HomeMy WebLinkAbout07-30000023
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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
07-30000023 Date
4901 CALIFORNIA AVE
PW - ENCROACHMENT PERMIT
6/07/07
Owner
Contractor
FIRST ASSEMBLY OF GOD BAK
4901 CALIFORNIA AV
BAKERSFIELD CA 93309
. ( 66) 327-8446
OWNER
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Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee
Issue Date
ENCROACHMENT PERMIT
687418
200.00
6/07/07 Valuation
o
Qty Unit Charge Per
1.00 200.0000 EA PW ENCROACHMENT
Extension
200.00
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Special Notes and Comments
Build 3' retaining wall then build
6' chain link fence on top of wall;
fence will be 326' long on Marella the
side st of church and school.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 200.00 200.00 .00 .00
Grand Total 200.00 200.00 .00 .00
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the.
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Signature of Applicant (Owner/Agent) Print Name
I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACfS 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,
~
Signature or5ty Engineer
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Additional Terms on the Back
07- 7--3
,
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 indenui.ified 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 s~id 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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APPLICATION FOR ENCROACHMENT PEIl.1WIT
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFORNL~:
Erl"
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Pursuant to the provisions of Chapter 12,20 of the Bakersfield Municipal Code, the undersigned applies for a pennit
to place, er~t, use and maintain an encro~chment on public property or right-of-way as therein defined,
1. Full name of aoolicant and comnlete address including phone nwnber: ri /l5 r Il S Sf m 13 IV; (J -I
eO D' Sf~ckottl.( C H.I1,'SflIJN S?Ch(Jp I '-I1d! (ql,'~ qile $'J. 1~V;~V b
2. Nature or description of the encroachment for which this application is made: 1"11 ~ fa JA. . _3 -: 3 Yz. ~.t
~ \o\Q~\C' ~ L -\-C> f'e ~ d i....t- \}J. ~ Co .~~ c~-Ge~ n('.lL (J'f\ ~f'Qi; uUJ
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3. Location of the proposed encroachment: r('\Cu"~ \.\ c. \...JJcu.<T
-30~b6 G~."~
4. Period of time for which the encroachment is to be maintained: 'r-~u~
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold hannless City, its
officers, agents and employees against any and allliabillty, claims, actions, causes of action or demands, whatsoever
against them, or any pfthem, before administrative, quasi-Judicial, or judicial tribunals of any kind whatsoever, arising
out of, cormected 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 tlie aforesaid encroachment during the
~ife of said encr~achment or 1:U1til such time that this pennit is rev?ked, ' " . '.' .
Applicant further agrees that upon.the expiration of me perinit for which this application i~ made, if granted, or'YRQ!l
the revocation thereofbv the Citv engineer. applicant will at his own eost and exoense remove the same from the DubHe
pronertv 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 or said encroachment. .
. .
Applicant further agrees to obtain and keep all liability insurance required by the City Engineet 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 inju,ry or property damage liability or both and required
endorsements evidencing the insurance required. The type(s) and amount(s) of insuranc e' coverage is:
,."
..... ~
. ~.
Applicant acknowledges the right of the City Engineer, pursuantto.~crsfie!.Q...MunicipalC9de ...ChJrPJe~J2,20 to
revoke the pennitat any time. '. ~ /7/ .
Date: {, -~ -.' Of - '--' /;f~.
. SIgnature 0 Appndant (Owner or RepresentatIve)
PER.~IT
I HERIBY CERTIFY THAT I HAVE MADE A..'i INVESTIGATION OF THE FACTS STATED IN THE
FOREGOING APPLICATION AL'iD FIND ffi.\T THE MAINTENk"iCE OF SAID ENCROACHMENT (1) WILL
(NOT) StIBSTAJ.VfIALL Y INTERF~EWI. USE OF THE P{jBLIC PLACE WHERE THE S~'IE IS TO
BE LOCATED A'ID (2) WILL (NOT) E A HAZARD TO PERSONS USING SAID PUBLIC PLACE;
SAID A1PLICATION IS THEREFO (GRA.'4T (DENIE.D). SAI:D PERMIT SHALL EXPIRE
. .
S~,ty Engmeer
Date:
No,
'07 300 J..3
/{ ~.'~-,
- Cl?Y Q~ 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.
/l1 A., t II t.. w",y
(Street for puposed encroachment)
Bv~ ~~~
(Owners Name)
Lj901
of ~O6)-l
('1 (; [ , 4ve.
(Address of purposed enc~oachment )
Phone:
3~ 7-~7I5/b
Date: b~' (P ... ff1
Date:
. Date:
4) Name:
Address:
Date:
!i) Name:
Address:
Date:
6) Name:
Address:
Date:
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A CORDm CERTIFICATE OF LIABILITY INSURANCE f DATE (MMlDDIYYYY)
3/8/2007
PRODUCER (866) 662.8210 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Steward Insurance & Risk Management ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Assemblies of God Districts Ins & ~Isk Mgmt Program ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POBox 10263
Springfield, MO 65808-0263 INSURERS AFFORDING COVERAGE NAIC#
INSURED First Assembly of God. Bakersfield INSURER A: Church Mutual Insurance Company
SCA-520-736 INSURER B:
4901 California Avenue INSURER c:
Bakersfield, CA 93309 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~';: r.H.~~ TV,,,:nc: POUCY NUMBER POUCY EFFECTIVE POUCY EXPIRATION LIMITS
~ERAl UABIUTY EACH OCCURRENCE S 1,000,Ooe
A X ~ nMERCIAL GENERAl LIABILITY 0084474-02.698454 9/1/2006 9/1/2007 PREMISES lea oCOJrencsl S 1,OOO,Ooe
f---' ClAIMS MADE ~ OCCUR MED EX? (Any one person) S 5,OOe
- 1.000,00[
PERSONAL & ADV INJURY $
- 3,000.00[
GENERAl AGGREGATE S
- 3,OOO,Ooe
~ AGGRn LIMIT APPLIES PER: PRODUCTS - COMP/O? AGG S
POLICY p'~g: n LOC
~OMOBILE UABIUTY COMBINED SINGLE LIMIT S
ANY AUTO . (Ea accldenl)
I--
I-- ALL OWNED AUTOS BODlL Y INJURY
S
SCHEDULED AUTOS (Per penlon)
l-
I-- HIRED AUTOS BODILY INJURY
S
NON-oWNED AUTOS (Per eccldent)
l-
I-- PROPERlY DAMAGE S
(Per accident)
~RAOE LIABILITY AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG S
OESSlUMBRELLA UABIUTY EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE AGGREGATE 5
S
R DEDUCTIBLE $
RETENTlON 5 S
WORKERS COMPENSATION AND I ~~~IrJ#s I I~
EMPLOYERS' UABILITY
ANY PROPRJETORIPARlWERlEXECUTIVE E.L EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE S
II yes, describe under :
SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT S
O1llER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Commercial General Liability Additional Insured: County of Kern, Its Officers Employees, Agents, Boards and Commissions, subject
to the coverage provided by the referenced policy per Additional Insured Designated Person or Organization Form A220 (01-98),
regarding use of facilities at Buena Vista Aquatic Recreation Area for First Assembly of God's 8th Grade Class Party on May 23,2007,
Altn: Bryan
CERTIFiCATE HOLDER
CANCELLATION
The County of Kern, Its Officers,
Employees, Agents, Boards and Commissions
Kern County Parks and Recreation Dept.
1110 Golden State Ave.
Bakersfield, CA 93301-
SHOULD ANY OF TIlE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE TIlE EXPIRATlON
DATE TIlEREOF, TIlE ISSUING INSURER WlLL ENDEAVOR TO MAlL 1~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
ACORD 25 (2001/08)
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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: July 10, 2007
SUBJECT: Encroachment Permit Application for: 4901 California Ave.
Name of Applicant: First Assembly of God
. Description of Encroachment: Build 3' retaining wall with a 6' chain fence
built on the wall, this will exceed height requirements; but is within height
requirements when measured from the high side.
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
applicant to build wall and 6' fence along Marella St.
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\4901 California Ave..doc
07-23
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B .~ K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 3, 2007
SUBJECT: Encroachment Permit Application for: 4901 California Ave.
Name of Applicant: First Assembly Of God
Description of Encroachment: Build 3' wall, behind sidewalk with 6' chain
link fence an top,
Please review the attached encroachment permit and return to me at your earliest convenience.
710S/ uo1
fi?4Jt/e rrrE16lf1" G-rcee-rzr
M~,.,1U{1-1 WC<JfIf"
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S:\PERMITS\ENCROACH\TRAFFIC\4901 California Ave..doc
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OB 4~ K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ralph Korn, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 2, 2007
SUBJECT: Encroachment Permit Application for: 4901 California Ave,
Name of Applicant: First Assembly of God
Description of Encroachment: Build fence out to sidewalk on a 3' retaining
wall.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:\PERMITS\ENCROACH\INSURANC\4901 California Ave..doc