HomeMy WebLinkAbout1329 34TH STS A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 21, 2009
SUBJECT: Encroachment Permit Application for: 1329 34th St.
Name of Applicant: Dale & Susan Taylor
Description of Encroachment: Install 6' high wrought iron fence around
perimeter of property. Mercy Plaza
Respiratory is located on this property.
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
applicant to install fence as described above.
The applicant has provided proof of appropriate insurance coverage to Risk Management.
Based on their review, staff recommends approval of the permit.
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S: \PERMITS \E NCROACH\2
tW
ENCROACHMENT 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 . . . . . 09- 30000030 Date 7/13/09
Property Address . . . . 1329 34TH,ST
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
- ---- --- ---------- - - -- -- --- - -- - --
TAYLOR DALE & SUSAN
2323 16TH ST ## 100
----- ---------- - --- - - - - -- IV` -�
BAKERSFIELD CA 93301 �
'nn l
----------- -- -----
Permit . . . . . . ENCROACHMENT PERM
Additional desc
Phone Access Code 923334
Permit Fee . . . . 208.00 �...a
Issue Date . . . . 7/13/09
Qty Unit Charge Per
1.00 208.0000 EA PW ENCROACH
--------------------------------------------
Special Notes and Comments
INSTALL 6' HIGH WROUGHT IRON FENCE
AROUND PERIMETER OF PROPERTY. MERCY
PLAZA RESPIRATORY IS LOCATED ON
PROPERTY. CONTACT: BETH SELZAM,
324 -2545.
--------------- -- ------ ---- ---- --------- -----
Fee summary Charged Paid
------- ---- - - - - -- ---- - -- - -- -- - - - - ---
Permit Fee Total 208.00 208.0 ..,v .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 an7tie.
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 (GRANTED) (DENIED). Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
a
B A. Imo. E R S F I E E E
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ralph Korn, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 15, 2009
SUBJECT: Encroachment Permit Application for: 1329 34'h St.
Name of Applicant: Dale & Susan Taylor
Description of Encroachment: Install 6' high wrought iron fence around
perimeter of property. Mercy Plaza
Respiratory is located on property.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
SAPERMITS\ENCROACH\INSURANC \1329 34th StAoc
B A K E Rv S F I E L, I
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer II
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 15, 2009
SUBJECT: Encroachment Permit Application for: 1329 34`" St.
Name of Applicant. Dale & Susan Taylor
Description of Encroachment: Install 6' high wrought iron fence around
perimeter of property. Mercy Plaza
Respiratory is located on property.
Please review the attached encroachment permit and return to me at your earliest convenience.
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S: \PERMITS \ENCROACH \TRAFFIC \1329 34th StAoc
LOCATION OF ENCROACHMENT(Address required where available): 192 ? , 3 q Y-A- S+. K K S
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 6Z (-!I /6Z4 /2F- S lot e19 6 y
COMPLETE ADDRESS: 13 2q 3 q V k PHONE: rG G
. l.lc cxSF► z Ll� Cg g73 3 v / FAX: (4 U 96 it y
CELL:
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.): U R- 6aLt -47" Z/LaA) r6A) C- % P,5j2 /P(r--ML- OF P2 o Pt/Z-1-7f
PERIOD OF TIME FOR ENCROACHMENT: INDEF NI ITE or OTHER: Pia l"L�
(Please Circle)
CONTACT PERSON B E:TM SEL-ZA rt PHONE: �� k 1� 3 z q — 2 Sq S
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 won 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.
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke �,�(k
the permit at any time. ti
Encroachment Permit Fee: $208.00
S:\PERMITS\ENCROACH\—Encroachment Permit Req Form.DOC January 2009
CITY OF BAKERVIELD
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.
(Street for puposed encroachment) (Owners Name)
of 3.2�- � 3 q _rk S-� I
jAddress at purposed encroachment )
SIGNED
1) Name:
Address:
2) Name:
Phone: G 61),-3 2-q - 2 ,y6
.!address. 3) Name:
Name :'"�
Address: , ?A 1
4) Name: l� c� r� (� � v i �-
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Jun 23 2009 12:14PM # Mercy. Plaza Pharmacy 661- 324- 9644 p.l
AGj=L CERTIFICATE OF LIABILITY
INSURANCE
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ALTER THE COVERAGE AFFORDED BY THE POWQIES BELOW.
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ENCROACHMENT 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 . . . . . 09- 30000030 Date 7/13/09
Property Address' . . . . 1329 34TH ST
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
------ ------------ - -- - -- ---------
.TAYLOR DALE & SUSAN
2323 16TH ST # 100
BAKERSFIELD - - -CA- 93301--- - - - - -- ^ , 0
-- --------------- - - -- -- '`I \`�flL
Permit . . . . . . ENCROACHMENT PERM:
Additional desc
Phone Access Code 923334
Permit Fee . . . . 208.00
Issue Date . . . . 7/13/09
Qty Unit Charge Per
1.00 208.0000 EA PW ENCROACH
--------------------------------------------
Special Notes and Comments
INSTALL 6' HIGH WROUGHT IRON FENCE
AROUND PERIMETER OF PROPERTY. MERCY
PLAZA RESPIRATORY IS LOCATED ON
PROPERTY. CONTACT: BETH SELZAM,
324 -2545.
----------------------------------------- - ---
Fee summary Charged Paid
------- ---- - - - - -- ---- -- - - -- --- - - - - --
Permit Fee Total 208.00 208.0 vv .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 ti e.
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 (GRANTED) (DENIED). Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
d
ENCROACHMENT PERMIT
APPLICATION FORM / i7�.7
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE /
BAKERSFIELD CA 93301
(661) 326 -3724 Fax: (661) 852-2012 ( 0
LOCATION OF ENCROACHMENT(Address required where available): /,3Z q ik
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 2 M6zC!f PL-t9z4 %1£S1°r(LN d,2
COMPLETE ADDRESS: /3 2q 3 q Y'k S PHONE: CG G 0 3 2(( '1 C`i Sr
C)9 g73 3 v t FAX: L y
CELL.:
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.): U (l. 6 rti. t- 7' Z/L Z) ,J r A.) C-6- (P /�1 }�,�il r Hl 6 V14 0 i P9 y P£/1-Z,�
i
PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE or OTHER: KAYO
(Please Circle)
CONTACT PERSON E: rN S E L Z � r't PHONE: (L I� 3 z Lt
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 ngineer 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.
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke,��
the permit at any time. J
L\
Encroachment Permit Fee: $208.00
S:\PERMITS\ENCROACHN—Encroachment Permit Req Form.DOC January 2009
CITY 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
sidawalk within the public right of way.
Owners Name
(Street for puposed encroachment) � )
of % 3.2.q � s� � �` s-t
(,Address of purposed encroachment )
SIGNED
1) Name:
Address:
2) Name:
Phone:
Address:
3) Name: 6P v5'- �✓�
Address:
4) Name: 1�✓ r� t;� v I �-
3 v�-
Address:
3) Rbrr��:�
Address: 19��
6) Name:
Address:
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http: / /cobgi s. ei.b akersfield. ca. uslservleticom. esri. esrimap. Esrimap? S erviceName= ovmap &... 6/23/2009
Jun 23 2009 12:14PM # Mercy:Plaza Pharmacy 661- 324- 9644 P.1
., CERTIFICATE OF LIABILITY
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PRODVOIIR (661) 885 -4542 I AXII (662).035-4500
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