HomeMy WebLinkAbout8713 FOX RUN DRENCROACHMENT 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 . . . . . 15-30000029 Date 8/10/15
Property Address 8713 FOX RUN DR
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
MANSOUR MARIA C OWNER
8713 FOX RUN DR
BARBRSFIELD CA 93312
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Permit ENCROACHMENT PERMIT
Additional deme . .
Phone Access Code . 1690395
Permit Fee . . . . 208.00
Ioans Date . . . . 6/10/15 valuatipn 0
Qty Unit Charge Per Extension
EASE FEE 208.00
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Special Notes and Comments
Will a nstruct a 6' high block all
around side and back yard behind
sidewalk.
Morris Mansour (661) 340-3102
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Fee summary Charged Paid Credited Due
Permit Fee Total 208.00 208.00 .00 .00
Grand Total 208.00 208.D0 .00 .00
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to
revoke t # permit at any time.
f /LZ�� �oY'J 1 S YNO.VIS.IVI✓
S' 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 US}NG SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE (GRANTED) (DENIED�id penDit-sihall expire on date stated above.
ignature of City Engineer
BA, ENCROACHMENT PERMIT—
.h� APPLICATION FORM
v e CITY OF BAKERSFIELD
{ PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
IFO BAKERSFIELD CA 93301
(661)326-3724 Fax: (661) 852-2012
LOCATION OF ENCROACHMENT(Address required where available): 59 11 ro X Q UA O I'
If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
APPLICANT INFORMATION
FULL NAME OF APPI
COMPLETE ADDRESS:
PHONE: 60--k9:7-c5533
\SCJ I`sts Eye\r�s4 -G331Z FAX:
CELL: 661, 3Wo-310Z
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete blocck� wall, raised
planter, etc.): if P.1 r kt %,L
.e
PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE or OTHER:
(Please Circle)
CONTACT PERSON trllc�r rt <qV�<.� Ihtr PHONE: 661, 3n O. 310 'Z
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, orjudicial 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 gwn 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: $208.00 1 p , ^p C� ,
S'APERMITS� NCROACMFnc hmm Permit Req 1...DOC 9AFC Y3 .1JI d Sept. 2013
B A K E R S P I E L D
Public Works Oepartment
1501 Twxlun Avenue
Bakersfield, California 83301
(661) 326-3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fence beside the sidewalk within tree
public righl-of-way.
ay:
'veal ar propose encroa<unenl wners ama
Or Ph.n.
(Address of proposed eneroechmenr)
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Date:
Date:
Date:
AUG/16/26I5/MGN 12:17 PM NGI Insurance
Policylnquiry
Policy Summary P
Homeowners Policy
Name ami M+i1ioo Pdd mss
MORRIS PND MPRIA M NSWR
8713 M RUN DR
BAIQ"R.BFTPr^ CA 93312-4010
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8713 1 RON DR
Pa[=S=D CA 93312^4010
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MORRIS AND MARIA MANSOUR
CA NEW GENERATION INS
POLICY NUMBER; 980.9103726331
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AUG/10/2015/MON 12:17 PM NGI Insurance PAX No,661 327 0079
PolicyTnquiry
In case of loss under section I, only that Pmt of the loss oven the stated
deductible i cocetmi.
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loss Settlement
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avbxeeof and ww_ssTea listed above, £om Youu "+a=T Llsuiunw Policy.
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Page 2 of 2
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F, .a I-�: E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
Jena Covey, Risk Manager 4u
FROM:
Bob Wilson, Supervisor ll, Subdivisions
DATE:
August 25, 2015
SUBJECT:
Encroachment Permit Application for: 8713 Fox Run Dr
Name of Applicant: Maria Mansour
Description of Encroachment: Will construct a 6' high block wall around
side and back yard behind sidewalk.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
8:IPERMIMENCROACHMNSURANCEW713 Fox Run Dr.Coc
I .a T-. E R S F I E L i3
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
John Ussery, Engineer III
FROM:
Bob Wilson, Supervisor Il, Subdivisions
DATE:
August 25, 2015
SUBJECT:
Encroachment Permit Application for: 8713 Fox Run Dr
Name of Applicant: Maria Mansour
Description of Encroachment: Will construct a 6' high block wall around
side and back yard behind sidewalk.
Please review the attached encroachment permit and return to me at your earliest convenience.
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5:\PERMIT8\ENCR0ACH\TRAFFIC\8713 Fox Run Drdoc