HomeMy WebLinkAbout05-30000091
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
05-30000091 Date
6918 GRAFTON CT MD
011-431-34-00-1
PW - ENCROACHMENT PERMIT
6/08/05
Owner
Contractor
CERVANTES CARLOS & ESMERALDA
6918 GRAFTON CT
BAKERSFIELD CA 93307
OWNER/BUILDER
BAKERSFIELD
CA 93301
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT'
380204
150.00
6/08/05
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
4' WROUGHT IRON AND BRICK FENCE
IN THE FRONT OF HOUSE. 62' X 6' BLOCK
FENCE ON SIDE OF HOUSE.
PENDING APPROVAL BY RANDY JOHNSON
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.
~'&w/L~~
. Ignature of Apphcant (Owner! Agent)
8rYJ-er t1.--l{)t1.
Print Name
Ce-r J/tt./lf~J
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)
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 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 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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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
05-30000091 Date
6918 GRAFTON CT MD
011-431-34-00-1
PW - ENCROACHMENT PERMIT
6/08/05
Owner
Contractor
CERVANTES CARLOS & ESMERALDA
6918 GRAFTON CT
BAKERSFIELD CA 93307
OWNER/BUILDER
BAKERSFIELD
CA 93301
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
380204
150.00
6/08/05
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
4' WROUGHT IRON AND BRICK FENCE
IN THE FRONT OF HOUSE. 62' X 6' BLOCK
FENCE ON SIDE OF HOUSE.
PENDING APPROVAL BY RANDY JOHNSON
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.
f;t/J/1A/LR1N (~
Signature of Applicant (Owner! Agent)
EsmfJ?:dclo,
Print Name
urvatrfeJ
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)
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 Ci Engmeer
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.
I have read and acknowledge the above.
~pplicant's Initials
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
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TO:
Raul M. Rojas, Public Works Director
FROM:
Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE:
June 24, 2005
SUBJECT: Encroachment Permit Application for 6918 Grafton
Name of Applicant Cervantes Carlos & Esmeralda
Description of encroachment. 4" wrought iron and brick fence
62'x6' block fence on side of house
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 - 9/
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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: June 20,2005
SUBJECT: Encroachment Permit Application for 6918 Grafton Ct.
Name of Applicant Cervantes Carlos & Esmeralda
Description of encroachment 4' wrought iron and brick fence
62'x6' block fence on side of house
Please review the attached encroachment permit and return to me at your earliest convenience.
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S:\PERMITS\ENCROACH\TRAFFIC\1 traffic memo,doc
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BJ\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: June 13,2005
SUBJECT: Encroachment Permit Application for 6918 Grafton Ct.
Name of Applicant Cervantes Carlos & Esmeralda
Description of encroachment. 4' wrought iron and brick fence
62'x6' block fence on side of house
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'-Insurance memo,doc
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· I .. CITY OF BAKERSFIELD PERMIT APPLICATION
PLEASE PRINT OR TYPE APPLICATION'
I
Project Info: t: :.l/V1 ce-- ~
. ~escrip.tion of,r ork to ):!~f~nned ,/l.L ~ _ Y'~ ~" /J I) -' ~,
Project LocahoD : l.(Jq I L .tr.L'1-(fUYl "'" L ~::rJt(J12l Lq
Address3!! Suite Number iJ'1 'f I
Tract Number Lot Number
Applicant is (please Circle One) c, Contractor Arch / Eng Other
Uo7
~ner: Catlttn1:e ~-
LasttQ~g 4r~
A~J~kl
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-c.a.rJ oS
~irstName
n Suite~ber -? .
Lcr D?/J r ~lt?1
Phone Number Fax Number
778 -5(P5
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Contractor:
Last Name (Company Name)
First Name
Address
Suite Number
City
Zip
Phone Number
Fax Number
,
Contractors License Number
License Expiration Date
Arch / Eog :
Last Name
First Name
Address
Suite Number
City
Zip
Phone Number
Fax Number
Architect f Engineer License Number License Expiration Date
, OFFICE USE ONLY
Permit Number
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APPLICATION FOR ~NCRO~CHMENT PERMIT :JJ~SD
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFORNIA:
1. Full name of applicant and complete address including phone number:
Period of time for which the encroachment is to be maintained:
\ (\ol e-P1 r\ I'-re..)
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, 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 .!!QQll
the revocation thereofbv the CItv engineer. applicant will at his own cost and expense remove the same from the public
propert~ or right of way where the same is located, and restore said public property or right of way to the condition
as near y as that in 'Yhich it was before the placing, erection, maintenance or existence or 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) ~nd amount(s) of insurance coverage is:
ltomggy;;s j(V;lArCAinceJ - ?()V~ tul1:vl 2t:!1DOO.00
-1)O\~-/~-
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' -25 - OS
PER'\IIT
I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED Ll'l 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 PIJBLIC PLACE;
SAID APPLICATION IS THEREFORE (GRANTED) (DENIED). SAID PERMIT SHALL EXPIRE
Date:
Signature of City Engmeer
No.
,
;,' CITY OIS BAKERSFIELD
J '
, DEPARTMENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
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We the undersigned , have no objection to the construction of a fence beside the
sidewalk within the public right of way.
0/(fl-F ToN Se/(u I 5"
(Street or puposed encroachment)
/ Sf / C'(.
of f&/q I U L?/Ut FrON
(Address of purposed encroachment)
SIGNED: ~.
1)!'lame:'0:~. ' .~ . .
Address: b q 0!? PI e!li)
2) Name: .~~ ~ ~=
Address: 1/// J6raJ1S;. (!j;
3) Name: (--;b5e 4~/:t.u Cc--
Address: 70 7 <J free) 1; S c. (
4) Name: J ()'~ fer/~ 4'
Address: Coer 7 clLU ( ~'r
5) Name: 4/ /f/ ri If 'f- e.-- v_e--.s:
Address: r; C) g;- J e-\:-' ~ " r-r
6) Name: ~I1.7 ds/W@Os
Address: 6~(7 ~/?:""~..../ c::e-.
By: (cud D S ~~IV V MlliS
(Owners Name)
bb' -378'- 56 5 J.-
Phone: "I 37'6- 0' 08
Date: 5-d <j- D S
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Date: 5'1" d- L.{L-Q:d
Date: s;:-- 0-.-4 '-05
Date: 5 -;J-L( - () 5
Date:
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Date:
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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_
Policy Number:
72 04 MP 247947
Policyholder:
(Named Insured)
ESMERALDA TORREZ
CERVANTES
& CARLOS CERVANTES
6918 GRAFTON CT
BAKERSFIELD CA 93307-7175
Issued:
MAR 09, 2005
Policy Period From:
AUG 13, 2004 to AUG 13, 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.
Change Effective Date:
MAR 08, 2005
The Following Change(s) Have Been Made To Your Policy:
The limit of liability for Section II Coverage E Personal Liability is revised.
The limit of liability for this structure (Coverage A) is based on an estimate of the cost to rebuild your
home, including an approximate cost for labor and materials in your area, and specific information that
you have provided about your home.
Residence Premises Information:
ESMERALDA TORREZ
CERVANTES
& CARLOS CERVANTES
6918 GRAFTON CT
BAKERSFIELD
CA 93307-7175
ONE FAMILY
FRAME DWELL I NG
YEAR OF CONSTRUCTION 2001
PROTECTION CLASS 4
INSIDE CITY
WITHIN 1000 FT FROM HYDRANT _
WITHIN 5 MILES FROM FIRE DEPT
FIRE DISTRICT 0034
PROTECTION TERRITORY 076
SECTION I
Property Coverages
Limits Of Liability
Deductible: $500 ALL PERILS
COVERAGE-A-DWELLI NG
COVERAGE-B-OTHERSTRUCTURES
COVERAGE-C-PERSONALPROPERTY
COVERAGE-D-LOSS OF USE
In case of a loss under Section I, we
cover only that part of each loss over
the deductible stated.
$
$
$
$
173,000
17,300
121,100
173,000
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
$ 300,000
$ 1,000
H5300
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Policy Number:
72 04 MP 247947
Policyholder:
(Named Insured)
ESMERALD CERVANTES
Policy Period From:
AUG 13, 2004 TO AUG
ELITE II POLICY
DECLARATIONS
Non-Assessable
Page 3 of4
. Issued:
MAR 09, 2005
13, 2005
PREMIUM SUMMARY
Premium Based On
Premium Amount
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POLICY PREMIUM
WORKERS COMPENSATION
Annual Premium
Annual Premium Includes Discounts For:
CLAIM FREE
HOME/CAR
HOME PROTECTIVE DEVICE
NEW HOME
$
$
$
554.00
3.00
557.00
10
(')
C\I
o
o
FORMS and ENDORSEMENTS MADE PART OF POLICY
,..:
"'"
Ol
,...
"'"
C\I
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C\I
3
Fire 2502
Fire 2530
Fire 3090
Fire 3191-A
Fire 3037-A
Fire 3381
Fire 3882
Elite II Homeowners Policy ,
Workers Compensation and Employers' Liability
Insurance Endorsement
Lender's Loss Payable Endorsement
Amendatory Endorsement
Amendatory Cancellation, Renewal and Ncnrenewal
Endorsement
Building Ordinance or Law
Mandatory Endorsement
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ADDITIONAL INTERESTS
FIRST MORTGAGEE
COUNTRYWIDE HOME
LOANS I NC
ISAOA ATIMA
400 COUNTRYWIDE WAY
SIMI VALLEY CA 93065-6298
LOAN #86165996
.........
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Issued By: NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
Countersigned At: SACRAMENTO, CA
Prior Declaration Issued: NOV 24, 2004
Home Office - Columbus, Ohio
By:C.E.MEYERS
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ELITE II POLICY DECLARATIONS
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Page 2 of 4
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
regarding 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
$ 1,000
$ 1 , 000
$ 1 , 000
$ 1 , 000
$ 2,500
All Covered Losses
Category
MONEY
SECURITIES
WATERCRAFT,
TRAILERS
MANUSCRIPT
COMPUTERS
BUSINESS PROPERTY
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$
$
$
$
$
Limits of Liability
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 APPL i ES
BOECKH INDEX 0720.0
BIOLOGICAL DETERIORATION/DAMAGE CLEAN UP
ACCIDENTAL DEATH BENEFIT
EACH CHILD
EACH ADULT
FIRE DEPARTMENT SERVICE CHARGE
CREDIT CARD - FORGERY
$
$
$
$
$
500
2,000
500
1,000
, 5,000
Options Applicable
OPTION-I-EXTENDED REPLACEMENT COST
PERSONAL PROPERTY
OPTION-J-REPLACEMENT COST PLUS
DWELLING
OPTION-L-PROTECTIVE DEVICE CREDIT
LOCAL FIRE OR SMOKE ALARM SYSTEMS
FIRE EXTINGUISHERS
DEADBOLT LOCKS ON ALL EXTERIOR ENTRYWAYS
OPTION-M-PERSONAL INJURY
ORDINANCE OR LAW 10% OF COVERAGE A
WORKERS COMPENSATION
PART TIME OR OCCASIONAL EMPLOYEE
APPLIES
APPLIES
APPLIES
APPLIES
APPLIES
APPLIES
SPECIAL PROVISIONS
YOUR PROPERTY IS NOT EXPOSED TO BRUSH FIRE HAZARD.
ELITE II POLICY DECLARATIONS
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Page 4 of4
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IMPORTANT PHONE NUMBERS
Nationwide 24-Hour Claims Number: 1-800-421-3535
For QUESTIONS About Your Policy, Call
Nationwide Customer Solution Center at 877-0nYourSide (877-669-6877)
or log on to Nationwide.com
For Hearing Impaired: TTY 1-888-662-8446 Nationwide Regional Office: 503-238-4100
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