HomeMy WebLinkAbout12281 PIERCE STENCROACHMENT 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- 30000063 Date 10/27/14
Property Address . . . . . . 1930 CARVER ST
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
-
------------------------
-----------------------
INGLESIA DE RESTARUACAION LA S OWNER
12281 PIERCE ST
ARLETA CA 91331
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Permit . . . . . . ENCROACHMENT
PERMIT
Additional desc . .
Phone Access Code . 1546217
Permit Fee . . . . 208.00
Issue Date . . . . 10/27/14
Valuation
. . . .
0
Qty Unit Charge Per
Extension
1.00 208.0000 EA PW ENCROACHMENT
208.00
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Special Notes and Comments
Place 6' stone and wrought iron
fence /��._,
&%r 151""
around property at back of sidewalk.
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Contact person: Victor Alonzo
661 -483 -7549
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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
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to
revoke the rmit at a y ime.
ign re A plicant (Owner /Agent) rint 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)
SUBST ALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2)
WILL N CON TUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
'i HEREFORE ( RANT (DENIEDSaid permit shall expire on date stated above.
fll--'S�
City Engineer
Additional Terms on the Back
10/21/2014 12:30 5596383336
'c�► CERTIFICATE OF LIA
PRODUCER
MeiAnonite insurance Services
PO Box .976
Reedley Ca 93654
INSURED
Iglesia be Restauracion Liar Senda, Antigua
1930 Carver St
Bakersfield CA 93307
MENNONITE AID PLAN
.2:3 l�
PAGE 02/02
B I LITY I N S U RAIN C E DATE (MMIDOMWY)
3.0/21/2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO FLIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURERS AFFORDING COVERAGE
NAIL 0
INSURERAI CuiC7.eOne Insurance Co
GENERAL AGGREGATE
INSURER D:
PRODUCTS - COMP /OP AGG
INSURER C!
COMBINED SINGLE LIMIT
(Ed nerldent)
INSURER D;
SONLYINJURY
(Par pairem)
IN8URCR C;
RCDILY INJURY
(Pnr!Iccldent)
THE POLICIES OF INSURANCE L.I°TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PC
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO W
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED 145REIN IS SUBJECT TO ALL THE TEF
POLICIES. AGGREGATE LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
GENERAI, LIABILITY
X I COMMERCIAL GENERAL LIABILITY
CLAIMS MADE L"I OCCUR
GEN'L AGGREGATE R
E LIMIT APPI,IFO PE:
POLICY F7 I M M LOC
AUTOMOW40 LIABILITY
ANY AUTO
ALI. OWNED AUTOS
SCI- GOULFD AUTOS
HIRED AUTOS
NON-OWNED AUTOS
AdE LIABILITY
ANY AUTO
SSS I UMBRELLA LIABILITY
OCCUR ED CLAIMS MACE
DEDUCTIBLE
EMPLOYERS' VAfSILRY
PROPRIETOwPARTNERIRXFCUTIVP F7
,.ERIMEMISER EXCLUO €C?
OTHER
9609 -180 1 10/10/1.41 10/10/15
DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES
Construction of fence on church property.
ICY PERIOD INDICATED, NOTWITHSTANDING
RICH THIS CERTIFICATE MAY BE ISSUED OR
MS, EXCLUSIONS AND CONDITIONS OF SUCH
LIMIjS
EACH OCCURRENCE
11, 000, 0 0 0
ISCS fEn ocqurrenbb
$ r 00 Q r 0 0
MED CXP {Any owne Doman)
$ 000
PRRBONAL 6 ADV INJURY
$ �• / 00o, 0 0 0
GENERAL AGGREGATE
/ LO —0r' 0 0 0
PRODUCTS - COMP /OP AGG
S. ! 0 0 0 r 0 0 0
COMBINED SINGLE LIMIT
(Ed nerldent)
IF
SONLYINJURY
(Par pairem)
R
RCDILY INJURY
(Pnr!Iccldent)
$
PROPERTY DAMAGE
(Per ecCldent)
AUTO ONLY. RA ACCIDENT
$
RTHER THAN EA ACO
IJTO ONLY: AGO
EACH Q0OURRENOF
$
8
$
AGGREGATE,
g
WC STATU• OTIi-
IMI;C� ft,
E.L„ EACH ACCIDENT
$
E.L. 1318PASE -CA EMPLOYE •
S
81. DISEA0111 -POLICY LIMIT
City of Bakersfield SHOVLDANYC PTHEASOVEbFSCRIUEDPOLICIESBE CANCELLED BEPORE THE EXPIRATION
Department
DATE THEREOF, THF. ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O.. DAYS WRITTEN
of Public Works DATE
TO THE CERTIFICATE HOLDER NAMED TO THELFFT, BUT PAILLIPMTObOsoSHALI.
�^ ^ 1 Tru.XtT, n Ave IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THR INSURER, ITB AGENTS OR
\�
sfield CA 93303. REPRESENTATIVES..
y�
AUTWORI2Ep RCPRESENi'ATNC ..
vgrp 0 jf68 -2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
B A K E R S F I E L D
Public Works Department
1501 Truxtun Avenue
Bakersfield, California 93301
(661) 326 -3724
'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.
(Strcei for proposed encroachment)
(Address of proposed encroachment) qo1
SIGNED:
1.) Name:
Address:
By:
(0wners name)
t)hont.-!M2--�DD!52�'
2. Name: �f ie
Address:
3.) Name: L-
Address:
t �
4.) Name: ���Y� U. 1� C l
Add ress: - -S.4I i fa(2
5.) Name: �-
Address: I '� '
Date.: /0 �'
Date /
Date:
Date: J L L
Date:
6.) Name: /� U Date: i �} C f r
Address:���1'
10121/2014 12:30 5596383336 MENNONITE AID PLAN PAGE 01/02
Mennonite Aid Plan
Mennonite - insurance Services
FO Box 878. 1 i 10 J Street
Reedley CA. 93654
Telephone (559) 635 -2327 FAX (559) 638 -3336
FAX COVER SHEET
Frow Jeremy Linscb.eid, General Manager
Date: a �t (7f '
To: �utL(tNc., Wor-k5 L'44 ttlnl.:
Regarding: _;z Aq a A ao
FAX #: �' / �'.S� � (off Wages including cover: rR
If you do not receive all of the pages, please call us at 559 - 638 -2327, 9:00 am -5:00 pm.
Of
L A Imo:. E R S F I E L I
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Cov , Rak Manager
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: October 29, 2014
SUBJECT: Encroachment Permit Application for: 1930 Carver St
Name of Applicant: Iglesia de Restauracion La Senda Antigua
Description of Encroachment: Place 6' high stone and wrought iron fence
around property at back of sidewalk.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S: \PERMITS \ENCROACH \INSURANCE \1930 Carver St.doc
40
'00.� -01 ------
E A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer III
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: October 29, 2014
SUBJECT: Encroachment Permit Application for: 1930 Carver St
Name of Applicant: Iglesia de Restauracion La Senda Antigua
Description of Encroachment: Place 6' high stone and wrought iron fence
around property at back of sidewalk.
Please review the attached encroachment permit and return to me at your earliest convenience.
I
If
S1PERMITS \ENCR0ACH \TRAFFIC \1930 Carver St.doc
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