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HomeMy WebLinkAbout1128 Truxtun AvenueENCROACHMENT 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- 30000009 Date 5 /24/19 Property Address . . . . . . 1128 TRUXTUN AVE Application type description PW - ENCROACHMENT PERMIT Owner ------------------------ RODAND 1128 LLC 2020 EYE ST BAKERSFIELD CA 93301 Contractor ------------------ - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2361277 Permit Fee . . . . 420.00 Issue Date . . . . 5/24/19 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 420.00 ---------------------------------------------------------------------------- Special Notes and Comments Will install and maintain 4 - 5'x 5' tree wells per City parks standards on Trees are going to be watered using a the M Street side. They will be drip irrigatin system. maintained by prropety owner, Rodand1128,,_ LLC. Joel Andreesen (661) 706 -6772 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------- - - -- -- ---- - -- - -- ---- -- - --- --- -- - - - -- - - - -- -- -- Permit Fee Total 420.00 420.00 .00 .00 Grand Total 420.00 420.00 .00 .00 Applicant ackngvl{ledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the perxpit At any time. Signature of ApFlfc -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) (DEED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back NEW 5'x5' TREE WELL - SEE LANDSCAPE PLAN- TYP. OF 4 W W ry U) rt- EXISTING CONCRETE SIDEWALK l is v, v. vvi v BLUE PAINT l PATH OF TRA ALLEY TRUXTUN AVENUE SITE PLAN SCALE: 1/16 11 = 1 ' -0" ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where available):112N AVJL 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 RODANO h1-$ LLC COMPLETE ADDRESS: < < aA TV' U tVi& A\_IONE PHONE: actDIS 03%rkg33C( FAX: fF _ _ CELL: PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): ,��CiG _ Crv�' .ticZ Q.1�i(1 f a ppcya PERIOD OF TIME FOR ENCROACHMENT. INDEFINIT r OTHER: (Please Circle) r�M r_ ^ CONTACT PERSON Sde l A %Ada p PHONE: (s� �0 .. 6 V 6_6 ` ` keuk4v of RfJDAND «a LL 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 there, 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 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 amounts) of insurance coverage required are: Residences: Homeowners General Liability coverage in an amount of at (cast $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: 5420.00 S:%PGRMITS \ENCROACH \6ncroachment Permit Req roffn.1W Aug 2017 00 c0 Rai 60" 61 1/8" R-8707 Tree Grote NEENA 7„ MOM aavµT 18" — 6 TREE GRA TE PLAN AND SECTION FRAMES ARE ASSEMBLED USING A 6" X 1 1/4" X 1/4" THICK STEEL PLATE BOLTED TO FRAME w/ (2) 3 /8 -16UNC X 1 STNLS STL. FLAT HD. CAP SCREWS i i PER NF -45480 N � � N NOTES• 1. Bolt Tree Grote Holves together w/ (2) %2-13 x 3* stns steel hex. bolt At hex. nut w/ washers. 2. All tree grate installation shall be in accordance with City standards the latest ADA Standard4 manufacturer's latest recommendation Section 20 of the Standards Specifications, and as directed by the Recreation and Parks Director. 3 All materiels shall be new and free from defects 4. See approved landscape plans and special provisions for specific model number, size, quantity and manufacturers requirements 5 AO slots ore %' wide Maximum. 6. Tree grate ilstollotion halves bolted together w/ (2) 112 x 3" - 13 thread stainless steel hex. bolt, hex. nut and washers. 7 Any and all changes from this standard shall be approved by the Recreation and Parks Director prior to any tjpe of construction. _ -16UNC TAPPED HOLES 0 ASSEMBL Y DETAIL FILENAME: L -21 �® CERTIFICAT OF LIABILITY INSURANCE I DATE(MMIDO/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUIN REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER G INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provislons or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endomement(s). PRODUCER Kell% Davis State Farm 2665 Calloway Drive Ste. 206 Bakersfield, CA 93312 _ I.lc. #OH36786 INSURED - -- - RODAND1128,LLC 1128 TRUXTUN AVE. BAKERSFIELD, CA 93301 D: Paige Jelavich ,. 661- 829 -1011 INSURERS) AFFORDING COVERAGE Farm General Insurance C.m.i 661 -829 -1018 "•�^""'c� CERTIFICATE NUMBER: EVISIN TIM IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEFN ISSUED TO THE INSURED NAMOD p NUMBER- OVE FOR THE POLICY PERIOD INDICATED. NOT\MTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iR AD SUBR TYPE OF INSURANCE POLICY NUMBER POLIC EFF POLIC EXP - - -- COMMERCIAL GENERAL LIABILITY LIMITS CLAIMS -MADE IX1. OCCUR EACH OCCURRENCE s 2,000,000 t - -- PREMISES a oc Hence t Y 90- C9- L116 -1 pm ?n)__ EXP Any one pon 1; 5,000 GEN'L AGGRE TE UMR APPLIES P 02/14/2019 02/14/2024 PERSONAL 6 ADV INJURY S GA AUTOMOBILE Deductible S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 0cciden ANY AUTO + Ea $ OWNED SCHEDULED I BODILY INJURY (Per person) $ HIRE DS ONLY NOTNS BODILY INJURY (Per accident) S AUTOS ONLY AUTOS ONLY TR�OPERIY DAMAGE S UMBRELLA LIAO S OCCUR EXCESS LIAR I CLAIMS-MAQE 90- C9- L206 -8 02120!2019 02/20/2020 EACH OCCURRENCE S 8,000.000 AGGREGATE $ 8,000,000 DED RETENTIONS WORKERS COMPENSATION $ AND EMPLOYERS' LIABILITY TE E M- ANY ANY PROPRIETORrPARTNER/EXECUTIVE [TIN (► FICE A4En NH EXCLUDED7 [ N / A EL EACH ACCIDENT s If yes, describe under E.L. DISEASE - EA EMPLOYEE S DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES IACORD 101, Additional Remarks Schedule, may be attached it nwre space Is required) 1 OCATIONS: 1128 TRUXTUN AVF. 1111 17TH STREET 1121 1 r I H STREET BAKERSFIELD, CA 93301 BAKERSFIELD, CA 93301 BAKERSFIELD, CA 93301 ADDITIONAL INSURED: THE CITY OF BAKERSFIELD, ITS MAYOR, COUNCIL, EMPLOYEES, AGENTS AND VOLUNTEERS ARE ADDED AS ADDITIONAL INSURED'S WITH RESPECT TO THE CONCRETE CUTTING AND REMOVAL OF CONCRETE AND THE INSTALLATION OF FOUR (4) TREE WELLS AT 1128 TRUXTON AVENUE. M STREET SIDEWALK (I.E. THE INSTALLATION OF A CHAIN LINK FENCE AT 1501 TRUXTON AVENUE). SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BAKERSFIELD PUBLIC WORKS DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 1501 TRUXTON AVENUE BAKERSFIELD, CA 93301 AUTHORIZED REPRESENTATIVE, ACORD 26 (2016/03) ©1988- �ACORD C RPORATIO N. All rights reserved. The ACORD name and logo are registered marks of 1001486 132849.12 03- 16-2015 POLICY U PRO 1_ J LOC G GENERAL AGGREGATE $ $ 4,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES IACORD 101, Additional Remarks Schedule, may be attached it nwre space Is required) 1 OCATIONS: 1128 TRUXTUN AVF. 1111 17TH STREET 1121 1 r I H STREET BAKERSFIELD, CA 93301 BAKERSFIELD, CA 93301 BAKERSFIELD, CA 93301 ADDITIONAL INSURED: THE CITY OF BAKERSFIELD, ITS MAYOR, COUNCIL, EMPLOYEES, AGENTS AND VOLUNTEERS ARE ADDED AS ADDITIONAL INSURED'S WITH RESPECT TO THE CONCRETE CUTTING AND REMOVAL OF CONCRETE AND THE INSTALLATION OF FOUR (4) TREE WELLS AT 1128 TRUXTON AVENUE. M STREET SIDEWALK (I.E. THE INSTALLATION OF A CHAIN LINK FENCE AT 1501 TRUXTON AVENUE). SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BAKERSFIELD PUBLIC WORKS DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 1501 TRUXTON AVENUE BAKERSFIELD, CA 93301 AUTHORIZED REPRESENTATIVE, ACORD 26 (2016/03) ©1988- �ACORD C RPORATIO N. All rights reserved. The ACORD name and logo are registered marks of 1001486 132849.12 03- 16-2015 2. Any insurance provided to the additional in- sured shall only apply with respect to a claim made or a "suit' brought for damages for which you are provided coverage. 3. With respect to the insurance afforded to the additional insured, the following is added to SECTION II — LIMITS OF INSURANCE: If coverage provided to the additional insured is required by contract or agreement, the most we will pay on behalf of the additional insured will be the lesser of the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits Of Insurance shown in the Declarations. This endorsement shall not increase the ap- plicable Limits Of Insurance shown in the Declarations. 4. With respect to the insurance afforded to the additional insured, the following is added to Paragraph 3. Duties In The Event Of Occur- rence, Offense, Claim Or Suit of SECTION II — GENERAL CONDITIONS: The additional insured must: See to it that we are notified as soon as practicable of an "occurrence" or an of- fense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occur- rence" or offense took place; CMP- 4786.1 Page 2 of 2 (3) The nature and location of any injury or damage arising out of the "occur- rence" or offense; b. Tender the defense and indemnity of any claim or "suit' to us and to all other insur- ers who may have insurance potentially available to the additional insured; and c. Agree to make available any other insur- ance the additional insured has for de- fense or damages for which we would provide coverage under SECTION II — LIABILITY. 5. With respect to the insurance afforded the ad- ditional insured, the following replaces SEC- TION II — LIABILITY of Paragraph 7. Other Insurance of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: a. This insurance is primary to and will not seek contribution from any other insurance available to the additional insured, provided that the additional insured is a named in- sured under such other insurance. b. Regardless of any agreement between you and the additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional in- sured has been added as an additional in- sured on other policies. There will be no refund of premium in the event this endorsement is cancelled. (2) The names and addresses of any in- jured persons and witnesses; and All other policy provisions apply. CMP- 4786.1 1007033 148011 08 -21 -2014 Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. IN, :- 1 ( L L I PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Michelle Mendenhall, Engineering Technician DATE: June 3, 2019 SUBJECT: Encroachment Permit Application for: 1128 Truxtun Avenue Name of Applicant: Rodand 1128 LLC Description of Encroachment: Four tree wells on the M Street side of the property Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. & \PERMITS \ENCR0ACH \INSURANCE \1128 TRUXTUN AVE.doc • .0000 L3 A K E 1� I E L. L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ed Murphy, Engineer III v\ � J FROM: Michelle Mendenhall, Engineering Tech DATE: June 3, 2019 SUBJECT: Encroachment Permit Application for: 1128 Truxtun Avenue Name of Applicant: Rodand 1128 LLC _ Description of Encroachment. 4 tree wells on the M Street side Please review the attached encroachment permit and return to me at your earliest convenience. SAPERMITS\ENCROACMTRAFFIM1128 TRUXTUN AVE.doc