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HomeMy WebLinkAbout5012 Oswell Park DriveENCROACHMENT 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 . . . . . 19- 30000008 Date 4/23/19 Property Address . . . . . . 5012 OSWELL PARK DR Application type description PW - ENCROACHMENT PERMIT Owner Contractor --- --------------- - - -- -- ------------------ - - - - -- RANCHO JEREZ 2016 LIVING TRUST OWNER 5012 OSWELL PARK DR BAKERSFIELD CA 93307 ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2342889 Permit Fee . . . . 420.00 Issue Date . . . . 4/23/19 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments April 23, 2019 9:02:51 AM mmendenhal. Place 4' high wrought iron fence at back of sidewalk in front of house, along the grass line. There will be not poles bigger than 4" in line of sight area for driveway. Contact person: Ana Villalobos 330 -8003 ---------------------------------------------------------------------------- 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. lZ /1 1' /_, E / c,— ,- r za/lld � Signature of Applicant (O r /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 Skid pe�rmit shall expire on date stated above. 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. I have read and acknowledge the above. Applicant's Initials B K�,�s� ENCROACHMENT PERMIT -�► �� APPLICATION FORM t7 CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE O BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852 -2012 LOCATION OF ENCROACHMENT(Address required where available): If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. FULL NAME OF APPLICANT I A r V c, r ✓t COMPLETE ADDRESS: -'�;-O 1 Z CsS ryeI 1 p o t k- 19r-_ PHONE: 6-6/ 330 -800J Q ci k co Pi P Id cA 9 31 3 o7 FAX: CELL: PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): � -I f i KVA s t C, -t Fe -\. C, V. &C- h,.IA PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE OTHER: (Please Circle) . CONTACT PERSON_ Ary - y - un,16 oCaS PHONE: (oG / '3 3 G '£3 u v 3 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 City Engineer, applicant will at his own cost and expense remove the same from the public propM 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 :\PERMITSIENCROACH\Encroachment Permit Req Form.DOC Aug. 2017 --:� 1, C J' - (Z:5' -fir I 4/25/2019 Go gle Maps 5012 Oswell Park Dr 5012 Oswell Park Dr - Google Maps Image capture: Feb 2012 © 2019 Google Bakersfield, California P Google Street View - Feb 2012 - Fcr GG it https: / /www.google.com /maps /place/ 5012 +Oswell+ Park +Dr, +Bakersfield, +CA+ 93307 / @35. 3578296,- 118. 947796, 3a,75y,335.9h,78.72t /data =!3m7! 1 e... 1/1 $AKERSFIELD 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 proposed encroachment) s) l L o.S c-,e l l 1?a r" k �k r (Address of proposed encroachment) SIGNED: 1.) Name: By: Ka f C�, 1^�r /1 ctrl ek- (Owners Name) Phone- I - 3 S S// Z_ Address: LOO R 6S [kle -j/ pa rk t- 2.) Name: Address: 3.) Name: Z5- Y,�'Gf C-/ Y <f s Address: �5 06 q 5 k/✓(2 Pc.,Y J 4 cr 7, 4.) Name: ^rZ Address: Date: 1 Date: �// // t Date: L/ A / I r f Date: ) 7 -/J 5.) Name: {,(;�L.!� �1 (�C _ Date: Address: h> `.jk, Z f >,lL 6.) Name: ��C► �" r C� Ge " ly I Cl C&-k� Date: Address: • See Signatures needed for approval page Vt Ir`d ca LO t1 (N to U) a w r to LO K� to LO to L c� to t) ia} 0 1, 'E Ir �* J J L LI f) r r Lin r r LO r- r C-3 LO P7 r \ t LL}e L it! c� r.a �Fa cy i]1 & Home ""etropoiiian uirect Property and Casualty Insurance Company Homeowners Declarations Number: 8344357870 /Term: From 11/10/2018 to ;10/2019, 12:01 A.M. Standard Time r the location of the property Named Insured: MARIA FERNANDEZ 5012 OSWELL PARK DR BAKERSFIELD CA 90337 09/06/2 ST Page 1 of 2 Renewal Effective Date: 11/10/2018 Bill To: Insured The residence premises covered by this policy is located at: 5012 OSWELL PARK DR BAKERSFIELD CA 93307 Basic Policy Coverages A - Dwelling B - Private Structures C - Personal Property F - Personal Liability: Each Occurrence G - Medical Payments to Others: Each Person Loss of Use Causes of Property Loss Special Perils Building Property Loss Settlement Extended Loss Settlement Personal Property Loss Settlement Replacement Cost on Contents Additional Coverages Workers Compensation Coverage Optional Coverages Personal Injury Deductible(s) $2500 deductible applies to each loss. Limits $ 261,700 $ 52,340 $ 183,190 Premiums $ 711.00 $ 300,000 $ 45.00 $ 5,000 $ 15.00 $ 65,425 Ind Ind $ Inc[ $ 21.00 Current Annual Premium: $ 792.00 Forms and Endorsements: HP1000 0902 HP2000 0205 HP3300 0904 H P5100 0105 H P6000 0205 H P7000 0902 C1 17CA 0108 HA01 CA 0108 H F2500 1002 Discounts for the following have been included in the current annual premium: * 10% Protective Device Discount MetLife Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its affiliates, Warwick, RI. y / $ MPL 1380 -000 0001800701601 1 7dnnnlnnnu o1 w w 1 c oe- ...�.......... H P4520 0113 HA30CA 0108 Printed in U.S.A. 0298 • .00'� T-,: E R r T L r� PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager F� "V' FROM: Michelle Mendenhall, Engineering Technician DATE: April 25, 2019 SUBJECT: Encroachment Permit Application for 5012 Oswell Park Drive Name of Applicant: Maria Fernandez Description of Encroachment: 4' high wrought iron fence at back of sidewalk in front of house Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S, \PERMITS \ENCROACH \INSURANCE \5012 Oswell Park Dr.doc 40 13 _ -\, I� I, R S F I E L L� PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ed Murphy, Engineer III UV-VAI' FROM: Michelle Mendenhall, Engineering Tech I DATE: April 25, 2019 SUBJECT: Encroachment Permit Application for: 5012 Oswell Park Drive Name of Applicant: Maria Fernandez Description of Encroachment.- 4' high wrought iron fence at back of sidewalk in front of house Please review the attached encroachment permit and return to me at your earliest convenience. /- S: \PERMITS \ENCROACH \TRAFFIC \5012 OSWELL PARK DR.doc