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HomeMy WebLinkAbout2413 Teresa CtENCROACHMENT PERMIT CITY OF BAKERSFIELD "h : v PUBLIC WORKS DEPARTMENT KIT F- 1501 TRUXTUN AVE -arty BAKERSFIELD CA 93301 11 IF :`� �'' (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- 30000013 Date 8/13/18 Property Address . . . . . . 2413 TERESA CT Application type description PW - ENCROACHMENT PERMIT Owner ------------------------ URIBE JUAN DE DIOS 2413 TERESA CT BAKERSFIELD CA 93304 Contractor ----------------- - - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2231595 Permit Fee . . . . 420.00 Issue Date . . . . 8/13/18 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments August 13, 2018 3:27:07 PM mmendenhal. Place 6' high block wall at back of sidewalk on Hughes Lane side of property, the length of the property. Contact person: Juan Uripe•4A4 -0438 --------------------------------- ^' ------------------------------------------ Fee summary Chcjrged Paid Credited Due Permit Fee Totj 1 420.00 420.00 .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 revok ,the permit at any time. Si t 1' er /Agent) Print Name r' 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. 1 have read and acknowledge the above. Applicant's Initials ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852 -2012 LOCATION OF ENCROACHMENT(Address required where available): If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. FULL NAME OF APPLICANT APPLICANT INFORMATION CJ13 1-J .6.- -6 e o - aW-1 'Ci -c-- COMPLETE ADDRESS: 7k�Z-c=10 C T, C-& , > _3 -4-02 PHONE: FAX: CELL: PROJECT INFORMATION cj v� 8 DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): C'-o/cJCA-c T,:f /2e�4 PERIOD OF TIME FOR ENCROACHMENT: NDEFINITE r OTHER: I (Please Circle) CONTACT PERSON 10 a Y&/ � cP 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 upon 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 Pennit Req Form.DOC Aug. 2017 BAKERS FIE LD 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. Jq (Street for proposed encroachment) (Address of proposed encroachment) SIGNED: 1.) Name: Address: 2.) Name: BY: (Owners Name) Phone. (4 60 Address: 3.) Name: Address: 4.) Name: Address: 5.) Name: Address: 6.) Name: `�Amb<f WVV ) A-V- T) Date: % % % i / Date: -7 Date: I Date: 74-47* Date: i-) ?- /' -%-c�10 /'�' cA cl Date: I LI I I Address:y �O1" Gam's CA • See Signatures needed for approval page U a� ^L` W 1 el E 0 E N O 0 V ✓D � N O O O O N O O O O O O O co 0 c0 N J Q I t I 7 — — O 3 E 0 E N O 0 V ✓D � N O O O O N O O O O O O O co 0 c0 N J Q T6452 -3 GO gle Maps Hughes Ln Image capture: Jul 2015 © 2018 Google Bakersfield, California Google, Inc. Street View - Jul 2015 h b GK 0� ac o b �Ir ,.� eao ?2413 Tere! 8/13/2018 co co sg 9s Z9 00 a CY) 09 09 99 Cl) ' C!t 9205 > K, 09 09 9p N O N N Q N /9 96 co oti D 9 t-0 99 d4 C1 O N py O \ o Q �ILL PSI. 5 b D9 09 0/ p\ C N N N N %6 U s� O1 �1� o ob'��1 14) 7 y N N N Q CA co l 1� 5 J ` v I (3C) O�'7 09 9 of s9 19 `� 9 CO � O O a co m 4d 19 _ 19 9b o Q' M {,�,/ N O N N• � � � � N 'o N N N N N N l m DATE (MM/DD/YYYY) ACC>R o EVIDENCE OF PROPERTY INSURANCE 106/29/2018 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY HONE 661 - 835 -8960 COMPANY NAICN 25143 1lIL4.H_o .ExU' -- — StateFarm Hope Stitt State Farm 200 New Stine Rd Ste. 132 State Farm Fire and Casualty Company • • • Bakersfield, Ca 93309 r"" 661 - 835 -8981 _ ADDRESS: IOrlann .ZaVala.eznaLStaleTarm.COm (A/C, No CODE: SUB CODE: AGENCY 55 0676 CUSTOMER ID M: — LOAN NUMBER POLICY NUMBER I NSURED JUAN URIBE 0504226756 87-05- V466 -6 2413 TERESA CT EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL BAKERSFIELD, CA 93304 04/24/2018 04/024/2019 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: —71 PROPERTY INFORMATION LOCATION/DESCRIPTION 2413 TERESA CT BAKERSFIELD, CA 93304 -7097 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 EVIDENCE OF PROPERTY INSURANCE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION PERILS INSURED X BASIC BROAD SPECIAL COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE - -- - - - - -- - -- -- — 1.000 Dwelling 180,000 Dwelling Extension up to 18,070 Personal Property 135,525 Loss of Use Actual Loss Personal Liability 300,000 Damage to Property of Others 500 Medical Payments to Others 1,000 ncludi CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. hNLPI 11V1- .. . . NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE LOSS PAYEE X MORTGAGEE Flagstar Bank Fsb Isaoa /Atima PO Box 7026 Troy MI 48007 -7026 LOANS — 0504226756 AUTHORIZED REPRESENTATIVE ACORD 27 (2016/03) ©1993 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1004363 142988.2 01 -21 -2016 PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ed Murphy, Engineer III FROM: Michelle Mendenhall, Engineering Tech Iti DATE: August 20, 2018 SUBJECT: Encroachment Permit Application for: 2413 Teresa Court Name of Applicant: Juan Uribe Description of Encroachment: Place 6' high block wall at back of sidewalk with along side of house on Hughes Lane F7;1 Please review the attached encroachment permit and return to me at your earliest convenience. S. \PERMITS \ENCROACH \TRAFFIC\2413 Teresa Ct.doc • PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Michelle Mendenhall, Engineering Technician DATE: August 20, 2018 SUBJECT: Encroachment Permit Application for: 2413 Teresa Court Name of Applicant: Juan Uribe Description of Encroachment: 6' high block wall at back of sidewalk on side of house along side Hughes Lane Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S' \PERMITS \ENCROACH \INSURANCE\2413 Teresa Ct.doc