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Home My WebLink About1801 Pine StreetENCROACHMENT 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 . . . . . 18- 30000027 Date 12/03/18 Property Address . . . . . . 1801 PINE ST Application type description PW - ENCROACHMENT PERMIT Owner ------------------------ BROCK MELINDA 1801 PINE ST BAKERSFIELD CA 93301 Contractor ---------------- -- - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2281434 Permit Fee . . . . 420.00 Issue Date . . . . 12/03/18 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments December 3, 2018 3:35:47 PM mmendenhal. 4 existing light posts placed 6' from curb and 6'2 from block wall. Existing stained concrete in front of residence will also be maintained by property Contact person: Robert Doty 204 -8401 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ------- --- - -- - - -- ---- - - - - -- ---- -- ---- ---- - - - - -- ---- - - - - -- Permit Fee Total 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 revoke the permit at any time. 4� 11�4 I 2�k D/", Signature o Ap ant (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. W 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. nve read and acknowledge the above. Applicants Initials ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852 -2012 TION OF ENCROACHMENT(Address required where available): % $y t (1/1 e —5 � If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. APPLICANT INFORMATION FULL NAME OF APPLICANT " � G� COMPLETE ADDRESS: 2 /`j 6-4e, n PHONE: 661 `zaY -W01 bi✓ l�y;t l U �� `7330 l FAX: CELL: PROJECT INFORMATION DESCRIPTION OF ENC Tols� OACHMENT Exam le:6,0 W Wood or wrought iron fence, concrete block wall, raised planter, etc.): U l P JA6eU j1 r►t wld 6i 9jr /�'� iii %U( 4,A1 i -5 13 o F eoA6rdc Fly m ly 1? laC,,(' "U PERIOD OF TIME FOR ENCROACHMEN : INDEFINI or OTHER: (Pleas . CONTACT PERSON D 1 4 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 Ci!y 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 Permit Req Form.DOC Aug. 2017 wa IF APPLICANT IS UNABLE TO OBTAIN A REQUIRED SIGNATURE vlol S � � �i ii ii ii ii i♦ i , �iiiiiiiiiiiiiiiii. Curb ond Gutter ►iiiii� ��iiii�ii �'� iii iii` � ► �iiiii i♦i, Street Centerline ------- - - - - -- -------------------------- �I �I �I ------- - - - - -- I� I� I� ---------------- -------------------------------- -- - - - - -- Lxgtin�orPr�osed Sidewo/k -- - - - - -_ Curb and Gutter Street Centerline .0�� 0 1=00MUNIft BAKE RS FIELD Public Works Department 1501 Truxtun Avenue Bakersfield, California 93301 (661) 326 -3724 TO WHOM IT MAY CONCERN: r �S We the undersigned, have no objection to the construction of a 40 beside the sidewalk within the public right -of -way. P1 Re 4 By: nelfnc A Qrra (Street for proposed encroachment) (Owners /Name) (� paa l � j Ile ST Phone- (Address of proposed encroachment) SIGNED: 1.) Name: Address: 2.) Name: Address: 3.) Name: Address 4.) Name: Address: 5. Name: pkl6l' �iV Date:�g /0 Date: %/• �° 0�0 Date: LL Date: /Z - /— 1S/ Date: Address: 6.) Name: Date: Address: • See Signatures needed for approval page S\- j c w �ll( T n► i S 0 i Q i N � Q�6• i T n► i S 0 i Q i 70a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IL 1% m 1� ............. imp L too JAI I.c O 00 CD 13 A• AAA - Print Home Policy Details AAA CI Homeowner's Policy Details Policy No: CH0120199308 !' 11 Current Term 10/07/2018 - 10/07/2019 PROPERTY INFORMATION https:Happs.cal i f. aaa. coin /accapps /insurance /policies/Pol icy/PrintH... Location of Residence Premises 1801 Pine St Bakersfield, CA 93301 Package Type AAA YourHome COVERAGES AND LIMITS OF LIABILITY Coverages Property Coverages Dwelling Other Structures Unscheduled Personal Property Loss of Use Liability Coverages Personal Liability Medical Payments to Others Total Premium MORTGAGEE(S) / OTHER INTERESTS Name QUICKEN LOANS INC. Po Box 717 Amelia, OH 45102 DISCOUNTS Limits of Liability $555,000 $55,500 $416,250 $111,000 $500,000 Each Occurrence $1,000 Each Person $1,798 Loan Number 3376043971 Policy Discounts Multi - Policy: , CEA Other Discounts: Protective Device , Loyalty , Roof Type , One Story ENDORSEMENTS AND CERTIFICATES Deductible(s) Water $1,000 Other Perils $1,000 Number Title H0402 AAA YOURHOME H0216 ALARM OR FIRE PROTECTION SYSTEM 2369 AMENDATORY ENDORSEMENT 2395 AMENDATORY ENDORSEMENT 438BFU LENDER'S LOSS PAYABLE ENDORSEMENT Type Mortgagee I o1' 3 11/27/2018, 7:48 I'M Y _, K E R S F 1 E L L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ed Murphy, Engineer III ON, FROM: Michelle Mendenhall, Engineering Tech DATE: December 4, 2018 SUBJECT: Encroachment Permit Application for: 1801 Pine Street Name of Applicant., Melinda Brock Description of Encroachment: 4 existing light posts placed 6' from curb and 67' from block wall. Please review the attached encroachment permit and return to me at your earliest convenience. SAPERMITS \ENCROACH \TRAFFIC \1801 Pine St.doc I�. E R S F I E 1- T) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Michelle Mendenhall, Engineering Tech nician,jr` 1^ t!A DATE: December 4, 2018 SUBJECT: Encroachment Permit Application for 1801 Pine Street Name of Applicant: Melinda Brock Description of Encroachment: 4 existing light poles place 6' from curb and 6'2" from block wall Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S. \PERMITS \ENCROACH \INSURANCE \1801 Pine St.doc