HomeMy WebLinkAbout04-30000057
ENCROACHMENT PERMIT
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN A VB
BAKERSFIELD CA 93301
(661) 326-3724
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA:
Pursuant ttrthe 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.
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Application Number
pin number . . . , . ,
Property Address . , .
ATN (11 Digits) :
Application description
Owner
. . . 04-30000057 Date
.277711
1817 FAIRVIEW RD
7/27/04
PW - ENCROACHMENT PERMIT
Contractor
OWNER/BUILDER
GONZALEZ PETRONILO & MARIA N
1817 FAIRVIEW RD
BAKERSFIELD CA 93304
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Permit . . . . ,
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . ,
BAKERSFIELD
CA 93301
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ENCROACHMENT PERMIT
251207
150.00
7/27/04
valuation
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Qty unit Charge Per
1.00 150,0000 EA PW ENCROACHMENT
Extension
150,00
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Special Notes and Comments
ENCROACH INTO RIGHT OF WAY WITH BLOCK
WALL OUT TO SIDEWALK
~ to I Block wall @ klz-of SIdewalk
J.lolV3 S,de yard.
Fee summary Charged
Paid
Credited Due
Permit Fee Total 150.00
Grand Total 150.00
150.00
150.00
.00 .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.
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Signature of Applicant (Owner/Agent)
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Print Name
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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)
I WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE (G~ED) (DENIED). Said permit shall expife~on)date stated above,
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Signature ofCit{Engineer
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Additional Terms on the Back
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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.
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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
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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: August 4,2005
SUBJECT: Encroachment Permit Application for 1817 Fairview Rd.
Name of Applicant Gonzalez Petronilo & Maria
Description of encroachment. 6' high block wall on Chester Nimitz St.
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
04 - 57
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B~A..KERSFIELD
PUBLIC WORKS DEPARTMENT
- MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 26,2005
SUBJECT: Encroachment Permit Application for 1817 Fairview Rd.
Name of Applicant Gonzalez Petronilo & Maria
Description of encroachment. 6' high block wall on Chester Nimitz St.
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\1817 Fairview Rd.doc
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Bi\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 26,2005
SUBJECT: Encroachment Permit Application for 1817 Fairview Rd.
Name of Applicant Gonzalez Petronilo & Maria
Description of encroachment block wall along Chester Nimitz St. 6' high
Please review the attached encroachment permit and return to me at your earliest convenience.
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S;\PERMITS\ENCROACH\TRAFFIC\1817 Fairview Rd..doc
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City of Bakeiefield
*;i CuSTO~ER RECEIPT ***
0~ar: VDAvrs Ty~e: OC Drawar: 1
)j!ib~; '7171/04 ~1 Receipt no: 146<39
Description Quantity, A80unt
2604 30000057 '
BP BUILDING PERMITS
1.~ ' $150.09
Tender detail
CS C&SH
lotal ~endered
'i'otal r:ayrnent
Chs.nse
S2e0.00
$200.00
$15$.01J
$50.09
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Trans date: 7/27/04 Tille: 16:00:02
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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 encroaclunent on public property or right-of-way as therein d.efined./ / (7. -" II
599 - '-I 0 r-e.11
1. Full name ~f appHc,ant and complete address including phone ~her:, 0.10.1) ts 7 - 'f 77,s-
~tror1do VI~Pn+eJ Gon2IJfe<:: If/r] fOirvltvv J3af<l;rs.{)/J10 ffl C/33 'I
2, Nat'fl" or description of the encroachment for which this application is made:
1:pxneni....0 , ()fJL -PI' f)(Ip ./
3. Locationoftheproposedencroaclunent: \A/pst ~irlp/ 0{2 h()m~.
4. Period of time for which the encroachment is to be maintained:
Applicant agrees that if this application is granted, ap'plic.mt shall indemnify, defend and hold hannless City, its
officers, agents and employees against any and allliablhty, cl.dms, actions, causes of action or demands, whatsoever
against them, or any 9fthem, before administrative, quasi-judicial, or judicial tribunals of any kind whatsoever, arising
out of, connected with, or caused by applicant's placr.ment, er ~ction, use (by applicant or any other person or entity)
or maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroaclunent during the
life of said en(;roachment <.'r until such time that this permit is revoked . '
Applicant f.lrther agrees that upon the expiration of tht;: p,ermit for which this application is mad,e, if granted, ;~r upon
the revocatij}n thereofbv the City ene:ineer. aDDlkant wLl at his o'yn cost and expense remove rhe same from the Dublic
~ert~ OJ.' right ,of w~y w:here the same is loca~ed, and r~store s~d public prop~rty or right ,of way to the condition
as near y ~ that m which It was before the placmg, ere.:tlOn, lIlRIDtenance or eXlstence or saId encroachment.
Applicant furtherar..rees to obtain and keep all liability bsurance required by.the City Engineel' in full force and effect
for howevt;;c long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of
Insurance I:~videncing 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:
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to
revoke the permit at any time. ' , -t"" J I
Date: ~ -r:;,~~ u.~W
Signature {{ ~ ant wner or Representative
PERMIT
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) WD..L (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE;
SAID APPLICATION IS THEREFORE (GRANTED) (DENIED). SAID PERMIT SHALL EXPIRE
Date:
/~tltY En~eer
No.
Agents Gary L Been
Name 2822 F St Ste 1
& Address: Bakersfield CA 93301-1800
Phone Number ( 661 ) 322-9502
AREA CODe
Mortgagee
Name and
Address
Named
insured
Address
Location
of Premises
(If other
than shown
above)
EVIDENCE OF INSURANCE FOR MORTGAGEE INTERESTS
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Coverage afforded by the poliCY is provided by:
Fire Insurance 0 Mid- Century
Exchange Insurance Company
The Company designated on the reverse side as number
O Farmers
Insurance Exchange
BANK OF AMERICA 173
lSAOA/ ATlMA
PO BOX 1675
CORAOPOUS PA 15108-6903
Loan Number. 3300992538
POlicy Number: 915630039
PETRONILO V.GONZALEZ A MARRIED MAN AS HIS SOLE
AND SEPAPATE PROPERlY. AND RAMON ORTEGA A SINGLE
1817 FAIRVIEWRD
BAKERSFIELD CA 93304-7118
Second Mortgagee:
Loan Number:
This fonn is not the contract of insul'8nce. It is a memorandum of coverage limited to mortgagee interests and applicable to the dwelling
building or Mobile Home at the location above. The provisions of the policy will prevail in all respects.
Inception Date 11/03/2004
Renewal Date 01/01/2006
Expiration Date (If "none :' the policy will be renewed automatically,
subject to the forms then current, for each succeeding policy period, and is subject to termination by this company only after written notice to
the Insured, to the Mortgagee, and to all other interested parties,)
POLICY TYPE:
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ACCIDENTAL DIRECT PHYSICAL LOSS
(Special Form)
BROAD (Broad Form)
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EXAMPLES OF TYPES OF POLICIES '
Special Form Homeowner- Protector Plus Homeowner; landlords Protector;
Townhouse Owner; HO-B; DF-3; DP-3; Special Form Mobile Homeowners
Condominium Owner; DF-2; DP-2, Additional Extended
Coverage
Basic Homeowner; Actual Cost Basic; HO-A; DF-1; DP-1; Basic Form
Mobile Homeowner
FIRE, E.C. (Basic Form)
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POLICY LIMIT OF LIABILITY: Dwelling Building or Mobile Home Protection $ 210,000.00
Deductible Applicable to Dwelling or Mobile Home $500 III All Insured Perils
~ Ljaij!,,,),", =,CX'JD. 0
Total Annual Policy Premium $ 455. 73 ~ Paid 0 Please Remit
Fonns and Endorsements Applicable at Inception III Loss of Use 0 Extended Replacement Cost
Includes coverage up to 1ZS''<' of the dweDing covell!
121 438 BFU NS 542, DP300 388 ED, E4136A 3RD ED, H4128A 1ST ED, S9072 1ST ED, S90921ST ED, 59099 1ST ED
258531 103 ED,
DJJ19~
Authorized Representative
Vice President
Title
07/21/2005
Date
95
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07 355
Disl. Agl
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FAR MER S.
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. . CITV OF. BAKERSFIELD
~ DEPARTMENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
We the undersigned I have no objection to the construction of a fence beside the
sidewalk within the public right of way.
C.\~--,<,\-e_c. W " ~\ ~~ -\"2-
(Street for puposed encroachment)
Bv: ~P/~~n-~\\c> ~^-7~Z
(Owners Name)
of
Phone:
(Ad ress of purposed encroachment)
SIGNED:
6) Name:
Address:
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2) Name:
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Date:
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5) Name:
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