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HomeMy WebLinkAbout930 18th StBA ENCROACHMENT PERMIT Y �;,enrosreo�C� li`-1 # CITY OF BAKERSFIELD (� PUBLIC WORKS DEPARTMENT t� 1501 TRUXTUN AVE BAKERSFIELD CA 93301 gL1FO '� (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 . . . . . 18- 30000014 Date 8/14/18 Property Address . . . . . . 930 18TH ST Application type description PW - ENCROACHMENT PERMIT Owner ------------------ - - - - -- MUSTANG SQUARE LLC 1412 17TH ST STE 412 BAKERSFIELD CA 93301 Contractor ------------------ - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2231843 Permit Fee . . . . 420.00 Issue Date . . . . 8/14/18 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments August 14, 2018 10:09:18 AM mmendenhal. Two 4" round x 48" high tube steel bollard - embed minimum 30" in a 12" diameter f ooting minimum 3" coverage all sides - grout solid, across drive approach on 0 Street side of property Contact person: Tom Carosella 631 -2692 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --- -------- - - - - -- ---- - - - - -- ---- - - - - -- ---- -- - - -- ---- - - - - -- Permit Fee Total 420.00 420.00 .00 .00 Grand Total 420.00 420.00 .00 .00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to rev ermit at any 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 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 or judicial tribunals of any kind whatsoever, arising out of connected with, or caused by applicant, or in any way arising from, the terms and provision of this permit or the placement, use (by applicant or any other person or entity) or maintenance of said encroachment, whether or not caused in part by a party indemnified hereunder, except for CITY's sole active negligence or willful misconduct. The applicant further agrees to maintain the aforesaid encroachment, including, but not limited to, repairing or replacing the encroachment at Applicant's cost even if CITY inadvertently damages or destroys the encroachment in the ordinary course of CITY's business, during the life of the 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 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 must contact Dig -Alert at 811 at least 2 full working days prior to all excavating. 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 issuance evidencing sufficient coverage for bodily injury or property damage liability of both and required endorsements evidencing the insurance required. I have read and acknowledge the above. Applicant :s Initials If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. FULL NAME OF APPLICANT COMPLETE ADDRESS: G: DESCRIPTION OF ENCROA planter, etc.): _- ���lrcl S PHONE: FAX: CELL: PROJECT INFORMATION (Example: Wood or wrought iron fence, concrete block wall, raised T PERIOD OF TIME FOR ENCROACHMENT: ,�v II NDEFINITE OTHER: "l .`� J lease Circle) 1'��, CONTACT PERSON �i►rfl�r� PHONE: - 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 up2n 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 The Commercial Liability policy must identify City and City's mayor, council, officers, agents, employees, and designated volunteers as Additional Insureds. Encroachment Permit Fee: $420.00 S :\PERMITS\ENCROACH\Encroachment Permit Req Form.DOC Aug. 2017 QADDED NOTE PER N ACCORDANCE w/ NSPECTOWS NSTRUCTK* S c BNEW TREES PER CITY STANDARDS - Y OTHERS PER 14 ACCORDANCE NS�PECTOORS INSTRUCTIONS r/ C ROUND x 48' HGH TUBE STEEL BOLLARD MBED MNMUM 30' N A 12' DIAMETER FOOTW6 W ND.IUM 3' COVERAGE ALL SIDES - GOUT Solz - -- — w C f� O _ J � W N ADDED NOTE PER N ACCORDANCE w/ INSPECTOR'S NSTRUCT)ONS NEW TREES PER CITY STANDARDS - BY OTHERS Q ADDED NOTE \ NEW DETECTABLE WARNNG - SEE DETAIL 12/A -5.0 �, -0' EXISTNG PLANTER T( 2% MAX SLOPE N At 1800 O St - Google Maps Go gle Maps Bakersfield, California Google, Inc. Street View - Aug 2016 P 1 930 18th 18000St Page 1 of 7 ;r4 Image capture: Aug 2016 © 2018 Google tlC-rd loc-�ic*-, https: / /www.google.comlmapsl @35.3754725,- 119.0129848,3a,60y,60.24h,90t /data =! 3m6! ... 8/21/2018 930 18th St - Google Maps Go gle Maps 93018th St .,f Imagery 02018 Google, Mapp ata ©2018 Google 20 ft Page 1 of 7 �A( .. ; .4 B&lC-rA [ 93018th St Bakersfield, CA 93301 At this location https: / /www.google.comlmaps /place/ 930 +18th +St, +Bakersfield, +CA +93301 / @35.375601... 8/21/2018 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MPoVDD/YYYY) F 8/10/2018 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MONTGOMERY INSURANCE AGENCY 5500 Ming Ave #220 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TYPE OF INSURANCE POLICY NUMBER Bakersfield, CA 93309 (661)832-9311 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. NATIONWIDE MUTUAL, INS. CO. INSURER B: MUSTANG SQUARE, LLC 1412 17TH STREET, #412 INSURER C: $ 100,000 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. INSR LTR D 'L NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDNY POLICY EXPIRATION DATE MM/DD/YY LIMITS RE TA VES. GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurence $ 100,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 5,000- 0 0 0 CLAIMS MADE OCCUR PERSONAL& ADV INJURY $ 1,000,000 A ACP 7865454074 03/28/18 03/28/19 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY D PRO- JECT I LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Eaacoldenl) BODILY INJURY ALL OWNEDAUTOS SCHEDULED AUTOS (Per person) S BODILYINJURY $ HIRED AUTOS NON- OWNEOAUTOS (Paraccklent) PROPERTY DAMAGE $ (Peraccident) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTOONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000 X I OCCUR CLAIMSMADF AGGREGATE $ 5,000,000 $ ACP 7865454074 03/28/18 03/28/19 $ A DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WCSTATU• OTH- TORYLIMRS ER EMPLOYERS' LIABILITY ANY PROPRIETORIF'ARTNF3t/EXECIlfIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERlMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS! VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS THE CITY OF BAKERSFIELD, ITS MAYOR, COUNCIL, EMPLOYEES, AGENTS AND VOLUNTEERS ARE ADDED AS ADDITIONAL INSURED'S TO THE ENCROACHMENT PERMIT (BOLLARDS LOCATED ON 0 STREET) LOCATION: 930 18TH STREET, BAKERSFIELD, CA 93301 CERTIFICATE HOLDER CANCELLATION CITY OF BAKERSFIELD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVENUE NO(RESEN O THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL BAKERSFIELD, CA 93301 IMO BLIGATION OR LIABIL OF Y KIND UPON THE INSURER, ITS AGENTS OR RE TA VES. AU ORIZED EP EWATIVE ACORD25(2001108) ©ACOh6 CORPORATION 19$8 I _,> I E x r I F, 1. z) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ed Murphy, Engineer III FROM: Michelle Mendenhall, Engineering Tech DATE: August 21, 2018 SUBJECT: Encroachment Permit Application for: 930 18`' Street Name of Applicant: Mustang Square LLC Description of Encroachment: Two 4" round x 48" high tube steel bollards across drive approach on O Street side of property Please review the attached encroachment permit and return to me at your earliest convenience. S \PERMITS \ENCROACH \TRAFFIC \930 18th St.doc I� E R Ii T F L T) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager L FROM: Michelle Mendenhall, Engineering Technician DATE: August 21, 2018 SUBJECT: Encroachment Permit Application for: 930 18`h Street Name of Applicant: Mustang Square LLC Description of Encroachment: Two 4" round x 48" high tube steel bollards across drive approach on O Street side of property Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S: \PERMITS \ENCROACH \INSURANCE \930 18th Street.doc