HomeMy WebLinkAbout3408 DEMING CTENCROACHMENT 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- 30000054 Date 7/24/14
Property Address . . . . . . 3408 DEMING CT
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
RAMIL MICHAEL P & MARISA A OWNER
3408 DEMING CT
BAKERSFIELD CA 93309
(661) 827 -0772
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Permit . . . . . . ENCROACHMENT PERMIT
Additional desc .
Phone Access Code 1501832
Permit Fee . . . . 208.00
Issue Date . . . . 7/24/14 Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 208.00
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Special Notes and Comments
6' high concrete block wall behind face
of house around back yard. Will follow
the 10, line of sight rule in the back
because of an alley access.
Adrian Hernandez (661) 304 -6424
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Fee summary Charged Paid Credited Due
P mi Fee Total 208.00 208.00 .00 .00
rand Total 208.0ttheity .00 .00
Appli t acknowledges4th right oineer, pur suant to the Bakersfield Municipal Code Chapter 12.20 to
rev he permit at a e. r
tl%((%ti f- rririt�- L° �---
S&AiVe of Appl Own Agent) Pr'nt 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 C DIS.-CLL TE 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
ENCROACHMENT E
�j
APPLICATION FORM
CITY OF BAKERSF'IELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
(661) 326 -3724 Fax: (661) 852 -2012
LOCATION OF ENC'ROACIIMENT(Address required where
C 14 g 33 c�9
If there: is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
APPLICANT INFORMATION
:.FULL ll;lt N E OF APPLICANT — o ,,,.,_ Del tv Lr , 4e- v ha, y,d t! z-
COMPLE`I'E ADDRESS: _� � 6 3' LD M h g C1, , PHONE:
Oct, K e-l-s T i'.= I d 01 41330 q FAX: w
CELL: 7
DESCRIPT ON OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.): cGVV0—C,+ e.. l ock
(Please Circle)
Applicantt 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 there, 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
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 it 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 Liabilit}7 coverage in.an amount of at least, $300,060.00
Commercial: Commercial liability coverage in an amount of at least $1,000,000.00
Encroachment Permit Fee: $208.00
S : \PEltM [TS\ NC R0ACH\Encroachment Permit Rcq I'orm.DOC January 2009
B A IC E R S T B 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.
(Street for pro"pos d encroacllinent)
Of
{Address of proposod enerotichment)
SIGNED:
11.) Name?
Address:
2.) name:
Address:
3 j Dame:
Address:
4.) "Nam
Address
5.) Name:
Address
.} Name;
Address
(Orners Name} r
Date: _ l
Date:
Date: �IQZ'g�fT
Date:
Date: -7
Date_ — ��-- /L
ME110ED.
Property & Casualty Company
DWELLING FIRE DECLARATIONS
Policy # DL190294 -00
New Business
Effective: 02103/2014
MERCED PROPERTY & CASUALTY COMPANY P.O. BOX 834 ATWATER, CA 95301 1- 800 - 348 -6747
Named Insured and Address:
Your Agency's Name and Address:
Joe E. Hernandez and Delia C. Hernandez
Mennonite Insurance Services, Inc.
3408 Deming Court
P.O. Box 878
Bakersfield, CA 93309
Reedley CA 93654
Phone: 559 - 638 -2327
Policy Number: Policy Term: From 02/03/2014 to 02/03/2015 12:01AM
DI-1 90294-00 Standard Time at the insured premises.
Payment Plan: Full Pay
Insurance is to be provided only with respect to the location's) and /or coverage(s) for which a limit of liability is
specified, subject to all of the conditions of the policy.
Location of Property Insured - 3408 Deming Court Bakersfield CA 93309
Limits of
Policy Coverages and Limits of Liability Liability
Premium
Basic Coverage Limits and Premium
Section 11- Liability Coverages
L- Personal Liability $300,000
$80
Medical Payments (DF) $5,000
Each Occurrence $25,000
Other Coverages and Mandatory Fees
Personal Injury
$8
Additional Residence Occupied by Insured
$20
Total Annual Premium:
$108
THIS IS NOT A BILL
Schedule of Forms and Endorsements
• CP0401 (1 -73) Comprehensive Personal Liability Endorsement
• DP0034 (1 -77) Renewal Plan
• DP -300 (12 -92) Special Provisions
• HO -82 (4 -84) Personal Injury
• HO -90 (9 -84) Workers Compensation Residence Employees
• MM -6 (2 -86) Amendatory Comprehensive Personal Liability Endorsement
• MMH50 (1 -83) Additional Residence Owner Occupied
• SFP -1 (8 -86) Standard Fire Policy Endorsement
Coverage afforded is subject to policy limits, terms and conditions.
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Countersigned
Page 1 of 2 Policy # DL190294 -00 Process Date: 0211012014
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E K E R S F I E L L3
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer III
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: July 25, 2014
SUBJECT: Encroachment Permit Application for: 3408 Deming Ct
Name of Applicant: Joe & Delia Hernandez
Description of Encroachment: 6' high concrete block wall behind face of
house around backyard. Will follow the 10'
line of sight rule in the back because of an
alley access.
Please review the attached encroachment permit and return to me at your earliest convenience.
S: \PERMITS \ENCROACH \TRAFFIC \3408 Deming Ct.doc
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B A K E R S F I E L L)
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager Aj
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: July 25, 2014
SUBJECT: Encroachment Permit Application for: 3408 Deming Ct
Name of Applicant: Joe & Delia Hernandez
Description of Encroachment: 6' high concrete block wall behind face of
house around backyard. Will follow the 10'
line of sight rule in the back because of an
alley access.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S: \PERMITS \ENCROACH \INSURANCE \3408 Deming Ct.doc