HomeMy WebLinkAbout05-30000078
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 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 . . . . . .
Application type description
05-30000078 Date
3201 MEADOW VISTA ST
PW - ENCROACHMENT PERMIT
5/06/05
Owner
Contractor
GOTTWALD THOMAS ROY & REGINA K
3201 MEADOW VISTA ST
BAKERSFIELD CA 93306
OWNER/BUILDER
BAKERSFIELD
CA 93301
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee
Issue Date . . .
ENCROACHMENT PERMIT
349928
150.00
3/30/05 Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
170lf. of 4' fence on the corner of
charger ave and meadow vista 871-1554
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
pe~~-yime. d /I~-
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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)
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.
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Signature of Cit{-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
adininistrative 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.
acknowledge the above.
cant'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: April 28, 2005
SUBJECT: Encroachment Permit Application for 3201 Meadow Vista St
Name of Applicant Thomas & Regina Gottwald
Description of encroachment. 170' of fence on the corner of Meadow Vista
& Charger
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\3201 Meadow Vista,doc
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Bj\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: April 5, 2005
SUBJECT: Encroachment Permit Application for 3201 Meadow Vista S1.
Name of Applicant Thomas & Regina Gottwald
Description of encroachment 170' of 4' fence on the corner of Charger &
Meadow Vista
Please review the attached encroachment permit and return to me at your earliest convenience.
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: March 31, 2005
SUBJECT: Encroachment Permit Application for 3201 Meadow Vista St.
Name of Applicant Thomas & Regina Gottwald
Description of encroachment. 170' of 4' fence on the corner of Charger &
Meadow Vista
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
11
S:\PERMITS\ENCROACH\INSURANC\3201 Meadow Vista.doc
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....~ $ .~ APPLICATION FOR ENCROACHMENT PER..\1IT
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFOR.:.'lL.\:
Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a pennit
to place, ere~t, .use and ~tain an encroachment on public property or right-of-way as therein defined.
1. Full name of aoolicant and camolete address including phone n~ber: 7{)/'V) I? tf:tJ 7/1A./A- L/J
1z..0 I .hI~~wl/' C;~A '.r,: ~#; cA. f~:J4.' ~7/ - / ~~.~
2, Nature or description of the encroachment for which this application is made: o/"'r- 0_ ' ~ '-'t ~
t{L~ . F#cL CVC/-o,SIN(, ,eI{~r ~~' I,#'S'"?'A~ ~
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3. Location of the proposed encroachment:
;f/ Ie- cd2.Iv~
4. . Period oftime for which the encroachment is to be maintained: ;,2'~ ~I:
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Applicant agrees that if this application is granted, ap,pIicant shall indemnify, defend and hold harmless City, its
officers, agents and employees against any and allliablhtr, claims, actions, causes of action or demands, whatsoever
against them, ot any pfthcm, before administrative, quasi .Judicial, or judicial tribunals of any kind whatsoever, arisin~
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 l.lntil such time that this permit is revoked. . , ,',
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Applicant' ~rther agrees that upon, th~ expiratio!l of th~ l'e~t [or which this application is made, if granted, or'Yng!l
the revocation thereofbv the Cltv engmeer. apphcant WIll at his own cost and exoense remove the same from the oublic
property or right of way where the same is located, and restore said public property or ri2ht of way to the condition
as nearly as that in which it was before the placing, erection, maintenance or existence ox said encroachment. '
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Applicant further agrees to obtain ana 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
Instirance evideIJ.cing sufficient coverage for bodily inju,ry or property damage liability or both and required
endorsements evidencing the insurance required. The type(S) and amount(s) of insurance' coverage is:
Jl{!sfWA-L LI/t!J/{,.It' y M-' #.AcJl
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Applicant ackno.wledges ~he right of the City Engineer, pursuantto~BaJsersfi~ld Municipat.Cgde~hwJDy1-2.20 to
revokethep<rn11t~t"ytune.. , ~, ~'
Date: 'J./~$L25 . . ~~ d. - ~~
... '-Signature of Appn~ (o;'ner or' epresentatlve
PER.~nT '
I HERIBY CERTIFY THAT I HAVE MADEA..'l INVESTIGATION OF THE FACTS STATED IN THE
FOREGOING APPLICATION AL'iD FIND TIL-\T mE MAINTENA~CE OF SAID ENCROACHMENT (1) WILL
(NOT) stJBSTA.L'lTLUL Y INTERFERE WITH THE USE OF THE Pl:rBLIC PLACE WHERE THE SAME IS TO
BE LOCATED AND (2) Wll,L (Non CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE;
SAID APPLICATION IS THEREFORE (GRA.'iTED) (DENIED). SAID PERMIT SHALL EXPIRE
SI~ cngmeer
Date:
No.
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. CITY O~ BAKERSFIELD
. OEPARTMENT 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,
~VI #/(J78 ;7".)C cIlM5-Gfl ~
, (Street for puposed encroachment)
Bv: T'~ ,~~.19-~
(Owners Name)
'of '3 ~.I ~'~lb~ '(/(.Ii?r S7.
(Address of purposed encroachment)
Phone: ~?I-, /:sW
SIGNED:
1) Name: Y/ ,fot' ~I t1J mer
Address: ' r; . r
- 2fName: " O~'v'l /~ ;:: IE (; (~
.!\ddrcss: -:1' 2"( /11 tftJ./).r-'- J/1.t'r4
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. 3) Name: " '. .
Address: ~O.6-. ,') VkfJ. ~
.4) Name: f!}1 f"ll ?bne. N 1-gIAJDJI{ jP'l/
Address: h I btf th. MJ:" fl:p e. . .
5} Name: ~..( \..... - ec..J..
Address: ~ '3.lp 'tl\e~~ LJ \<;\c... 5\,
6) Name: >< ~/- ~
Address: .,~~ ~a~ vtrf!7!J-{ $7
Date: 3 - 2/ ~ as-
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Date: ~... 2..1-D5
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ELITE II POLICY
DECLARATIONS
Non,Assessable
Page 1 of 4
These Declarations are a part of the policy named above and identified by policy number below. They
supersede any Declarations issued earlier. Your Elite II Policy will provide the insurance described in this
policy in return for the premium and compliance with all applicable policy provisions. See policy for details
regarding the other coverages and additional coverage options.
.~D
Policy Number:
72 04 MP 219219
Policyholder:
(Named Insured)
THOMAS ROY GOTTWALD
REGINA KELLY
GOTTWALD
3201 MEADOW VISTA ST
BAKERSFIELD CA 93306-1835
Issued:
NOV 05, 2004
Policy Period From:
DEC 31, 2004 to DEC 31, 2005 but only if the required premium for this period has been paid, and only
for annual renewal periods if premiums are paid as required. Each period begins and ends at 12:01 A.M.
standard time at the Residence Premises.
The Following Change(s) Have Been Made To Your Policy:
The limit of liability' for Section I Coverage A Dwelling is revised.
Limits of Liability for Policy Option Earthquake has been changed.
The earthquake percentage deductible shown below is based on the Earthquake and Volcanic Eruption
Endorsement's primary coverage limit.
Residence Premises Information:
THOMAS ROY GOTTWALD
REGINA,KELLY
GOTTWALD
3201 MEADOW VISTA ST
BAKERSFIELD
CA 93306-1835
ONE FAMILY
FRAME DWELLING
YEAR OF CONSTRUCTION 1992
PROTECTION CLASS 3
INSIDE CITY
WITHIN 1000 FT FROM HYDRANT
WITHIN 5 MILES FROM FIRE DEPT
FIRE DISTRICT 0002
PROTECTION TERRITORY 076
SECTION I
Property Coverages
Limits Of Liability
Deductible: $500 ALL PERILS
COVERAGE-A-DWELLI NG
COVERAGE-B-OTHER STRUCTURES
, COVERAGE-G-PERSONAL PROPERTY
COVERAGE-D-LOSS OF USE
$
$
$
$
166,900
16,690
116,830
166,900
In case of a loss under Section I, we
cover only that part of each loss over
the deductible stated.
EXCEPTIONS
15% EARTHQUAKE DEDUCTIBLE BASED
ON THE EARTHQUAKE AND VOLCANIC
ERUPTION COVERAGE ENDORSEMENTS
PRIMARY COVERAGE LIMIT. SEE
ENDORSEMENT FOR DETAILS
I
H5300
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ELITE II POLICY DECLARATIONS
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Page 2 of 4
SECTION II
Liability Coverages
COVERAGE-E-PERSONAL LIABILITY
FOR EACH OCCURRENCE:
PROPERTY DAMAGE AND
BODILY INJURY
COVERAGE-F-MEDICAL PAYMENTS
TO OTHERS EACH PERSON
Limits Of Liability
$ 500,000
$ 1,000
PERSONAL PROPERTY -SPECIAL LIMITS OF LIABILITY
The special limits shown below for each category is the total limit for each loss for all property in that
category. They do not increase the Coverage - C - Personal Property limits of liability. See Policy for details
regardi'ng the Special Limits of Liability. These limits are included in the basic Policy premium.
Theft Losses Only
Category
JEWELRY, WATCHES AND FURS
CAMERAS ' '
GUNS "
TOOLS
SILVERWARE
Limits of Liability
OPTION A BELOW
$ 1,000
$ 1,000
$ 1,000
$ 2,500
All Covered Losses
Category
Limits of Liability
MONEY
SECURITIES
WATERCRAFT
TRAILERS
MANUSCRIPT
COMPUTERS
BUSINE'SS PROPERTY
$
$
$
$
$
$
$
200
1,000
1,000
1,000
1,000
3,000
500
OTHER COVERAGES/OPTIONS APPLICABLE
See Policy or Endorsements for details regarding the Other Coverages and Options that apply to your policy.
Other Coverages Limits of Liability
INFLATION PROTECTION
BOECKH INDEX 0732.3 '
BIOLOGICAL DETERIORATION/DAMAGE CLEAN UP
ACCIDENTAL DEATH BENEFIT
EACH CHILD
EACH ADULT
FIRE DEPARTMENT SERVICE CHARGE
CREDIT CARD - FORGERY
Options Applicable
OPTION-A-JEWELRY, WATCHES AND FURS
OPTION-I-EXTENDED REPLACEMENT COST
PERSONAL PROPERTY
OPTION-J-REPLACEMENT COST PLUS
DWELLING
OPTION-L-PROTECTIVE DEVICE CREDIT
FIRE EXTINGUISHERS
DEADBOLT LOCKS ON ALL EXTERIOR ENTRYWAYS
ALERTING FIRE/BURGLARY ALARM SYSTEM
ORDINANCE OR LAW 10% OF COVERAGE A
WORKERS COMPENSATION
PART TIME OR OCCASIONAL EMPLOYEE
EARTHQUAKE
APPLIES
$ 5,000
$ 500 .
$ 2,000
$ 500
$ 1,000
$ 2,500
APPLIES
APPLIES
APPLIES
APPLIES
APPLIES
APPLIES