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Home My WebLink About10912 TRENTADUE DRBA ENCROACHMENT PERMIT of ERS F + CITY OF BAKERSFIELD o PUBLIC WORKS DEPARTMENT � 1501 TRUXTUN AVE v". BAKERSFIELD CA 93301 cgLIFO (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 NUtber . . . . 15-30000035 Date 9/SE/15 Property Address 10912 TRENTADUE DR Application type description PW - ENCROACHMENT PERMIT Owner Contractor COONTZ DANIEL P 6 MISTI D OWNER 10912 TRENTADUE OR BAKERSFIEL) CA 93112 --------------------------------------------------------------------------- Permit . . . ENCROACHMENT PERMIT Additional desc . . phone Access Code 171210E Permit Fee .00 Issue Date 9/18/15 Valuation 0 --------------------------------------------------------------------------- Special Notes and Commeats 2' Slick wall with a6' wood fence on Lop. 6' rod iron gate for parking. Daniel Coontz (661) 243-5441 ---------------------------------------------------------------------------- Fee s ary Charged Paid Credited Dae Permit Fee Total 208 .Do 208 .00 .00 .00 Grand Total .00 .00 .00 .00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revo the pefmit at any time. 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. P U�M/\ -Signature of City Engineer~ a�P�^V%C� ENCROACHMENTPERMIT �� 3 APPLICATION FORM ^m r" (TTY OF BAKERSFIELD �ei �li!il o �i PUBLIC15 1WORKS UXTUNARTMENT e 1501 TRUXTUN AVE BAKERSFIELD CA 93301 o (661)326-3724 Fax:(66g852 n-2012 LOCATION OF ENCROACHMENT(Address required where available): f09(2 len Zlayiie _•y_r-7�3�Z If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. FULL NAME OF APPLICAN'I' COMPLETE ADDRESS: /QT[, PHONE: FAX: CELL: PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter: etc.): tsi�G� �v' Iti%xI mer Cr 6' rcooi i rot air PERIOD OF TIME FOR ENCROACH MENT:INDEFINITE r OTHER: (Please Circle) CONTACTPERSON Cj �,`N1 LL PHONE: �C�r 243-.�9yr Applicant agrees that if this application is granted, applicant shall indemnifv, 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 oL connected with, or caused by applicanCs 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 property or. rightf wav where theeame is Igcated and restore said public property or right of wav to the condition as nearly as that in which it was before the placing, erection, maintenance or existence of said encroachmen. Applicant futhei 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. "Phe type(s) and amounts) of insurance coverage required aro: Residences: I lomeowners General Liability coverage in an amount of at least $300,000.00 Commercial: Cora nnercial Liability coverage in an amount of at least '1.000,000.00' Y Encroachment Permit Fee: $20$.00 S:EPLItMI'IPermit Req Form.DOC January 2009 13 A K E R 6 F 1 E L D Public Works Department 1501 Trumun Avenue Bakersfield,. California 93301. (661)326.3724 TO WHOM IT MAY CONCERN: We the undersigned, have no objection to the construction of a fence be tide the sidewalk within the puNi/c�rigLht-of-way. / ners N2me) .� fi l v�lhf0. Ln, _ RY: ems) os ;Snce:� pori enaVachmer.l) Ir^�/ w nc LOV I Tenfexidu a Dr. 243 -54 k l (Address of prooered eneroechmenQ 1) Name: I.I.Q w.. "•-+-- Address: _. 00 r4n ?-) Name: Address: /L°nrL•r{1'L�- �1� 3.) Names Al�4 Address: 4.) Name: 1} Address: , , �.�--W 5) Name: O'fftLr—� Address: 5.) Name. �1—L Qjxi d ' cwwi Address: -0e� t,A;Cfl—L12C + Date: SeP+ IS Date: 6— Date: �,/.� d•01.5 Date: °(' /¢ " d-6(( Date. "-L5 Declaration Number: 001 Limit Policy Number: XH0206792-11 Effective Dater 03/25/2015 Refer to Form Daniel P. & Misti D. Coontz Page 3 Refer to Form $ 10 I COVERAGE DECLARATIONS $ 30 PH061761009 Refer to Form $.25 10912 Trentadue Drive Bakersfield, CA 93312 $ 5 FLocationddress: rages: Limit Deductible I Coverages: Cov A - Dwelling $ 254,000 $ 500 Cov B - Detached Stmctures $ 25,400 $ 500 Cov C - Personal Property $ 177,800 $ 500 Cov D - Loss of Use $ 50,800 Section 11 Coverages Cov E - Personal Liability $ 300,000 Cov F - Medical Payments Each Person $ 1,000 Each Accident $ 25,000 Property Insurance Disclosure: This location Includes Specified Additional Amount of Insurance for Coverage A - Dwelling.. This location Does Not Include Earthquake Coverage. This location Does Not Include Building Code Upgrade (Ordinance or Law) Coverage - Form PH0041009 Not Purchased. This location Includes an Annual Inflation Guard of 4%. Additional Coverages Personal Property Replacement Cost Specified Add'1 Amt Insurance Cov'A' H.O. Plus Identity Theft Coverage Workers Compensation Form Limit Premium H004901000 Refer to Form $ 0 PH0081009 Refer to Form $ 10 PHOGI IO12 Refer to Form $ 30 PH061761009 Refer to Form $.25 H024900801 $ 100,000 $ 5 S -k I� E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer III FROM: Bob Wilson, Supervisor II, Subdivisions DATE: September 21, 2015 SUBJECT: Encroachment Permit Application for: 10912 Trentadue Dr Name of Applicant Daniel & Misti Coontz Description of Encroachment. Existing 2' block wall with a 6' high wood fence on top around side/back yard. Please review the attached encroachment permit and return to me % t y ur earliest convenience. 9%30Z�tf (ND7 f) t lCa H7 G//V� 0�5 EEOS�� 6 VT remL MC 16 ffT M.jY1MjL' n��u!/zEr�Eivr t-nt'F SAPERMITMENCROACWTRAFFIC10912 T,. lt. u Dr.d.. • R S r I 1✓• L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: September 21, 2015 SUBJECT: Encroachment Permit Application for: 10912 Trentadue Dr Name of Applicant: Daniel & Misti Coontz Description of Encroachment: Existing 2' block wall with a 6'high wood fence on top around sidelback yard. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. SI\PERMITS\ENCROACH\INSURANCE\10912 Tmntadue Dr me