HomeMy WebLinkAbout11109 CAMINO MAJORCA MDENCROACHMENT PERMIT`L
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 . . . . .
05- 30000105
Date 11/15/05
►`i` L < cis 3�ff
Property Address . . .
11109 CAMINO MAJORCA MD
i�l� �l7 J'
ATN (11 Digits):
001- 241- 10 -00 -3
Application type description
PW - ENCROACHMENT PERMIT
Owner
Contractor
------------------ - - - - --
SIEGEL BETTINA KARIN
------------------------
OWNER /BUILDER
11109 CAMINO MAJORCA
BAKERSFIELD CA 93311
BAKERSFIELD
CA 93301
(661) 663 -9531
----------------------------------------------------------------------------
Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 470211
Permit Fee . . . . 150.00
Issue Date . . . . 11/15/05
Valuation . .
. . 0
Qty Unit Charge Per
Extension
1.00 150.0000 EA PW
ENCROACHMENT
150.00
----------------------------------------------------------------------------
Special Notes and Comments
ADDING VINEL FENCE IN THE FRONT YARD.
----------------------------------------------------------------------------
Fee summary Charged
Paid Credited
Due
--- -------- - - - - -- ---- - - - - --
Permit Fee Total 150.00
---- - - - - -- ---- - - - - --
150.00 .00
---- - - - - --
.00
Grand Total 150.00
150.00 .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.
11/sypl_ 6zo � 4. orj1=L
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) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE ORANTE D (DENIED). Said permit shall expire on date stated above.
Signature o City Engineer
Additional Terms on the Back
0
S A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: *0 Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: January 5, 2006
SUBJECT: Encroachment Permit Application for 11109 Camino Majorca
Name of Applicant Siegel, Bettina Karin
Description of encroachment. Front yard fence behind sidewalk not over 4'
high
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
installation of a front yard fence behind sidewalk not over 4' high.
The site is located at 11109 Camino Majorca.
The applicant has provided proof of appropriate insurance coverage to Risk Management, and
has provided signatures of all immediate neighbors stating that they have no objection to the
proposed construction.
Based on their review, staff recommends approval of the permit.
SAPERMIMENCROACH\_Approval memo.doc
B A I� E R.. S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 23, 2005
SUBJECT: Encroachment Permit Application for 11109 Camino Majorca MD
Name of Applicant Siegel Bettina Karin
Description of encroachment. Adding vinel fence in front yard behind
sidewalk
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
SAPERMIMENCROACHUNSURANQ11109 Camino Majorca.doc
F A K E R S F I I R L i7
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 28, 2005
SUBJECT: Encroachment Permit Application for 11109 Camino Majorca
Name of Applicant Siegel Bettina Karin
Description of encroachment front yard fence behind sidewalk not over
4' high
Please review the attached encroachment permit and return to me at your earliest convenience.(f 9
lov. 2°!, 204T
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SAPERMITS \ENCROACH \TRAFFIC \11109 Camino Majorca.doc
APPLICATION FOR ENCROACHMENT PE&MIT
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CAiLIFORNLA:
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.
1. Full name of applicant and complete address including. hone number: f J eM_i, g_ �a_r'v\
2. Nature or description of the encroachment for which this application is made:
3. Location of the proposed encroachment: 6' r .
4. Period of time for which the encroachment is to be maintained: o r-e"/ C r _
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless 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 -u on
the revocation thereof by the City engineer, applicant will at his own cost and expense remove the same from the Du lic
Proyert X 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 Eng' eet 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 ype(s) and amount(s) of insurance' coverage is:
COO 1001 ow
Applicant acknowledges the right of the City Engineer, pursuantao Bakersfield Municipal...Ccde,,ChppWr 12.20 to
revoke the permit at any time.
Date: q-
ignature o App i ant (owner dr epresent ve
PERMIT
I HEREBY CERTIFY THAT I ILAVE 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 PUBLIC PLACE WHERE THE SAME IS TO
BE LOCATED AND (2) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE;
SAID APPLICATION IS THEREFORE (GRANTED) (DENIED). SAID PERMMIT SHALL EXPIRE
Date:
ignature of ity Engineer
No.
' aTY OF. BAKERSFIELD
DEPARTMENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fence beside the
sidewalk within the public right of way.
�l 0 C re W.w r. a w` or LL-- e: Bv: e, �1 �" a S , e Q-
(Street for pupose encroachment) (Owners Name) V
of k lk o A �)M d l- rc- g Phone:
(Address of purposed encroachment)
SIGNED
1) Name: r' Z 22te:
Address: •`
No YYi!'�-v zCA-
2) Name: Date: 11 U
.Address: �.�..�1� � � (1 � r ( G
3) Name: Date:
Address: M13 C� Ct�w�iv�� Wl av
4) Game: Date' 1 � - t 2 � O sr
Address: pp
5) Name: wA 1( cL Dete: \ Or
Address: M\ \\I e3 S!2Q C. CL
6) Name: Date:
Address: .1...L 04 Ale 00- 0&
11/15/2005 12:43 6613973447
Policy Change
Propose)
Named Insured
(:E TTINA' K SIEGEL
1109 CAMINO MAJORCA
.tSFiELD CA 93311
CIS INSURANCE SPECS. PAGE 01/01
IN TRAVELERS
HOMEOWNERS POLICY
Your A►gettey's Name and Address
CALIFORNIA INS SPECIALISTS
PD BOX 5579
BAKE:RSFIELD, CA 513389
Your Policy Number: 976759223 633 1 Fox' Policy Service Call: (661) 397 -3944
Your Account Number: 976759223 For Claim Service Call: 1- soo- cLAxM33
Policy Period
FROM: 02- 27•-05 To: 02 -27 -06 12c01 A.M.
STANDARD TIME AT THE RESIDENCE PREMSES
Change Effective Date: 11/08/05
Location of Residence Premises
111)9 CAMINO MAJORCA
BAKIRSFIELD CA 93311
P retaum for This Change. $ 7.00
Reasons for Change: Increase to Personal Liability Change to Account Credit
Section I - Property Coverages Limits of Premium
Liability
A - DWELLING
$ 128,000
$ 324.00
B - OTHER STRUCTURES
12,800
INCL
C - PERSONAL PROPERTY
89,500
INCL
D - LOSS OF VSR
38,400
INCL
Section 11- Liability Coverages
E — PERSONAL LIABILITY (BODILY INJURY MO
PROPERTY DAMAGE) EACH OCCURRENCE
F - MEDICAL PAYMENTS TO OTHERS-
EACH PERSON
$ 300,000 $
1,000
33.00
INCL
Policy Forms and Endorsements
m
„
HO -3 CA (10 -92) Honueown�ara 3 Special Form
HA -300 CA (04 -04) Special Provisions
56494 CA (03 -99) Personal Property Replacement Cast
$
47.00
°=
56512 CA (03 -99) Additional Replacement. Cost Protection
4.00
5$273 (12 -99) Additional Replacement. Cost Protection
Increased,
30.00
Amount - Maximum Additional Amot.nt of
Insurance 50%
°
HO -027 CA (07 -02) Limited Fungi Other NCiorobes or Rot
m�
Remediation
d
�=
Limit of Liabij.jty: $5,000
43813FU NS (05 -42) Lenders Loss Payable Xndorsement.
T,
55769 (0300) Workers Compensation and Employaxs
�
INCL
n�!�1
o�
Liability Insurance Endorsement
4.
Total Premium
$
438.00
°=
u�
.�_
Continued on next page Agent Copy
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