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HomeMy WebLinkAbout04-30000061 .. APPLICATION FOR ENCROACHMENT PERMIT PERMIT NO.: EN-01529 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. 1. Full name of applicant and complete address including phone number: COMMERCE DRIVE PARTNERS A CALIFORNIA LIMITED PARTNERSHIP 5601 TRUXTUN AVE ST #190 93309 C/O GREGORY BYNUM Phone No.661 3950541 2. Nature or decription of the encroachment for which this application is made: LANDSCAPING AND SIGNAGE 3. Location of proposed encroachment is : 4865 TRUXTUN AVE BAK PER THE ATTACHED SCHEMATIC SITE THE PROPERTY LINE AND THE TOP OF SLOPE PLAN, THE GRADE SEPARATION RIGHT OF WAY BETWEEN 4. Period of time for which the encroachment is to be maintained: PERPETUAL Applicant agrees that if this application is granted, applicant will idemnify, 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 mantain 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 insuance evidencing sufficient coverage for bodily injury or property damage liability of both and required endorsements evidencing the insurance required. The type(s) and amount(s) of insurance coverage is: WALTER MORTENSEN INSURACE LIABILITY 2,000,000. Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. Date:04/15/2002 Signature of Applicant (Owner/Agent) 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) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE (GRANTED) (DENIED). Said permit shall expire Date:04/15/2002 v % frjf} 1fl1J VflJJ1 Ave- . APPLlCA nON FOR ENCROACHMENT PERMIT ,'Bt'J ..-16 Z q ;. " .. ~ TO THE CITY ENGL'lEER OF THE CITY OF BAKERSFIELD. CALIFORN~: Pursuant to the provisions of Chapter 11.10 of the Bakersrield Municipal Code. the undersigned applies for a perm it to place. creel. use and maintain an encroachment on public propcny or right-of-way as therein defined. I. Full name of applicant and complete address including phone number:J;Olllmerc~ Drive Partners, a California limited partnershi~ Gregory D. Bynum and Associates. Inc.. 5601 Truxtun Avenue, Suite 190, Bakersfield, California 93309 (661) 395-0541 , ~ature or description of the encroachment for which this application is made: landscaping and si~n.ggp 3. Location of the proposed encroachment: per the attached schematic site plan. the r:rM'Ip separation right-of-way between the property li~e and the top of slope 4. Period of time for which the encroachment is to be maintained: perpetual.- Applicant agrees that if this application is granted. applicant shall indemnify. defend and hold hannlcss 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-judical.or judicial tribunals of any kind whatsoever. arising out ot: 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 runher agrees to maintain the aforesaid encroachment during the life of said encroachment or until such time that this permit is revoked. Applicant funher agrees that upon the expiration of the permit for which this application is made. if gnmted. or upon the revocation thereof bv the City en~ineer. applicant will at his own cost and exocnse remove the same from the public propertV or right otway where the same is located. and restore said public propeny or right of way to the condition as nearly as that in which it was before the placing. erection. maintenance or existence of said ~ncroacnment. Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect. tor 'however long the encroachment remains, Applicant shall furnish thc City Risk Manager with a Cenificate of Insurance evidencing sur"ficent coverage for bodily injury or propeny damage liability or both and required endorsements evidencing the insurance required. The type(s) and amount(s) of insurance coverage is: $1,000.000 broad form general liahility immr.gncp Applicant acknowledges the right of the City Engineer. pursuant to Bakerstield Municipal Code Chaptcr 12.10 to revoke the permit at any time, er. "1#'1 p. 8J1"~1I\ .; ~C'C.;~5. Ilte... 6xe~~ ~ Date: /1 j;;.. 7 /01 (/!~ - v. P. lure of Applicanl (Owner or Representative) PERMIT I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OFTHE FACTS STATED IN THE FOREGOING APPLICATION AND fiND THAT THE MAINTENANCE OF SAID ENCROACHMENT (I) WILLCNOT) SUBSTANTIALLY INTERFERE WITH THE USE OFTHE PUBLIC PLACE WHERE THE SAME IS TO BE LOCATED AND (2) WILL (NOT) CONSTITt:TE A HAZARD TO PERSONS USING SAID PUBLIC PLACE: SAID APPLICATION IS THEREfORE CGRANTEl)) (DENIED). SAID PERMIT SHALL EXPIRE Date: 5' //6/6'-. . ~~ Signature of City Engineer ~ No LEGEND !XW.ttJ(JfIKIIIl5IIfRlmlliOll ISU6III"!oiNOolV lJlilIWilafmmWQEl! DlAlCl!)Q.f!rI'arfDFM:S5II3..P .. 1s['~!:'~>1 ~~~HI) t~~~~~l tAlIWIt 1:-:.::-\x:>A =1k~ 0== o =--- . . =-="'" ..... c::::J - .~ . ;: i . TENANT A TENANT B F::I ,_ I lIa.IAlDWII..fASElClIT C,:'-,,:'':';) .II($lIIiI7,P$_5010... ~::~::~_'-;':) 1:::'_';':'1 I'-j":-".l MONUMENT SIGN ELEVATION SITE PLAN BEAUTY 5ALON (HAIR 5TYLI5T5, HANICURf5, PEDICURE5 l MAS5AGE) BUILDING GI1055 Fl.OOR />PEA 7.871.75 5,f, REOOIRED PAA~NG ST.AUS 0.87/..75 + 100 GSf or2 per bo1>er or o1yIIng ,110.) 79/80 PAA~NG ST.AUS PROVIDED ~-O',lIl'-O' -lYP,) - 81 REOOIlfl) ACa5511llE 5T.AUS 4 ACCE551lLE STAlLS PRCMDED 4 AREA CALCULATIONS ,', ./j\ MILAZZO & AssoC/AJFS --_inz. 3300 Truxtun Avenue, Suite 300 Bakersfield, California 93301.3137 trl ~ :7 1-" c:r' 1-'. rt rt o ~ "d "d t-' 1-'- n' (lJ rt 1-" o ::l ~ o I'i trl ::l n I'i o (lJ n ::J" S (1) ::l rt -- "" GIKiOIIV O. IIYNUM . ASSOCIAte, INC. a IfAl. ESTAn DEVELOPMENT SBYICES ""d (1) I'i S 1-'. rt Hl I'i o S (1 o ~ (1) I'i n ro t:::I I'i 1-'. <: ro ""d (lJ I'i rt ::l ro I'i Ul __>>ON , , , . , . , SHfffTflll SCHEMATIC SITE PLAN SCI\U T4fNl RomD """ ~MIIlPS. O.Y.n. IiOfIl1'~OI!i).1 SO.1 I'fII:JIfCl 395.0100 AACHITECTUAAL .~" ~ . - BAKERSFIELD PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ryan Starbuck, Civil Engineer III FROM: Marian P. Shaw, Civil Engineer VI, Subdivisions DATE: April 18, 2002 SUBJECT: Encroachment Permit Application for 5601 Truxtun Avenue Commerce Drive Partners Landscaping & signage Please review the attached encroachment permit and return to me at your earliest convenience. Of-- nD 'UV\{::Od- On. +m.\-~\C \im.. D~ J\~~-' G..[ ,/~ S:\PERMITS\ENCROACH\TRAFFIC\5601 Truxtun Ave.wpd .;_ r, . From: To: Date: Subject: Manar Haddad Robert Wilson Tuesday, April 09, 2002 9:36AM Commerce Drive Partnership AKA Bynum & Associates, insurance is on file and okay for enchroachment permit. Thanks '-'~ ,d,\ (. -.. -- ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIYY) no 03/27/2002 PRODUCER (661)834-6222 FAX (661)834-6662 1 "I;), ~C,K , MA lie", vr .., ~n...~ I lVi'll Walter Mortensen Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR License #90267 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4701 Stockdale Hwy. INSURERS AFFORDING COVERAGE Bakersfield, CA 93309 INSURED Gregory D. Bynum & Associ ates, Inc. INSURER A: Firemans Fund Insurance DBA: Gregory D. & Mary M. Bynum INSURER B: Commerce Drive Partnership, CA LP INSURER c: 5601 Truxtun Ave., Suite 190 INSURER D: Ba~ersfield, Ca. 93309-0627 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 MAY BE 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, 'LTR TYPE OF INSURANCE POLICY NUMBER "~k+~'(MMlDD/YY) '~~!fE (MMlDD/YY) LIMITS GENERAL LIABILITY ASIAZC80673485*** 06/01/2001 06/01/2002 EACH OCCURRENCE $ 2,000,00 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,00 I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 10,00 A PERSONAL & ADV INJURY $ 2,000,00 - GENERAL AGGREGATE $ 4,000,00 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 I n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY ASIAZC80673485*** 06/01/2001 06/01/2002 COMBINED SINGLE LIMIT - (Ea accident) $ ANY AUTO 1,000,00' - ALL OWNED AUTOS BODILY INJURY t-- (Per person) $ ~A SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY ty (Per accident) $ NON-OWNED AUTOS I--- I--- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY ASIAZC80673485*** 06/01/2001 06/01/2002 EACH OCCURRENCE $ 5 ,000,001 00 OCCUR o CLAIMS MADE AGGREGATE $ 5 , 000,00' A $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TORY LIMITS I IVER- EMPLOYERS' LIABILITY EL EACH ACCIDENT $ E,L. DISEASE - EA EMPLOYEE $ E,L DISEASE - POLICY L1MI,!" ,$ '-. OTHER " ' ."', , ' 10 days notice of canc~llation for non-payment of premium DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS tE: 10788 Commerce Drive (Loc #13) Named Insured: Commerce Drive Partnership :ity of Bakersfield, It's mayor, council, officers, agents, employees & volunteers are incl~~~d IS additional insured as respects to operations of the named insured per form CG2010 attached~ CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER CANCELLATION v; ,. , City of Bakersfield 1501 Truxtun Ave. Bakersfield, CA 93301 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL -.lL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE L::~~~ Ken Schultz Inc./RTB > c .- .. ~ . - -, ;)re-~ ~oA. .J.. 9 I "7 7 (err>' - o ,l-" r ' BAKERSFIELD r' PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Raul M. Rojas, Public Works Director FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: May 15,2002 SUBJECT: Encroachment Permit Application for Installation of sign and landscaping. Commerce Drive Partners 4865 Truxtun Avenue Engineering and Traffic staff have reviewed the attached encroachment permit to allow the installation of sign and landscaping. The site is located at 4865 Truxtun Avenue, The applicant has provided proof of appropriate insurance coverage to Risk Management. Based on their review, staff recommends a~val of the permit. - S:\PERMITS\ENCROACH\2002 Permits\5601 Truxtun Ave.wpd :J.t/~;tCj ~ "' " .I:f- '. ~ . -~; E eEl V E D'~ ,. .ii"~ .,' " . ~ BAKERSFIELD PUBLIC WORKS DEPARTMENT -. - -- MEMORANDUM ~';-r)" ~"."J ~::0 7 ,-~-..J PUBLIC WORKS DEPARTMEI\'!f DATE: January 20, 2005 TO: Raul M, Rojas, Public Works Director FROM: Marian p, Shaw, C.E. III - Subdivisions SUBJECT: Encroachment Permit Application for 4865 Truxtun Avenue D y 'Pl~m P::lrtners ~/ZlE::~ Oe-vt D. $1 Nt.\ \iV\ J., A6lbt)tf.>1A.~ Permanent Building Signage for Address Engineering and Traffic staff has reviewed the attached encroachment permit to allow the installation of permanent building signage for address. The site is located at 4865 Truxtun A venue. 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 the review, staff recommends approval of the permit. S:\Permits\encroach\approval\4865trux \MDF // /:1 ~-.... OLf ~ & I o'1-l>1 h_,-""'....~ ---- .'t" {~: ,~, ~ . ~ BAKERSFIELD PUBLIC WORKS DEPARTMENT Traffic Engineering Memorandum DATE: January 20, 2005 FROM: Pat Flaherty, Risk Manager Marian P. Shaw, C.E. III - Subdivisions ,~(\..w TO: SUBJECT: Encroachment Permit Application for 4865 Truxtun Ave, . D Yquem Partflers.?)~DfZ.v\ D. 8\1t..:l11\,\I\ ~ A660blA~5 Permanent Building Signage for Address Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. ~jv S:\Permits\encroach\traffic\4865trux \MDF r ( '~ ~~... ,.... "" ~ . ~ BAKERSFIELD PUBLIC WORKS DEPARTMENT Traffic Engineering Memorandum DATE: December 10, 2004 TO: Ryan Starbuck, c.B. III - Traffic Engineering FROM: Marian P. Shaw, C.B. III - Subdivisions I I I < SUBJECT: Encroachment Permit Application for 4865 Truxtun Avenue D-YqJlpm Par-tnen;~~oevj D.~t-Jlil-ll\ ~/~IkI-~> Permanent Building Signage for Address Please review the attached encroachment permit application and return to me at your earliest convenience. Ivl()~ 104- OM- 1'-"1- (7 F S:\Permits\encroach\traffic\4865truxtun \MDF 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 , . pin number . . . . . . Property Address Application description Owner 04-30000061 Date .256689 , 4865 TRUXTUN AVE . . PW - ENCROACHMENT PERMIT 9/01/04 Contractor Appl,caN't Greg D. Bynum & Associates 5' ~ 0 I T r u 't tUN f..l (/ e. 9 330'} D YQUEM PARTNERS 5601 TRUXTUN AV STE 190 BAKERSFIELD CA 93309 Permit . . . . . Additional desc . Phone Access Code Permit Fee Issue Date . . . VITAL SIGNS OF BAKERSFIELD 4000 EASTON DR SUITE 16 BAKERSFIELD CA 93309 (661) 325-1987 ENCROACHMENT PERMIT 266171 150,00 9/01/04 Valuation o Qty Unit Charge Per 1.00 150.0000 EA PW ENCROACHMENT Extension 150.00 Special Notes and Comments PERMANENT BUILDING SIGNAGE FOR ADDRESS Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 150.00 150.00 .00 .00 Grand Total 150.00 150.00 .00 .00 ~ Signature of Applican f the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the ~~. '4!OY 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. A Signature of City E~ineer -- 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 '. 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 . . Pin number . , . . . . Property Address Application description 04-30000061 Date .256689 4865 TRUXTUN AVE . , PW - ENCROACHMENT PERMIT 9/01/04 Owner Contractor D YQUEM PARTNERS 5601 TRUXTUN AV STE 190 BAKERSFIELD CA 93309 VITAL SIGNS OF BAKERSFIELD 4000 EASTON DR SUITE 16 BAKERSFIELD CA 93309 (661) 325-1987 Permit . . . . . Additional desc . Phone Access Code Permit Fee . . . Issue Date ENCROACHMENT PERMIT 266171 150.00 9/01/04 Valuation o Qty Unit Charge Per 1,00 150,0000 EA PW ENCROACHMENT Extension 150.00 Special Notes and Comments PERMANENT BUILDING SIGNAGE FOR ADDRESS Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 150.00 150.00 ,00 .00 Grand Total 150,00 150.00 .00 .00 Applicant acknowle permit at any ti he right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the Pri~ Nt , 4/01' 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, Signature of City Engineer Additional Terms on the Back .' \:>1> 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 ackrwwledge the above. _Applicant's Initials " ~ 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 undersi~ed applies for a permit to place, erect, use and maintain an encroachment on public property or right-of-way as therem deffued. :.i ::. .~ ~----------~ ---- - --._- - 1. Full name of applicant and complete address includihg phone number: -:-~"-~\ "b '_~'1~ _':~~~_,__, _ ~~tA.~~T~-:-.---S:6;f-- =r=~~~-4~~ ~~k~4t.Jd--CA-5'4~o1 b"- I 6!~~~~L_, ' , - -. 'I 2. Nature 6;oe'scription ~fthe encroachment for which this application is made: .oa ?~~~ ~.. ; lc\.. ,"-....~ s,.~ -Cw- .", S'S-c I'r-/ ~ ~.L-. 3, Location of the proposed encroachment: --1f~-':+k-' Y"\ 0 ~~ ~+ eJ\~ 1'\ :-e....- ~ --' f"{' V-?-/ - -..------ - L-.J6--'--j-:-~~ Y'lS b S., t 1\2_'>C..~_"'-- '-:-~e-. - ~-----,_ _ 4. Period of time for which the encroachment is to be maintained: ~F 0 r-- 'i-L=---\ ik d---rL \o~;lJ l~ 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, clalms, 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 revoJ<ed. ~ - .-----.-- , ."./----- Applicant further agrees that upon the expiration of the rermit for which this application is made, if granted, or upon the revocation thereofbv the City engineer. applicant wil 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 keel> all liability insurance required by the City Engineer in full force and effect for however long the encroachment remaInS. Applicant shall fhrmsh the City Risk Manager with a Certificate of Insurance evidencing sufficient coverage for bodily mjury or property damage liability or both and required endorsements evidencing the insurance required. The type(s) and amount(s) of insurance coverage is: /;,..h( t. l? ! c.- 0/ I 000, ()OO. 00 (/V( ~ ^- ~ ?; 000/ 000, 00> ? 0 Ltc; , Applic~t acknowl,edges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the penmt at any tlme. Date:, '0, '2-~ .2-00"" ,~ ~' '. .' Signature of l\Ppli...~~sentative) PERMIT I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION AND FIND THAT mE 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 Engineer No. G;\GROUPDA 'N'onns\EncroacluncntPennitApp.Vlpc-; ". -J.. CITY OF BAKERSFIELD INS~CE RE9UIREMENTS FOR STREETS AND ENCROACHMENT PERMITS STREETS PERMITS For street permits issued to contractors for work on major arterials and collectors (select GEO City web to determine street type) the following insurance is required: (See sample certificate-attachment I) · Minimum of$ I ,000,000 comprehensive general liability insurance with an additional insured endorsement fonn in favor of the City, it's mayor, council, officers, agents, employees and volunteers (see example in attachment 2). · Minimum of$l,ooO,Ooo automobile liability insurance covering all vehicles working on the project. The certificate of insurance must name the City, its mayor, council, officers, agents, employees and volunteers as additional insured. · Workers' compensation insurance with statutory coverage or limits not less than $1,000,000 and employer's liability insurance with limits not less than $1,000,000. Waiver of subrogation in favor of the City of Bakersfield is also required (see example in attachment 3). For street permits issued for work on residential streets (select GEO City web to determine street type) the following insurance is required: · Minimum of $1 ,000,000 comprehensive general liability insurance. · Minimum of $1 ,000,000 automobile liability insurance covering all vehicles working on the project. · Workers' compensation insurance with statutory coverage or limits not less than $1,000,000 and employer's liability insurance with limits not less than $1,000,000. For any street permit issued to homeowners, the following insurance is required: · Homeowners personal liability insurance of not less that $300,000. (See attachment-4) Additional insurance and or endorsements may be required if City determines that the work may expose City to unusual risks. All commercial insurers must have an AM Best's rating of not less than AS on the general liability and the auto liability policy. (Go to www.ambest.com to detennine insurance company rating). 1 ~ -! ~ \~ CL ~~L ~~~4 -->~ ~ ENCHROACHMENT PERMITS For encroachment permits issued to business owners, the following insurance is required: · Minimum of $1,000,000 comprehensive generiU liability insurance with an additional endorsement fonnin favor of the City, its mayor, council, officers, agents, employees and , ) ~unteers. , For encroachment permits issued to homeowners the following insurance is required: · Homeowner's personal liability insurance of not less than $300,000. Additional insurance and or endorsements may be required if City determines that the work may expose City to unusual risks. All commercial insurers must have an AM Best's rating of not less than AS on the general liability and the auto liability policy. (Go to www.ambest.com to detennine insurance company rating). ._~YG-Z3-04 ! 02:20PM FROM-Walter Mortensen Insurance / Marketing 661-834-1175 T-568 P 001/002 F 889 - ACORQ. CERTIFICATE OF LIABILITY IN::iUKAN\"C I 08/23/;ZOU4 PIlODU~ (661)834-6222 FAX (661)281-4992 THIS CERTIFICATE IslSSUEP AS A rJlATTER OF INFORMATION Walter Mortensen Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR License 190267 ALTER nlE COVERAGE AFFOROEO BYTHE POLICIES BELOW. 4701 Stockdale HwY. HAle # Bakersfield" CA 93309 INSURERS AFFORPING COVERAGE: Ir.ISURED Gregory D. Bynum & Assoc,ates, Inc. INSlJ RER A: Firemans Fund Insurance D'Vquem Partners INSURER B; 5601 Truxturn Ave.. Suite 190 INSURIiA c: Bakersfield. CA 93309-06l7 INSURi:R D~ II\ISURER E~ cn\ll=DAG'"~ THE POLICIES OF INSURANCE LISTEIlBELOW HAVE BEI:fIlISSUED TO THE INSUR~O NAMED ABOVE FOR. THE pQLlCV PEIUOClINOlcAreO. NOTWITHSTANDIN' ANV REQUIREMENT, TeRM ORCOIIIDITION OF ANV CONTRACT OR OTHER. DOCUMENT wiTH RESPeCT TO WHICH THIS ceRTIFICATe MAY BE-ISSUED OR MAY PERTAIN, THE INSURANCE AFFORCED BY TIlE POLICIES DESCRlI3ED HEREIN IS SUllJECT TO ALL. Tl1E TERMS, excWSIONS AND CONDITIONS OF SUCH POlJCIES. AGGREGAl'f LIMITS SHOWN MAY HAVJ;;. aEEN REDUCEO BY PAID CLAIMS. 11~~~J TYPE OF INSURANCE POUCVN\,IMBSFI P.e--5~~EXPlHATIOH UMITS 2.000.000 GENJ;;AALUAaILITY AZC807!i1791 06/01/2004 06/01/2005 EACHCCCURRENce $ Y cOMMERCIAL G"NEfW. LIA8ILIT'V PAMAGE TO RlaITeo · 100 000 U ClAIMS MADl" ill OCCUI\ M!:D EXP tAn~ one patIIDI1) $ 10 000 A J[ ND Deductible P~SCNAL & ACV INJuRY $ Z .000.00 _ TER. OIUST CERT. ACTS roV. G&r4ERAL AGGREGATl' $ 4.000.00 hL AGGREGATE LIMIT APPn PER: PRODUCTS. COM"IOP AGG $ 2.000,00 f'OLIC.,-n ~ LeC ~l.I1t*OElILe UA.IIIUTY AZC807S1791 06/01/2004 06/01/2005 CO/llIllIIIEC SINGI-E LIMIT $ ANV AUTO (~IIC1llllllnl) 1 000,000 - ALL OWNIiP AUTOS BOPII- Y INJURY - (Per pOmIl) $ A ex SCH~PULED AUTOS X HIRED AUTOS eoclLV INJURY S NON-OWNED AU1'OS (F'er aacIdIInl) ~ PROPI'RTY CAMAGl' $ (Ptlr gt;Qdenll =iE UA8IUTY AUTO ONL V . Ell ACCID~ t Am AUTO OTt1ER n-lAN SA ACC $ AUTO ONL'I': AGG $ I!J(cESSlUlol8REI.LA UABILITY AlC&0751791 06/01/2004 06/01/2005 SACI'! OCCURRENCE $ 5.000.000 :xJ OCCuR 0 CLAIMS MADE AGGREGATE :Ii 5.000,00 A. $ H DEDUCTIBLE S ReTENTION S $ WOIll<EI8 COMpENSAlION ANti 'I we STj\TU. I IO~ EMPl.OYER&" LWlIUlY ANY P1'lOPFUETCRlPAFmlJ;flJI!XECUTlIIE E.L. EACI'l ACCIDENT S OFFlCERlMEr.lBER EXCLUDED? E.L OISiA$e - eA EMPLOYEE $ If vas, dMl:ritle unGer SPECIAL pflOVISIONS llIllll'N E.L. DI5EA6E. POI-ICV UMIT S OTHEIl 10 days notice of tancellation for non-payment of premi um ~refl7~ OF OpeRATlONlIl L.OC.\'Tlor-as I vel-lJCIRS I EXcLUSlOIolS AOOEll BY ENDOfiSftailENT IllPECIAl. PROVl5IONS : 4 Truxtun Ave., Bakersfield, CA 93309 rhe City of Bakefsfield. 1~s mayor. council. officers, agents, employees and vol""tee~s a~e added is additional insured under the general liability as respects to the Dperation of the named insured per the il'tuched CCiZOlO. 10 days notice of cancellation for non-payment. c City of Bakersfield 1501 Truxtun Ave. Bakersfield. CA 93301 SHOUI.D AN'( OF 'l'HR ABOVE cE$ClUBED JIOUClIi!S BE QANCEUED BSFORE THE lOO'IRA11ON DAlE THEReof. THE ISSUING INSURBR WILL ENtlBAVOIl TD MAIL ~ DAYS WlVTTeN NOTIce TO TH! C:l!IlTlFICATE HOLDER IiIAMED TO THE LEFT, BUT pAlwRE TO MAIL sUCH NOTICE StW.I.lMPOSE NO OilUGA11ON OR UAaILITY OF ~Y KIND UPON THE INSUREft, ITS AGI;NT5 QIl ~PR~NTA1IVeS. AUTHC~ ~SIiN1'ATI\II! L;::.~~ Ken Schultz Inc. SAO J <IllACORD CORPORATION 1988 ACORD 25 (2001/Q8) RUG-23-2004 02:25PM FRX:661 834 1175 ID:8YNUM RSSOCIRTES INC PRGE:001 R=97% ,~ ,~G-Z3-04 OZ:ZOPM FROM-Walter Mortensen Insurance I Marketini 661-834-1176 T-668 P.ODZ/OOZ F-889 IMPORTANT If the certificate holder is an ADDITIONAL- INSUREO, the policy(ies) must be endorsed. A statement 01'1 this certificate does not confer rights to the certificate holder In lieu of such endcrsement(s). If SUBROGATION IS WAIVED, subject to the tel'ms and conditions of the policy, certain policies may require an endorsement. A statement on this certlflcate does not confer rights to the certiflcate holder In lieu of such endorsement(s). DISCLAIMER The certificate of Insurance on the reverse side of this form does net constitute a contract between the issuing Insurer(s), authorized representative or producer, and the oertificate holder, nor does It afflnnatlvely or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2DD1/08) AUG-23-2004 02:25PM FAX:661 834 1175 ID:BYNUM RSSOCIATES INC PAGE:002 R=97% :' ~UGj23:'tl4 02:25PM FROM-Walter Mortensen Insurance / Marketina 661-834-1175 T-569 P.003/003 F-890 POllCY NUMBER: AZC80751791 COMMER.CIAL GENERAL LIABILITY CG20 10 10 93 NAMED INSURED: Gregory D Bynum & Associates, Inc. TlUS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This enriorsement modifies ins\1tlUlce provided under the following: COMMERCIAL GENERAL LIABn.ITV COVERAGE PART. SCHEDULE Name of Per$on or Organization: The City of Bakersfield, its mayor, council, officers, agents, employees and volunteers 1501 Truxtun Ave. Bakersfield. CA 93301 (Ifna entry appcQ1'$ above, infomultionrequircd to complete this endorsement will be shown in lhe Declarations as applicable to this endorsement.) WHO IS AN INSUR.ED (Section IT) is amended to inClude as in insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations pmformed for that insuled. co 20 10 1093 Copyrigh~ Imurance Semces Office, Inc. 1984 AUG-23-2004 02:30PM FAX:661 834 1175 ID:8YNUM ASSOCIATES INC PAGE:003 R=100% ....- 3'- 0" ~ l- ~ ( .l.., 5'-0" .' ", I Tenant 1 {, Tenant 2 I Tenant 3 J 6'- 0" 12'- 0" ---L I \f~ , .~.,/..lo l' ~i.,. i.,. 7[' ,.~... """VJ.iI'~,~P- . I, 4865 TRUXTUN AVE. ".':.';;: '{;rii)D(~VE' -, ':~".<.-:_C~.lL A. J:~. l; Cf .., SET << _40' setback ~ ~ >< ~ e z z ...