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Home My WebLink About9400 STINE RD— aaa•.. Ala a Vi' 11-u: 1.11 1 Vi' Dian rllJl'1L'LL l./"11+1CV1(1V I/i: ...L,✓ 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 . . . . . 10- 30000025 Date 6/24/10 Property Address . . . . . . 9400 STINE RD Application type description PW - ENCROACHMENT PERMIT Owner Contractor Panama Buena Vista School Dist OWNER 9400 Stine Road Bakersfield, CA BAKERSFIELD CA 93313 (661) 397 -2200 ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 1012764 Permit Fee . . . . 208.00 Issue Date . . . . 6/24/10 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 208.00 ---------------------------------------------------------------------------- Special Notes and Comments Property owner is Panama -Buena Vista School District. Install fence behind new sidewalk. Approximately 45 linear feet of new sidewalk. Contact Person: Michael Buckey 661- 742 -7165 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --------- -- - - ---- - --- - - - --- ---- - - ---- --- - - - - - -- - -- -- - - - -- Permit Fee Total 208.00 208.00 .00 .00 Applicant acknaviedges the right oftheoCity Engimaq pursuant to1he Bakersflold Municipal Code Chapter 12.20 to revoke the permit at any time. (20 dd,'C QZ 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) qWFF4JE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFO URANT- (DENIED). Said permit shall expire on date stated above. a-A�40 Signature of City En veer Additional Terms on the Back EN PERMIT � APPLICATI ZORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852-2012 /Z) Y,10"126 LOCATION OF ENCROACHMENT(Address required where available):9400 Stine Road Bakersfield,! CA 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 Panama Buena Vista Union School District COMPLETE ADDRESS: 4200 Ashe Road Bakersfield,'CA 93313 PHONE: 661 397 -2200 FAX: 661 831 -1484 CELL: 661 742 -7165 PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): Install fence behind new sidwalk. ADnnX 45' lineal ft of nPn cidwAll, PERIOD OF TIME FOR ENCROACHMENT• INDEFINA or OTHER: e Circle) CONTACT PERSON- 'Mikhael Bucket/ PHONE: 661 391-2200 Ext 6437 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, 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 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 Encroachment Permit Fee: $2AW -. 'Or S:\PERMITS \ENCROACH \Encroachment Permit Req Form.DOC January 2009 B A K E R S F I E Lr 1) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ralph Korn, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: July 9,-2010 SUBJECT: Encroachment Permit Application for: 9400 Stine Road Name of Applicant: Panama Bueana Vista School District Description of Encroachment: Panama Elementary School to install a fence behind new sidewalk Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S: \PERMITS \ENCROACH \INSURANC \9400 Stine Rd.doc B A Imo. E R. S F I E L E7 PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ryan Starbuck, Civil Engineer III FROM: Bob Wilson, Supervisor II, Subdivisions DATE: July 9, 2010 SUBJECT: Encroachment Permit Application for: 9400 Stine Road Name of Applicant: Panama Buena Vista School District Description of Encroachment: Panama Elementary School to install a fence behind the new sidewalk. Please review the attached encroachment permit and return to me at your earliest convenience O�H S: \PERMITS \ENCROACH \TRAFFIC \9400 Stine Rd.doc �ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 06/24/2009 PRODUCER 661.636.449S FAX 661.636.4418 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Self Insured Schools of CA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO Box 1847 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Bakersfield, CA 93303 -1847 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED Self Insured Schools of CA SISC II 1300 17th Street PO Box 1847 Bakersfield, CA 93303 -1847 SISC I & II Member Districts (See attached) CC)VFRAr.FR INSURERS AFFORDING COVERAGE _ _ NAIC # INSURER A: Self Insured Schools of Calif. INSURER 8: INSURER C: INSURER D: —' - INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YYYY POLICY EXPIRATION DATE MM /DD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY SLP 7109 10 07/01/2009 0710112010 EACH OCCURRENCE $ 1,500,000 PREMISES Ea occurrence $ A CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ -- GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP /OP AGG $ AUTOMOBILE X LIABILITY ANY AUTO $1 ALL OWNED AUTOS SAP 7109 10 000 DED ACV COMP /COLE 07/01/2009 07/01/2010 c CO aaBINEDnt)INGLELIMIT $ 1,500,000 BODILY INJURY (Per person) I $ A SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON - OWNEDAUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS / UMBRELLA LIABILITY OCCUR D CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ TU- TORY LIMITS ER $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY OFFICERIMEMBER EXCLUD D7 ECUTIVE� (Mandatory In NH) If yea, describe under SPECIAL PROVISIONS below OTHER LANKET BUILDINGS & ERSONAL PROPERTY WC 7109 10 SPP 10 7109 07/01/2009 01 07 / /2009 07/O1/2010 07/01/2010 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 E.L. DISEASE - POLICY LIMIT BLANKET LIMIT $2,500 DEDUCTIBLE $ 1, 000 , 000 $250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Various permits and use of various facilities, for which the City of Bakersfield, its mayor, council, officers, agents, employees and designated volunteers are listed as additional insureds, as respects attached list of school districts covered under the SISC MOC. (See attached list) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Bakersfield NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Attention: David Stricker REPRESENTATIVESoll 1501 Truxtun Avenue AUTHORIZED 7S TA 7 Ba ersfield, CA 93301 ?�,,, ACORD 26 (2009/01) 1988-2009 ACORD P reserved. The ACORD name and logo are registered marks of ACORD wzum�o�+rns:�snna,euxi�in tl��`�'�