HomeMy WebLinkAbout2221 Myrtle StreetENCROACHMENT PERMIT
CITY 0 F -8AKE RS F 1 ELD
PUBLIC WORKS DEPARTMENT
•501- TRUXTbN AVE.
MKE RSFI'ELD CA 93301
(6.61) 326-:3724
TO THE CITY 'ENGINEER .CF 7 . HE C . ITY OF . BAK . ERSFIELD CALIFORNIA:.
Pq ' r ' suant-to. the. provisions of Chapter 12.20 of the Sakerstibld Municipal Code, the undersigned applies for a permit to place,
erect, use and maintain an encroachment-.on pu b lic pr(?perty or right of-way as:th erein defined.
A15plication Number
Property Address
AppliCition' type description.
. ..Yp
Owner
----------------- ------
ERLENVS.O.N. CHRISTIAN
2221 MYRTLE'ST
BAKERSFIELD CA 93301
Permit
Addi ti6na. I des c.
Phone Acciess. Code
Permit 'Fee
ISSue ]?ate . . .
Qty Unit. 'Chi
19-30.'00.0 0.28 2. Date. 1-1/0.5/19
.22`21. MYRTLE ST
PW - :ENCROACHMENT PERMIT
'Contractor-
- --------------------------
OWNER
ENCROACHMENT PERMIT-
2 . 4-5-19 . 61
575-.0.0
11/05115 Valuixti-6n
IrgL- 'Per :Extension
BASE' FEE 5.75.-O-0
------------------------------ ------------- ----------------------------
Special Noteis and 06mmieqits
ziov , embet. S, 201.9 3:18;50' PM inmendenhal..
Place 41 wrought- iron 'fence V6.." from
-back- of curb- and t:W.C? .6i3id6rblock cdlumris
- a . : nd a gate. fi I from :back ot. c . u-rb, all
along1ront of house.
qcntA'Ct person: thristiih Eirl-endson,
742-34:k-
-------------------
------------------------ --------------
Fee summary Charged Paid -Credited Due
------------ ------ ------------
PeYmit. Fee Tbtal 575. O.Q 57.5..00 .00
.dtiind Total 575 .'0.0 5-7.5..00 .00
Applicant acknowlj� dges'the right of the City - Engineer,. pd rsuaht. to "the Ba k6rsfield
revoke ti ieppfpl t at any time:
Sig dat6fe/6Vpp1iqant (Owner /Agent)
Print Name
M.uhicipal Code Chapter 1.2.20 to
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 U TANTIALLY INTERFERE'VVITH THE USE OF THE PLAMW H
ERE' THE SAME'ISTO.-BELOC-ATEDAND'.(2)
'WI'LL (NOT). CONST . ITUT . E. A.HAZARD TO PERSONS USING S . ING SAID'PUBLIC- PLACE; SAID APPLICATION 'IS
THEREFORE (GRANTED) (DENIED) Said permit shall expire on date stated above.
$ibriature of'City En"ginoer,
Additional Terms on the Back
Applicant agrees-that . if this application i0- granted, applicant..shall inde"mnify.; defend, and-hold harmless CITY, its officers, agents
-;�rid employaaa..again . st a . ny and -al . I liability., . i.lity, el . "a i . r . ng, SCUMS, causes &-.ac-tioh O!"-d'ehiands-W . hatso.eVer againtt, the . m,Jorahy 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 ini part by a party indemnified hereunder, except. for CITY's
sole -active -negligence orwillful misconduct, The applicant further agrees-to maintain the aforesaid encroachment, including, but
ilqt limited to, repairing g or replacing the en.croachmerit at - Appffi:ant's cost. even if CITY ihadvertently damages or . -h . destroys the.
y
encroachment in- the course of 'CITCs 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 -gra.nt6d,.or upon revocation
-thereof by the City Engineer, -applicant will at h is. own cost and expense remove th&.:Pame from... 4h6 public- property or right of way
where the. same is 1ocated, and restore said pu blid prope�ty or! right of w* to the condition as nearly' as that.-in which it 'w''as
I . .
before the placing, erection, maintenance or existence of "said On&o8ichffient.
Applicant must-contact 'Dig"Al 'Dig-Alert at .81'1 at least 2. full working hays :prior to -all -exc6V.;4.ng.
Applicant further ag rep.s.to obtain and keep all- liability insurance required by the. City. Enginder in full force-and -effect for ,however
long the encroachment remains. Applicant sh6l] furnish. -the City Risk Manager With a certificate oVissuance eVidencing
sufficiep
t
coverage , a (6d endorsements evidencing the insurance required.
ge for bodily injury & property damage: liability if both 'and.-requi
I / 4 and.acknowledie 1he -abore,
4pph c. aw .5 h? ilials
ENCROACHMENT PERMIT
APPLICATION FORM
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT 2
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
(661) 326 -3724 Fax: (661) 852-2012
LOCATION OF ENCROACHMENT(Address required where available): 7` c6-- 57'
o- 04- 7-2
If there is no address adjacent to work, describe limits of work by distances from nearest existing street intersection.
FULL NAME OF APPLICANT
COMPLETE ADDRESS: PHONE: rylo/ � Z 3 Y9 Z
e p ��,% FAX:
15�! 3 3 v / CELL:
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.): 6'4'`4fN-,4- s �✓✓
PERIOD OF TIME FOR ENCROACHMENT. INDEFINITE or
CONTACT PERSON
PHONE: a/ 7,V Z -F
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
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
fhe Commercial Liability policy must identify City and City's mayor, council, officers, agents, employees, and designated
volunteers as Additional Insureds.
Encroachment Permit Fee: $575.00
S :IPERMITSIENCROACH\Encroachment Pcrmil Rcq Form.DOC 7/1119
•
BAKE RS FIELD
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 encroady nt)
U
(Address of proposed encroachment)
SIGNED: _
1.) Name:
Address:
2.) Name:
Address:
( vners Name)
Phone
Date: /
Date:
3.) name: Date:
Address:
4.) Name: Date:
Address:
5.) Name: Date:
Address:
6.) Name: Date:
Address:
fyi
® See Signatures needed for approval page --Zoo
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•
$AKERSFIELD
Public Worko Department
1601 TrtlxtunAvenue
Bakersfield. California 93301
(661) 326 -3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fence beelde the sidewalk within the
public right -o tivay.
(Owners kzrne)
-L2'2-1 M 4 r+(,# Pharr- w �(2 -3
(Address of proposed encroachment)
SIGNED: - �J, v
1.) Name: (,tGiA
Addmsr-,, 17-.300 Jlk t4k 15 'iT
2.) N
Address:
3.) Name: GaCeALkn-0
Address: 2200 91-
4.) Name:
Address:
5.) Name:
Address:
6.) Name:
Nddress:
ae Signatures needed for approval page
a4C- D e• t 1 11 -1 I
Date:l 1— / 9 — /5
Date: � l' i q —1 C�
Date:
Date:
Date:
1
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0
11/20/2019 10:06:09 AM
1/4 Sections
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LOCAL
Public Works Information
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The City of Bakersfield makes no warranty, representation, orguarargee
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40"
Renewal Homeowners H03 Policy
INSURANCE -GROUP
P.O. ��x 8(9-1, iv :�l6tuG.ircl; LA 91,596 ;8041 CSI: Safeguard Insurance Company
it �viv.csc`ittsurtiucc.cWit
To continue: coverage. please send: in your payment by 12/14/2019. Thank:you
for. insuring with CSE.
Policy # Policy Term (begins and ends at 12 :01 a.m. Standard Time) Notice Date
CAH1258291 From 12/14/2019 To 12/1.1120.20 .000 10/24/20 t.9
Name.d.Insured and Address
ERLEND.SON, CHRISTIAN
2221 MYRTLE ST
BAKERSFIELD: CA 93301.3318
The. premises covered by this 2221 .MYRTLE ST
.policy is located at: BAKERSFIELD, CA 93301 73318
Agent C:ATALLI INSURANCE BROKERS
paulftatalli,coln
Address. Gode 440.85 -44085
80 WEST 41 ST AVENUE
SAN MATEO, GA 94403
Phone 850. 3494803 Fax::650 =349 -1958
Coverage at the above described location is provided only where a limit of insurance is shown or a premiumAs stated.
Section I Loss Deductible 5.2,500
Section I Coverage
Limit of Insurance
Premium
A - Dwelling
11,012.920
S 1;388.00.
B - Other:Structures
S 103,292
Irlclude:d
C - Personal Property
$723.044
3383.00
D -Lass of .Use
S 20fi;584
Included
Section II Coverage
E - Person.a.1 Liability
S 500;0.00.
3 37.00
F -.Medical Payments to Others'
51,000
Included
Total Basic Premium
S.1.1808.00
Th.e limit of insurance for this structure (Coverage A) is
for in area,
based on-.an estimate cf the. cost to rebuild your home.,.includingg an
specific
approxirnate.co.st labor and materials your :an.d
information that you have provided
about your home.: This.
limit is ad.lusted at each renewal to account for inflation.
Coverage Enhancements
Backup of.S.e.wers and Drains
.510:000
Included
Extended Replacement Cost
175%
Included
Safeguard Plus
5217.00
Identity Recovery
515.000
Included
Ordinance or Law
20%
Included
Loss Assessment
$5;000
Included
Service Line
$10.000
S 15..00.
Workers Compensation
Included
Discounts and Qther.Cred'tts
Loyalty
Included
Total Additional Premium /Credits
S 232.00
Total Fees S 0.00
Seismic Safety Commission Assessment (SSC) S 0.15
Total Annual'Premium $ 2;040.15
Third Party Billed Continued on next page
(03
BAKERSFIELD
TFE SOUND OF5MVie k f VeR&
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ed Murphy, Engineer III , (�
FROM: Michelle Mendenhall, Engineering Tech
DATE: December 20, 2019
SUBJECT: Encroachment Permit Application for: 2221 Myrtle Street
Name of Applicant: Chris Erlendson
Description of Encroachment: 4' iron fence 4'6" from back of curb and 2
cinderblockibrick columns and a gate 6'
from back of curb in front of house
Please review the attached encroachment permit and return to me at your earliest convenience.
S:\ PERMITS \ENCROACHMENT\TRAFFIC\2221 MYRTLE ST
(03
BAKERSFIELD
THE SOUND OFbWeVjka '��
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager
FROM: Michelle Mendenhall, Engineering Technician
DATE: December 20, 2019
SUBJECT: Encroachment Permit Application for: 2221 Myrtle Street
Name of Applicant:
Description of Encroachment:
Chris Erlendson
4' high iron fence 4'6" back from back of
curb and two cinderblock/brick columns and
a gate 6' from back of curb in front of
house
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:/ PERMITS /ENCROACHMENT /INSURANCE /2221 MYRTLE