ENGqROACHMENT(Address required where available): 6S,2o tjiv,ike°_ Lv, E'�AKeusCie�cl Lrh 4331)A If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. FULL NAME OF APPI COMPLETE ADDRESS: 'fir: +-e 'a2 J 0 1 FAX: 11113WIAiH fA116I OP. A7603 CELL: 453-60-fio?70 PROJECT INFORMATION DESCRIPTIO,,NAA OF ENCROACHMENT (�E(�xa=: Wood or wrought iron fence, concrete block wall, raised planter, etc.): I I C tJ 5rP wa K PERIOD OF TIME FOR ENCROACHMENT: NDCircle) r OTHER: ease CONTACTPERSON PHONE: �-- ASi% "6 a7 0 Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, in officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever against them, or any ofthem,. 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. provemyor right of way where the same is located, and restore mid public property or right of wav 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 theinsurance 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 an amount ufat least $1.000.000.00 Encroachment Permit Fee: $208.00 S:\PERMII S\ENCROAMEncroachment Permit Req Form.DOC January 2009 ACORQ, CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. the terms and conditions of the certificate holder in lieu of such Leavitt Insurance Agency 7881 W. Charleston Blvd. Suite 140 Las Veqas, NV 89117 DBA: KFC Restaurants 2650 Washburn Suite 250 Klamath Falls, OR 971 require an endorsement A statement on this certificate does not confer e core THIS IST CERTIFY THATTHE POLICIES F INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OFINSORANCE iINSR WVD POLICY NUMBER MM'DNYI'YY MH UNITS ACCORDANCE WITH THE POLICY PRONSONS. GENERAL LNBILItt ACP7815920251,1 V0612013 12/06/2014 BALH OCCURRENCE S DOD, OO _ BREMIRE91EaxaureRcej __1, 300,00 IX COMMERGALOENERAL LIABILITY ! CA 93301 MEO E%P (Airy persM) S S,OD F JCUIMSNAOEI JOCCUR 1 SII PERsoNALSApv wmR s 1, 000,00 A GENERAL AGGREGATE (s 2;000,00 GGREGATE IMITAITTLEI PER PROOUR6 COMPIOPAGGJ$ 2_000,00 FGENL POLICY jELO'r ! LOC 5 AuromoelLE uxeam ACP781592025 12106/2013.12/06/2014 IEaamdenq_ IS 1,000,00 BODILY IWIRY(Per t5 ANY AUTO pomorl __L B 1AUrOVrNED �AUTOSULED BODILY IN]URY Per aaltlenl) 6 X NON OVd1ED XIREDAUTOS � X AUTOS � fPR6PEPT4IIAMAG� :IP aatlonp 5 X UMBRELLA LWB XOCCUR ACP781592025 12106/2013 12106/20141 EACH OCCURRENCE 5 5,000,00 1AGGREGATE 5 5,000,00 A EXCESS UAB CILIAS -MADE OED ILRETENTIONS ! _ _ $ W ORKERSOM CPENSATION AND EMPLOYEB$'LNBILfI'Y YIN: TORY LIMITS ER ANY PROPRIETORIPARTNER.XEGUTIVF�� I OFFICERIMEMR ER EXCWGEO? I�NIA�� EL EACH PCCIDENT $ I E.L. DISEASE -EA EMPLOYE $______ (MyYandatoryin Np LJ OtSCRIPTION OF OPERATIONS bHmv I EL DISEASE -POLICY LIMIT S Property Special Form ! ACP781592025112106/2013 12/06/2014 $1,000 Property Deductible A jt%placement Cost Incl Business Income 12 Months ALS hhef DESCMMON OF OPERPTIONSI LOCATION51 VEHICLES IARach ACORD In, Additional Rereads SCOetlUlq Bmom apace ie romimtll. E: Encroachment at 6320 White Lane, Bakersfiled, CA 93308 overage subject to policy terms; conditions, limitations and exclusions a, wm I,..m. rr r,al,L ar5rr.r,.. ACORD 25:(2010/05) The ACORD name and logo are registered marks of ACORD. SHOULD ANY OF THE ABOVE DESCRIBED FOUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRONSONS. City of Bakersfield AUTHORIZED REPRESENTATIVE Public Works De arment 1501 TruxtunAve Bakersfield, CA 93301 Rodney Leavitt/WEBB a, wm I,..m. rr r,al,L ar5rr.r,.. ACORD 25:(2010/05) The ACORD name and logo are registered marks of ACORD. h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor II, Subdivisions DATE: January 7, 2014 SUBJECT: Encroachment Permit Application for: 6320 White Ln Name of Applicant: Agonaut food Partners LLC Description of Encroachment: Install handicap pathway up to property with rails and raised ramp Please review the attached encroachment permit and return to me at your earliest convenience. 5:�ERMITS\ENCR0ACH\TRAFFICM20 Mft Ln.d. • B _A, h E R S F I E L L> PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: January 7, 2014 SUBJECT: Encroachment Permit Application for: 6320 White Ln Name of Applicant: Agonaut Food Partners LLC Description of Encroachment: Install handicap pathway up to property with rails and raised ramp. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S? PERMITSIENCROACH%INSURANCE=20 Whtte Ln.doc