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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 --------------------------------------------------------------------------- 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 --------------------------------------------------------------------------- Special Notes and Comments Will a nstruct a 6' high block all around side and back yard behind sidewalk. Morris Mansour (661) 340-3102 ---------------------------------------------------------------------------- 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: $208.00 1 p , ^p C� , S'APERMITS� NCROACMFnc hmm Permit Req 1...DOC 9AFC Y3 .1JI d Sept. 2013 B A K E R S P I E L D Public Works Oepartment 1501 Twxlun Avenue Bakersfield, California 83301 (661) 326-3724 TO WHOM IT MAY CONCERN: We the undersigned, have no objection to the construction of a fence beside the sidewalk within tree public righl-of-way. ay: 'veal ar propose encroa<unenl wners ama Or Ph.n. (Address of proposed eneroechmenr) 9[01,01701; 1.) Name: (/ GV , V Date: QkkI Address: CG '0--(T 2.) Name: �O^�� e/7//i'1—O ✓� Date: Address: 3.) Name: Address: 4.) Name. Address: 5.) Name: Address: 6.) Name: Address: Date: Date: Date: AUG/16/26I5/MGN 12:17 PM NGI Insurance Policylnquiry Policy Summary P Homeowners Policy Name ami M+i1ioo Pdd mss MORRIS PND MPRIA M NSWR 8713 M RUN DR BAIQ"R.BFTPr^ CA 93312-4010 3AB Ity¢;dmm p� 1a lorn at 8713 1 RON DR Pa[=S=D CA 93312^4010 EOLTCY 1S4II&ATI049 98 1 984910372. 633 1 Y. Svaarex To.'e ers Cam ,-W TaH,Sa C/$ap3aV 0•e of The Travelgxs Pccparty casualty C-Vp -s One To SqL=e, Ha Eb£ , CP 06193 PAX No. 66I 327 6679 P. 602 Page 1 of 2 MORRIS AND MARIA MANSOUR CA NEW GENERATION INS POLICY NUMBER; 980.9103726331 +Went N,£mm¢i CA = G PATICN L 5 3117 19TR ST ggt(ERSF1EiA, CA 93301 Name as i � CTTT3a , in, CO CST.nnamats. INC .IAACWAT1M4 PO B(Zi 7706 Svzraran*Pr.n OR 45501 I/14N NUMB]R 771050487 1.11 P"Wd 07/05/15 - 07105/16 12:01 a.m. 8tandaxd Tice at the residence Prenise P Claim Semis r 11 1-800CfA1lm3 Fox Policy Service Call (661) 327-1000 574.00 TBie ie xat a Bill; 4ou �-1 m imwiwd aep utalY. P Cy cu 5 AND LIISLTe OF T.'mvr LIMIT 8actimi 2 - F-op",ty Com= A- C[udLLING................................................... I............ .$ 291,000 B - OPRER 9TA[S'tvaPs................................ I .............. I ...... .. S 25,200 ................................... C - PERSOfiaL m+CYGRTY...... ................. S 168,700 D - IOSS OF USE ................ .....--- ..----- _.---- ... _............ S 112,000 LIISTED .4UNCT, OTBEO. MiCROHFS M PDP REMEOT}1TAN Sectica I - e'rrperty Coaexa9e............................. ........... ...-.-. S 5,000 saetiw E - Linb Ey C - Personal Liability (Bodily I 39 and Pnopexty »ama9el Eerh m_carcence.. S 300,000 F - medical Mag is to.Others Each. Poraw................................... $ 1,000 B=CY � ASN IEVOOrz 241 Yp s vuvj8 The following cre i^ or discounts minced your premimp a omt Di9Ce,mt, Mss EYee Discount, Protective Devicee DiSCWot DedactiNes Section S PxopettY Covexa9es Deductible (411 Peril=)..... _.............. T�n"E https://plagt.t avelers.com/ENTEsERV/ENTESERVPolicylnquiry.aspx?Ta... 8/10/2015 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. OYCSC<u1L � a fAJHrA[ 6 LIPII'f >0 ¢4 O,ticeal � H 290 CD (05-07) Personal. PEOPe Y LiePlac®ent Cast ...................... Included* loss Settlement HO -420 C (05-07) Additional Replacea�t Ccst RnctectiOn.... 25% Included` 43EEM L5 (05-42) lcoder's Icae Payable Eu acpnant...................... Included' bIREMM FYBAS P � P s (10-06) flotreamexs.3 Special Foran H 300 M (04-13) Special PMV191o119 - California HO -90 Ck (05-07) Wonket'S Congxnsation Residence fhployaes.............. Included* aaaa 4.1am11a�e with your � Pali.cy, ffi 3 (10-06), mid t npe3=M1 avbxeeof and ww_ssTea listed above, £om Youu "+a=T Llsuiunw Policy. Mint: a9>e +".e.=i rust £or any n tya'e1 aaa x t ou mvc'xCye silaa As ^Included" i5 C,,talned in the Total Policy Pianiuht =mt. C ] i.g t u Swaaery as oe August 10, 2015 P, 003 Page 2 of 2 pd. Ilaaal WO. ®2014 Ple navelam IMemnfty Company. AN rights MMNM. https://plagt.travelers. com/ENTF-SERVIENTESERVPolicylnquiry.aspx?Ta... 8/10/2015 C � 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. -4/-Os Ok- "04 TtzA�FIC Sr�in.VPAJArr. (904 5:\PERMIT8\ENCR0ACH\TRAFFIC\8713 Fox Run Drdoc