HomeMy WebLinkAbout05-30000087
ENCROACHMENT 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 . . . . . 05-30000087 Date 5/02/05
Property Address . . . . . . 5703 SUMMER CYPRESS DR MD
ATN (11 Digits): - - -
Application type description PW - ENCROACHMENT PERMIT
Owner
Contractor
CASABAR JAIME C JR
5703 SUMMER CYPRESS DR
BAKERSFIELD CA 93313
OWNER
Permit . . . . ~
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date .. .
ENCROACHMENT PERMIT
366815
150.00
5/02/05
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
P/W ENCROACHMENT 50 LF
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 150.00 150.00 .00 .00
Grand Total 150.00 150.00 .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.
gent)
,-\~\-I...'t CAS.~~~<... ~"'-.
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)
SUBST ANTIALL Y 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.
~
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 provisions 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 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 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 fumish 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.
~,d and acknowledge the above.
~icant's Initials
-----
~
.
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: May 10, 2005
SUBJECT: Encroachment Permit Application for 5703 Summer Cypress DR..
Name of Applicant Jaime Casabar Jr.
Description of encroachment. 50' of 6' block wall
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
installation of description of encroachment. The site is located at address of encroachment.
The applicant has provided proof of appropriate insurance coverage to Risk Management, and
has provided signatures of all immediate neighbors stating that they have no objection to the
proposed construction.
Based on their review, staff recommends approval of the permit.
S:\PERMITS\ENCROACH\_Approval memo.doc
05 - 87
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: May 4,2005
SUBJECT: Encroachment Permit Application for 5703Summer Cypress Dr.
Name of Applicant Jaime Casabar Jr.
Description of encroachment 50' of 6' block wall
Please review the attached encroachment permit and return to me at your earliest convenience.
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S:\PERMITS\ENCROACH\TRAFFIC\5703 summer cypress dr..doc
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: May 3, 2005
SUBJECT: Encroachment Permit Application for 5703 Summer Cypress Dr.
Name of Applican Jaime Casabar Jr.
Description of encroachment. 50' of 6' block wall
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
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S:\PERMITS\ENCROACH\INSURANC\5703 Summer Cypress DR. ,doc
.....
ENCROACHMENT 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 . . . . .
Property Address . . . . " .
ATN (11 Digits) :
Application type description
05-30000087 Date
5703 SUMMER CYPRESS DR MD
5/02/05
PW - ENCROACHMENT PERMIT
Owner
Contractor
CASABAR JAIME C JR
5703 SUMMER CYPRESS DR
BAKERSFIELD CA 93313
OWNER
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
366815
150.00
5/02/05
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
----------------------------------------------------------------------------
Special Notes and Comments
p/w ENCROACHMENT 50 LF
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 150.00 150.00 .00 .00
Grand Total 150.00 150.00 .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.
-\~\ \-\.'E: ~s.0\\;jf\ ~ ,\ ~ .
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 ENCROACIlMENT (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.
~
Signature of.eity 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 provisions 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 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 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.
~ead and acknowledge the above.
~plicant's Initials
-~-
Balboa Insurance Company
Processing Center D-BILL: WELLS FARGO HOME MORT. INC
P.O. Box 85087, San Diego, CA 92186-5087 ~EW POLICY
PAGE: 1
GA: 1
ARROWHEAD GENERAL INSURANCE AGENCY
6055 LUSK BLVD
SAN DIEGO, CA 92121
PRODUCER: 154104 (888) 395-1200
INSURANCE COUNSELORS,INC.
A DIVISION OF GEICO DIRECT
ONE GEICO BLVD.
FREDERICKSBURG, VA 22412
lOCA TION (if different from Insured address)
NAMED INSURED AND ADDRESS
JAIME CASABAR
5703 SUMMER CYPRESS DRIVE
BAKERSFIELD, CA 93313
POLICY NO: BH02 0 0 0 0 0 8 Policy Period:
COUNTY: KERN
1 / 3 0 / 2 0 0 5 to 1 / 3 0 / 2 0 0 6
HOMEOWNERS DECLARATIONS
12:01 A.M. Standard Time at the Address of the Named Insured as Stated Herein.
COVERAGES
Al'm LIMITS
OF LIABILITY
168,000
PREMIUM OR LIMIT OF LIABILITY SHOWN FOR THE COVERAGE:
- - - SECTION I - - - - - - - - 1- - -SECTION 11- - -I
B.OTHER C.PERSONAL D.LOSS E.PERSONAL F.MEDICAL
STRUCTURES PROPERTY OF USE LIABILITY PAYMENTS
16,800 84,000 33,600 300,000 2,000
COVERAGE PROVIDED WHERE
I - - - - -
A.DWELLING
FOR LOSS UNDER SECTION I, WE COVER ONLY THAT PART OF LOSS OVER THE DEDUCTIBLE
STATED: $1000 LOSS DEDUCTIBLE
SUMMARY OF PREMIUM
BASIC PREMIUM
ADDITIONAL ,PREMIUM
TOTAL PREMIUM
$544
$152CR
$392
TOTAL PREMIUM
POLICY FEE
TOTAL POLICY
$392.00
$50.00
$442.00
POLICY SUBJECT TO THE FOLLOWING SURCHARGES, CREDITS, ENDORSEMENTS
FORM NO EDITION DESCRIPTION LIMITS
HO 00 03 4/91 SPECIAL FORM
HO 04 90 4/91 REP COST-PERS PROP
HO 04 16 4/91 PREM ALARM/FIRE PROT
NEW HOME CREDIT
TILE ROOF CREDIT
DEDUCTIBLE $1000
AHHO-10 11/04 CA INS GUARANTEE ASN
AHHO-50 11/04 MOLD EXCLUSION
AHHO-7 11/04 CA HOMEOWNERS ENDMNT
AHHO-9 11/04 LENDERS LOSS PAY END
HO 01 04 8/99 SPEC PROVISIONS CA
HO 24 90 1/93 WORKERS COMPENSATION
PNBIC 11/04 PRIVACY NOTICE
SP 019 12/04 SIGNATURE PAGE
UG 105C 5/97 CONSUMER AFFAIRS
UG 112A 7/94 INSURANCE DISCLOSURE
CA PHMITVB 11/04 DWELLNG LIMIT NOTICE
** IMPORTANT ** POLICY DOES NOT PROVIDE EARTHQUAKE COVERAGE
AND FORMS:
PREMIUM
$52
$10CR
$89CR
$16CR
$89CR
OCC: PRIMARY
PGM: ELITE
TERR: 050 BUILT: 2001 FRAME
PRT CLS: 003
* CONTINUED *
Date Issued: 12/15/04
IN~IIRFn 1 COPY
Balboa Insurance Company
Processing Center
P.O. Box 85087, San Diego, CA 92186-5087
D-BILL: WELLS FARGO HOME MORT. INC
ADDITIONAL INFORMATION
PAGE:
2
GA: 1
ARROWHEAD GENERAL INSURANCE AGENCY
6055 LUSK BLVD
SAN DIEGO, CA 92121
PRODUCER: 154104 (888) 395 -12 00
INSURANCE COUNSELORS, INC.
A DIVISION OF GEICO DIRECT
ONE GEICO BLVD.
FREDERICKSBURG, VA 22412
LOCATION (if different from Insured address)
NAMED INSURED AND ADDRESS
JAIME CASABAR
5703 SUMMER CYPRESS DRIVE
BAKERSFIELD, CA 93313
COUNTY: KERN
POLICY NO: BH02000008 Policy Period: 1/30/2005 to 1/30/2006
HOMEOWNERS DECLARATIONS 12:01 A.M. Standard Time at the Address of the Named Insured as Stated Herein.
1ST LOAN NO. 708-0187178843
MTG WELLS FARGO HOME MORTGAGE
PO BOX 6850
ISAOA
SPRINGFIELD, OH 45501
* END OF POLICY DECLARATIONS *
Date Issued: 12/15/04
INSURED 1 COPY
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APPLICATION FOR ENCROACHMENT PERMIT
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.
1. Full name of applicant and complete address including phone number: ...J~ \J\..~ CASA.. 'bAR
57D~ Su-W\VV\e..'r ~ ~Y--€.SS 1)" "6A~. ~ ~6'~ (o~\ - 8'35 - ~b 7
2. Nature or description ofthe encroachment for which this application is made: '\0 ~W-'E AN. \D..\~,I J.J (p
LUoo ()~ ~ W l~ F\ <:..E.\-o\..~t-S:.\ ~w...~ eu J:\..\...\.... D\..:DC..~ wi\-\A. \)..) \ \...-\.... ~ ~ \) \ \.... \
.(l \~ ~\-'I... '5\~lt..')h.\....~",
C~L-
331-38971
3. Location of the proposed encroachment: c..o~~~ at=- ~~\--\"""~ -:::,,,~ ~ tt, ~~ '\)'\(.
4. Period of time for which the encroachment is to be maintained: L..\ \=-~ \\U\,'t: OF- ~k.b:.
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless City, its
officers, agents and employees against any and allliabihty, 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 !illQ!!
the revocation thereofby 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 ot 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 is:
't'\P~\(Of\\;,~ \f>\j)()~L~ '- ~~()p.. \~~C.t; U04v~'(
~ 'be:>u, 'OC:0 ~~""" U~~\ l..-I. \'f
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to
revoke the permit at any time.
Date: .:5".-() ~- as-
RepresentatIve)
PERi"1IT
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 PUBLIC PLACE WHERE THE SAtlVlE IS TO
BE LOCATED AND (2) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PlJBLlC PLACE;
SAID APPLICATION IS THEREFORE (GRANTED) (DENIED). SAID PERMIT SHALL EXPIRE
Date:
No.
~'\<;'Fn.in=
4
'7 .
I,.
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ENCROACHMENT PERMIT INSURANCE REQUIREMENTS
I) Type and Amount of Insurance Coverage for ~ installation or construction
1) for residences
Homeowners coverage in an amount of at least $300,000
2) for businesses
Commercial General Liability coverage. in an amount of at least $500,000
II) Additional Insured Verbiage
The City of Bakersfield, its mayor, council, emplovees, agents and volunteers are added as
\i-..\,")"\-fI.U-A. "ON. {) F c..~t:1'otT ~ l.oc.t:: wA-l.L- .
additional insureds with respects to . p....~ 57D~ SUK.\'-.tl::;~ c..'t'~fZ.lfSS D(lL. (l.e. the
installation ofa chain link fence at 1501 Truxtun Ave.).
-------,--- -
2
,]' CITY O~ BAKERSFIELD
DEPARTMENT OF PUBLIC WORKS
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.
5\.) \-'\.\-lv'C~ <b~\Z-\ No. 6:'
(Street for puposed encroachment)
of57o~ Su.k.~lC~ ~'.fLS~ 'b'r t
(Address of purpo d encroachment)
SIGNED:
1) Name:
Address:
2) Name:
Address:
3) Name:
Address:
4) Name:
Address:
5) Name:
Address:
6) Name:
Address:
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Phone: 66 \ -- ?3S""'- 8gb 7
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