HomeMy WebLinkAbout1605 20TH STENCROACHMENT PERMIT
CITY OF BAKERSFIELD APFRO��j
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 . . . . . 10- 30000034 Date 8/17/10
Property Address . . . . . . 1605 20TH ST
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
CRITES ANGUS D II OWNER
414 MT LOWE DR
BAKERSFIELD CA 93309
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Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 1025899
Permit Fee . . . . 208.00
Issue Date . . . . 8/17/10 Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 208.00
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Special Notes and Comments 6 feet of clear sidewalk is to be maintained
Place wrought iron fence on sidewalk at all times.
with tables, chairs and planters inside.
Contact:
Maria
327 -9331
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Fee summary Charged Paid Credited Due
- -- -------- - - - - -- - --- - - - - -- ---- - - - - -- ---- - - - --- ---- -- - ---
Permit Fee Total 208.00 208.00 .00 .00
Grand Total 208.00 208.00 .00 .00
acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the
.nv time.
of Applicant (Owner /Agent)
lyl . 0 ut 1,10w-
Print Name
I RE Y CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING
APP I ATION 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) QNS11TUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE GRANTED ENIED). Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
E A K E R S F I E I- 1
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ralph Korn, Risk Manager
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: August 17, 2010
SUBJECT: Encroachment Permit Application for: 1605 20TH Street
Name of Applicant: Maria Gueldner
Description of Encroachment. Place wrought iron fencing on sidewalk
around tables, chairs and planters.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
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B A K E R 5 F I E L L�
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer II
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: August 17, 2010
SUBJECT: Encroachment Permit Application for: 1605 20th Street
Name of Applicant. Maria Gueldner
Description of Encroachment: Place wrought iron fence on sidewalk
around tables, chairs and planter.
Please review the attached encroachment permit and return to me at your earliest convenience.
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RD'_ CERTIFICATE OF LIABILITY INSURANCE OP ID LD DATE(MM /DD/YYYY)
X41 SUBST -1 08/05/10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Clifford & Bradford Ins Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1515 20th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Bakersfield CA 93301
Phone: 661 -283 -8100 Fax: 661- 283 -8111 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: American Economy Ins. Co. _
Sub Station INSURER 8:
Maria ''Gueldner INSURER C:
1605 2'',Oth Street INSURER D:
Bakersfield CA 93301
INSURER E:
COVERAGES
THE POLICIES OF 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 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.
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TYPE OF INSURANCE
POLICY NUMBER
P C CTI E
DATE MM /DD
P C EXPI ION--
DATE MM /DD/YYYY
- -'—
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$500,000
A
X
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FK OCCUR
02BO9177540
08/10/10
08/10/11
PREMISES (E�Eaoccccue0nce�
_
$500,000
'000
MED EXP (Any one person)
_
$ 10 ,
PERSONAL & ADV INJURY
$500,000
GENERAL AGGREGATE
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$ 500, 000
POLICY JEC T PRO- LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
A -
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
{:n
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESS! UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR /PARTNER/EXECUTIVEM
OFFICER/MEMBER EXCLUDED?
TORY LIMITS I ER
E.L. EACH ACCIDENT
_
$
E.L. DISEASE - EA EMPLOYEE
- - - - - -- --
$
(Mandatory in NH)
If yes, describe under
SPECIAL PROVISIONS below
E.L, DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
*10 DAY NOTICE OF CANCELLATION FOR NON - PAYMENT WILL APPLY. CERTIFICATE
HOLDER IS NAMED AS ADDITIONAL INSURED AS RESPECTS LEASED PREMISES LOCATED
1605 20TH STREET, BAKERSFIELD, CA 93301.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
ANGUSKR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ANGUS CRITES
414 MT. LOWE DR. REPRESENTATIVES.
BAKERSFIELD CA 93309 AUTHORIZED REPRESENTATIVE
ACORD 25 (2009101)
The ACORD name and logo are registered marks of ACORD
TION. -All rights reserved.
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