HomeMy WebLinkAbout05-30000102
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
05-30000102 Date 10/24/05
300 BAKER ST
021-313-09-00-1
PW - ENCROACHMENT PERMIT
C-4A-L I5d~-'L
.---- -
332:- tG{ 8
Owner
Contractor
BAKERSFIELD
CA 93301
,
7J..( L. fJfj-Lf1/l TIlBEClfUL!3:-
/J~fXyp(eJ-yJ cZ 1-
,
QS'3og
ST VINCENT DE PAUL STORE INC
300 BAKER ST
BAKERSFIELD CA 93305
OWNER/BUILDER
-----------------------------------------------------------------------------
. __ " c : - - . _ ".
, , '
Permit . " .',..
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
460188
150.00
10/24/05
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
SECURITY FENCE ENCROUCHING INTO RIGHT
OF WAY
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 150.00 150.00 .00 .00
Grand Total 150.00 150.00 .00 .00
'i.
1\pplicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the
Wrrni'(!:; .:/II] ~ U/CC 6-: fjrfC(}::6/L
Signature of Applicant (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)
SUBSTANTIALL RE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2)
WILL (NOT) ,ONSTIT A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE (GRANTED) (D NIED). Said permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
i'
Applicant agrees that if this application is granted, applicant shall indemnify, defend, and hold harmless CITY, its officers, agents and
employees against any and aU 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. '
f
!
I
I
I
I'
I
I,
Ii
,:
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.
ti
i!
.1
- !
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.
;Jrr,e read and acknowledge the above.
(:j;T Applicant' s Initials
.,
\
-~
, '<
"
~
.
7qL
~
~
BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 22, 2005
SUBJECT: Encroachment Permit Application for 300 Baker St.
Name of Applicant St. Vincent DePaul Inc.
Description of encroachment. Security fence encroaching into Street
R.O.W
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\300 Baker St..doc
#05-'/O~8
~
.
-
BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 2, 2005
SUBJECT: Encroachment Permit Application for 300 Baker St.
Name of Applicant St. Vincent DePaul Inc.
Description of encroachment Security fence encroaching into R.o. Way.
Please review the attached encroachment permit and return to me at your earliest convenience.
II/bl/0S
crlc. f[Z.OIJ/t'eJJ fe~~
.wr C7)Ctt;;t.-v
~ltbf1 '(JO(~ I\.NI eA.r(.
t~IMuP4 ~e6r,tlfl.,~ '
~
S:\PERMITS\ENCROACH\TRAFFIC\300 Saker St.doc
~
.
RECEIVED
OCT 2 7 2005
RISK MGMT.
-
Bj~KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: October 27,2005
SUBJECT: Encroachment Permit Application for 300 Baker St.
Name of Applicant St. Vincent De Paul Inc.
Description of encroachment. Security fence encroaching into R.o. Way.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
~)J
I
L_
I
S:\PERMITS\ENCROACH\INSURANC\300 Baker St.doc
t
City of Bakersfield
*** CUSTOMER RECEIPT ii~
Oper: BHAYSLET Ty~: OC Drawer: 1
Date: 10124/05 01 Receipt no: 47750
Description Quantity
2005 30000102
BP BUILDING PERMITS
1.00
Tender detail
elf CHECK
Total tendered
Total pSj'flent
Alllount
$150.00
1891
5150.00
S150.e9
S15e.00
TrailS date: 10/24/05 'rime: 11 :53:47
"HAPP\' HALWI-}EEN"
--",";"..
,/'.
"
APPLICA:nON 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 defmed.
"'JCO 8/\~ B.11 <:::'''T'_
1. Full name of applicant and complete address including phone number: v J '"1'" '- ....--y '- ...J l -
Sf. \) I tJCE:NT '0<2- ~4V L s:.rc QQ.. 'ItJ<.:... \
- I
2. Nature or description of the encroachment for which this application is made: &QIf€..':>'/ <-t F,- :5....rIJ'4C1c-
- .-Po.~-R~c:.e- (::'5N.. fJ~^. - -~-?J:>er d 0?ti'cCY-.SSj- - - -. ____n. .-.- -- ------
3. Location of the proposed encroachment: L( ff' t;]J)-C'l1.. Ao/"'\. S fYl:2'--'-'1<-('Z C,.-.. S4- 'fzen
~f}" .,0 Lr FT )'arfhrc["C A.~ C c.lvt~ c;::Jf'-J Ctl-tCo (IVcJ SI~Lu~('Z.)
4. Period of time for which the encroachment is to be maintained: L( p.e.
Applicant agrees that if this application is granted, ap'plicant 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, 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 ofthe permit for which this application is made, if granted, or !!QQ!!
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 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 is:
~~tt-+L . ihJt\.QC2-?--~ ~~/r J aOe: d a ~" E~
oCc::::.'-'V1../lc2~.. 1/ c;o~ dod C~..... ~
. f/
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to
revoke the permit at any time. .r;::;?~ _ /J _ /J _ ~ _ J /
Date: It) -Z4-0Y L~ . -,{/ 6crU/~
Ignature 0 App Icant wner or RepresentatIve
PERMIT ~~~., S vO.
,.
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 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
Date:
SIgnature of CIty Engmeer
No.
i
r-.~
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,
I] I/-Iz.e-/l. ~ C:./tIC' 0
(Street for puposed encroachment)
By: 51. //!IlJ(j3r'-.Jj fJepj LL--
(Owners Name)
of ~~O 8#t&l ~77Z Ec.T'
(AddreSs of purposed encroachment)
Phone: '3 '3 2.. -~ I ~:l ( 8
( c.4&... (ld~",,/&-frlIPI.,...c~...(}e.'L )
''\ .--
Date: lu ".,~ J. D:J
Date: 10....) j. OS'
2) Name:
Address:
3) Name:
Address:
Date:
4) Name:
Address:
Date:
Q!!e:
5) Name:
Address:
6) Name:
Address:
Qjte:
"j;,,~(....("......,',-' ~
l:l'~ ;J,H; L- ~
. '\~fr.'1'l6 ~.- ~ r-
...-........-...._~-,.
~~
e;.": 1-1-., c.'":>
.-",
\
I
I
0(.'" :%1, :~nll!-l 1); 411 '
P"9i1 ,I
Z afrtila '
09HrZf199l:
~~:60 SOOZ'~Z 1)0
OGT 24,2005 10:13
16613231160
Page 1
Nonprohts'
~WN
NONPROFITS' INSURANCE ALLIANCE OF CALIFORNIA
P,O. Box 8507, Santa Cruz, CA 95061
P: (BOO) 359-6422
F; (831) 459-0853
~
NOllprofits' Insurance
Alliante of California
J. ME'IlI(ll~ .. .AIlWlICU<<lNnClIIS
~OHpfllfi b' In~ur,luc\..:
.\ Ili.1I1(\' of <- ,11;('.I[lIi.,
I COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS I
PRODUCER:
KIA Insurance Associates. Inc.
P.O. Box 11390
Bakersfield, CA 93389
NAME OF INSURED AND MAILING ADDRESS:
Saint Vincent De Paul Store, Inc.
300 Baker Street
Bakersfield. CA 93305
POLICY NUMBER: 2005-07113.NPO
RENEWAL OF NUMBER: 2004-07113.NPO
POLICY PERIOD:
FROM 01/11/2005 TO 01/11/2006
AT 12:01 A.M. STi\NOARO TIME AT YOUR MAILING ADDRESS SHOWN ABOVE
BUSINESS DESCRIPTION: Secondhand Clothing & Furniture Store
IN RETURN FOR THE PAYMENT OF THE PREMIUM. AND SUBJECT TO ALL THE TERMS OF THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
LIMITS OF COVERAGE:
GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS - COMPLETED OPERATIONS)
PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT ...........................,
PERSONAL AND ADVERTISING INJURY LIMIT .......................,...........................
EACH OCCURRENCE liMIT ......... .......... ....... ......... .............. ....... ........ ..... ,............
FIRE DAMAGE LIMIT ............ .............. ............... ......... ...... ..,.. .....................,..............
MEDICAL EXPENSE LIMIT ..... ........ ................. ............,.......... ......,......,..........,........
ADDITIONAL COVERAGES;
$1.000.000
$1.000.000
$1,000,000
$1,000.000
$100.000 lIflyo"eRre
1 0.000 arly OMI per*O,l
SOCIAL SERVICE PROFESSIONAL LIABILITY
EXCLUDED
CLASSIFICATIONCS)
SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G
PREMIUM
$4,829
FORMS AND ENDORSEMENTS AflPlICABlE TO THIS POLICY ARE INCLUDED IN COMMt:KCIAL LINI:S COMMMON POLICY lJl:ClAKA liONS
~OUNTERSIGNEO: 01/12/2005
BY
~~~ Af).
(AUTHORIZED REPRESENTATIVE)
TtlESE DECLARATIONS AND TtlE COMMON POUCY DEClARATIONS. IF AIIl'l.ICABLE. TOGETHERWfTH THE COMMON POLICY CONDITIONS. COVERACE FORM(SI
AND FORMS AND ENDORSEMENTS. If ....Y.ISSUED TO FORM A PART THEREOF, COMPLETE TIlE ABOVE NUMBERED POLICY.
NIAC - GL . NPO
(00887)
~ .'
r-
Nonprofits'
~WN
NOllprofit> In,Ur.ln<;t'
,\lli~n<t' ,,( C.1ldorni.\
NON PROFITS' INSURANCE ALLIANCE OF CALIFORNIA
P.O. Box 8507. Santa Cruz, CA 95061
P: (800) 359-6422
F: (831) 459-0853
~
Nonprofits' Insuranc:e
Alliance of Califomia
A IW 1OI1N!WN1:1 .. . A HlAlllCl NQH/1()IIlS
NONPROFITS OWN
COMMERCIAL LINES COMMON POLICY DECLARATIONS
PRODUCER
KIA Insurance Associates, Inc.
P.O. Box 11390
Bakersfield. CA 93389
NAME OF INSURED AND MAILING ADDRESS:
Saint Vincent De Paul Slore. Inc.
300 Baker Street
Bakersfield. CA 93305
POLlCY NUMBER: 2005-07113- NPO
RENEWAL OF NUMBER: 2004-07113- NPO
POLICY PERIOD:
FROM 01/11/2005 TO 01/11/2006
I\T 12:01 A.M. STANDARD TIME AT YOUR MAILING AOORF.:SS SHOWN ABOVE
BUSINESS DESCRIPTION: Secondhand Clothing & Furniture Store
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
THIS POLICY CON!;ISTS OF THE fOLLOWING COV&RMiE !'ARTS FOR WHICII A PREMIUM IS INDICATED. THESE PREMIUMS MAY BE lOUIIJECT TO AOJUSlMENT.
PREMIUM
COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE .................. $4.829
COMMERCIAL AUTO LIABILITY COVERAGE PART ................................,..,.............. Not Covered
COMMERCIAL AUTO PHYSICAL DAMAGE COVERAGE'PART ....,............................... Not Covered
IMPROPER SEXUAL CONDUCT COVERAGE PART .......................... Not Covered
COMMERCIAL L1aUOR LIABILITY COVERAGE PART ................................................... INCLUOED
TERRORISM COVERAGE (Certified Acts) .....,.....................,........................................... Not Covered
TOTAL:
$4,829
FORM(SI ANC ENOORSEMENTlS) MACE A PART OF THIS POlIC"" AT TIME OF ISSUE:'
NIAC.GL-NPO NIAC.ll.NPO SCHEDUI.E G. SCHEDULE I,. CGOOO1/11.llII,
NIAC.ElIIO 04. NtAC.E 11(7.91., NIAC.f:1215.!)2. NIAC-EI513.o4, NIAC-E2218-95,
NlAC.E3OI4.()O. NIAC.E33I1.02. CGOO:l3/11.88. CG201 l-NPOll1~5. CG:lOI2111.85.
CG2026JII-8G. CG20J4I3-Y/. CG2116111.B5. CG 21 75/1202. CQ?24411 H15.
CG77941C493. aLOO 11/11.115, Il027012-'l4.
NlAC.X1I08 ~.
NIAC.E2811.99.
CG20111111-8S. .
CG24Q7I\ I-lib,
NIAC.E3Il.99.
NIAC-E2911.09.
CG2020111-95.
CG2504/1 '-8~.
~
'OMITS APPLICABLE FORMS AND ENDORSEMENTS IF SHOWN IN
SPECIFIC COVERAGE PART I COVERAGe FORM DECLARATIONS.
(AUTHORIZED REPRESENTATIVE)
THESE DeCLARA TlOH$ AND THI! COMMON POLICY DeClARA TIQNS. IF APPLICABLE. TOGETHER WITH THE COMMON POLICY CONDITIONS, COVl;RAGE FORMIS)
AND FORMS AND ENDORSEMENTS. IF ANY. ISSUED TO FORM A PART THEREOF. COMPLETE THE AeOVE NUMBERED POt-ICV.
NIAC _ CO _ NPO (00807 . DB)
COUNTERSIGNED: u1I12/2005 BY
(J~(/).
~ ab'ed
09UrZft99!
~S:60 ~OOZ'~Z lJO
KIA Insurance Associates,lnc.
P.O, Box 11390
Bakersfield, CA 93389
(04026 U7)
POLICY NUMBER: CWB0002618-02 - 07113
NAME OF INSURED AND MAILING ADDRESS:
Saint Vincent De Paul Store, Inc.
300 Baker Street
Bakerafield. CA 93305
POL.ICY PERIOD: FROM: 01111/2005 TO: 01/11/2006
.AT 12:01 A.M.- STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE.
'Exceptio"s; 12:00 noon in Maine, Michigan, North Carolina and Virginia
BUSINESS DESCRIPTION: Secondhand Clolhing & Furniture Store
I
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
POLICY. WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
(See SCHEDULE A for app!it;able coverage i"foonatiun & limits)
SECTION I . PROPERTY
POLICY DEDUCTIBLE: $ 250
BUILDINGS
BUSINESS PERSONAL PROPERTY (BPP)
OPTIONAL COVERAGES;
OptioMI CoverageS/Exterior Building Glass Dedudiblc .5500
Optional BOP Enhancement Endorsement (NAE-AMS-002)
Terrorism Coverage (Certified Acts):
Exception: CoveragA for Certain Fire Losses provided (nol optional);
53,870
$236
5411
Not Covered
$9
SECTION 1/ .: LIABILITY
N/A (Nol Available in this Policy)
TOTAL PREMIUM
$4.526
FORM(S) AND ENOORSEMENT(S) MADE A PART OF THIS POLICY AT TIME OF ISSUE:
NI\I!.AMS.OEC/,O 02. SCHEoUlE MO 02. NAF.POL-001Jll9.~1. N;U:.AMS~OO/'O 02, NAE..o.MS-002l1002, NAE.AMS-01D/l'02.
BP01S5I020<1. BPD57Il1DS 04. BP0564105 ()ot.
AUTOMATIC INCREASE IN INSURANCE: 4%
I COUNTERSiGNArtJRE:jjSE'.ONLy:.r~~}!tn~~i,;r~t~:~~;:;'ft:t:~~;;:~~;~.~~~~rt0.?ff:~~~;~.~r:i!W~~t!..;T'\~.'~.:':;:::::. .:: .,},: . -~ .~::.~: I
I Countersigned at: . By: Date:
Issuing Office: Santa Cruz Issued Dare: 01/12/2005
NAE.AMS-DEC (10102)
Page 1 of 2
S e6~d
09UrzH99l:
S~:60 SOOZ'~Z lJO
;' ........w ~
f?J 4-ft-.elL
--
"S I \
I CUIH.. f( ; i /\ /~ \'-.._#.
1 \../ . ,
~T. VIt\JCB-J\j) U -e.. O.+U l.- .- -- ---- ..-...
I ,I ;34-5 r'l 1
-:3:>0 e 4-ft., lS-fl.... <;;'
I ,
I tfl}l1.-U C ~ 016- ~2.C> -1..5'- 00 - <- 1
I '":
j
I 1
,
l
~ ff3.~ L e.. " f?yz.. Lj rR-~ f3.:j-Lfz.. f
t..VtLl I
I '\
,FYleJl"""'. <. c.J ~!3 ~t-J So'T'o "57; ~ I
; f ~
( r.e..e..,. /3~ r/l...cIM S't ()-( UJ 8L f-(
I Lj 1
,
{ f3~
I .:> "-.,) <S'/rtge-,
:
: '^~
,
!
0-
~t
12ecr v~s) 'F-a "t. - :>
u.pJ..t2.1 t1vJc.E: ~ CUrL!) ~
.G ~r r-e.i..J aL A-l\cJlf f\..S P (Jo/l-h-/~6 lOT
r
~
I
1 !
,
-<-
I I
,
Il,weST If l
r__~"" .L. - -
:5QQ..
I
"-
(fJ
,
t-
~
~
t;
t
""
('
4'
Q
~:
~.
.1;;.;/
...
tf 'FT 12a...q5 IJ~~ r ~
:).JT134-LIC ;::="U>"L F-ef\.J<Q.. C>A.J C'ff./L D ?
f