HomeMy WebLinkAbout06-30000024
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 . . . . . .
ATN (11 Digitsl :
Application type description
06-30000024 Date
4501 GLENGARY PL MD
6/14/06
PW - ENCROACHMENT PERMIT
Owner
Contractor
DEPPEN DAVID S & LAURA A
4501 GLENGARY PL
BAKERSFIELD CA 93313
OWNER/BUILDER
BAKERSFIELD
CA 93301
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
563932
150.00
6/14/06
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
APPL. FOR ENCROACHMENT PERMIT TO
ENCROACH INTO ROW FOR FENCEING.
CONTACT NUMBER 397-2630 DAVID
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 . any time.
J}/9v// c&e;'JM./
Print Name
I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FAcrS 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 (N~r;.s:r~ A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFO RANTED) DENIED). Said pennit shall expire on date stated above.
~
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 allliability~ 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 Digitsl :
Application type description
06-30000024 Date
4501 GLENGARY PL MD
6/14/06
PW - ENCROACHMENT PERMIT
Owner
Contractor
DEPPEN DAVID S & LAURA A
4501 GLENGARY PL
BAKERSFIELD CA 93313
OWNER/BUILDER
BAKERSFIELD
CA 93301
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
563932
150.00
6/14/06
valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
APPL. FOR ENCROACHMENT PERMIT TO
ENCROACH INTO ROW FOR FENCEING.
CONTACT NUMBER 397-2630 DAVID
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 y time.
t?.&v,L -irwe/V'
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)
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
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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B A K E R S
FIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 12, 2006
SUBJECT: Encroachment Permit Application for: 4501 Glengary PI.
Name of Applicant: Deppen David S. & Laura
Description of Encroachment: Fence side yard behind sidewalk
\
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
applicant to build a 6' fence/3' behind sidewalk on the side yard of Summerfield Dr.
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\4501 Glengary PI..doc
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B.A.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 11, 2006
SUBJECT: Encroachment Permit Application for: 4501 Glengary PI.
Name of Applicant: Deppen David S. & Laura
Description of Encroachment: Fence side yard behind sidewalk
Please review the attached encroachment permit and return to me at your earliest convenience.
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S:\PERMITS\ENCROACH\TRAFFIC\4501 Glengary PI..doc
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Bi\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Luda Fishman, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 7,2006
SUBJECT: Encroachment Permit Application for: 4501 GLENGARY PL.
Name of Applicant: DEPPEN DA VID S. & LAURA
Description of Encroachment: FENCE SIDE YARD BEHIND SIDEWALK
Please review the insurance certificate with the attached encreachment permit and return to me
at your earliest convenience.
S:\PERMITS\ENCROACH\INSURANC\4501 GLEN GARY PL..doc
~FIDELlTY
NATIONAL INSURANCE COMPANY
2201 FARNAM ST STE 200 POLICY NUMBER
OMAHA NE 68102-1218 NH6003019
HOMEOWNERS 3 SPECIAL FORM
Client ID 000000438082
RENEWAL
COVERAGE
DECLARATION
EFFECTIVE DATE
EXPIRATION DATE
OS/27/2006
OS/27/2007
NAMED INSURED:
DAVID SCOTT
LAURA A DEPPEN
4501 GLENGARV PLACE
BAKERSFIELD CA 93313
AGENT:
CHICAGO HERITAGE INS SVCS
10301 DEERWOOD PRK BLVD,ST 100
JACKSONVILLE, FL 32256
(888) 333-2120
LOCATION OF RESIDENCE PREMISES 4501 GLENGARY PLACE BAKERSFIELD CA 93313
EFFECTIVE TIME IS 12:01 AM. STANDARD TIME AT YOUR RESIDENCE
SECTION I
PROPERTY COVERAGES
COVERAGE A
DWELLING
$ 173,000
COVERAGE B
OTHER STRUCTURES
$ 17,300
COVERAGE D DEDUCTIBLE
LOSS OF USE $ 1000
SHORTEST
TIME TO REPAIR OR REPLACE
SECTION II LIABILITY COVERAGES
COVERAGE C
PERSONAL PROPERTY
$ 129,750
COVERAGE E - PERSONAL LIABILITY
$ 300,000 EACH OCCURRENCE
COVERAGE A - DWELLING
COVERAGEB-OTHERSTRUCTURES
COVERAGE C - PERSONAL PROPERTY
COVERAGE D - LOSS OF USE
COV E - PERSONAL LIABILITY
COV F - MED PAY TO OTHERS
LOSS SETTLEMENT-PERSONAL PROP
I _ BACK-UP OF SEWERS OR DRAINS
MOD FUNCTIONAL REPLACE COST
DISCOUNTS:
COVERAGE F - MED PAY TO OTHERS
EACH PERSON/$25,OOO EACH OCCURRENCE
$173,000
$17,300
$129,750
$300,000
$2,000
792.00
25.00
3.00
20.00
102.00-
LOSS SURCHARGE.....$ 50.80-
TOTAL POLICY PREMIUM $ 768.00
NO COVERAGE IS PROVIDED UNDER THIS POLICY FOR LOSS CAUSED BY EARTHQUAKE
MORTGAGEE(S): LOAN #
SUN TRUST MORTGAGE INC, ISAOA 0143958049
OAK STREET MORTGAGE ISAOA ATIM
SEE REVERSE SIDE FOR POLICY FORMS AND ENDORSEMENTS
FAMILIES/ YEAR OF PIG FT
APARTMENTS CONSTR CONSTR PIC OIG TERR HYDRANT
001 1978 FRAME 01 ** 040 1000
MILES FIRE
F. DEPT DISTRICT
5
11515H (08-03)
INSURED CA 05/15/2006 FNS CH3 CS
COpy 1 OF 2
0310000000
AMENDMENT PROVISION
If the Declarations indicates your policy is amended, it will be effective on the date shown, and wilIProvide the indicated insurance. Such amended
Declarations replaces all prior Declarations. All other tenns, conditions, agreements or limitations of the policy, other than contained on the
Declarations shall remain the same.
VESTING
HUSBAND AND WIFE AS COM'vIUNITI' PROPERTI' WITH RIGHT OF SuRVIVORSHIP
FORMS AND ENDORSEMENTS
* HO 00 03 1000
* AA 00 06 10 03
* ANIMAL EXCL 07 05
* A6120 CA 0505
* A6121 CA 0505
* A6122 CA 0505
* A6123 CA 0505
* A6125 CA 0505
* A6138 CA 0505
* A6139 CA 0505
* A6140 CA 0505
* A6142 CA 05 05
* FNIC DN CA 01 06
* FN1194 05 05
* FN1197 05 05
* FN1363 0506
* HO 01 04 12 05
* HO 04 07 12 05
* HO 04 08 12 05
* HO 0446 10 00
* HO 0495 10 00
* HO 0496 10 00
* HO 23 56 12 05
* HO 24 90 08 01
* IL N 018 09 03
* INSPECT NOTICE 04 05
* PRIVACY 07 01
* ZZ 01 01 08 03
* 438 BFU NS 05 42
DATE:
HOMEOWNERS 3 SPECIAL FORM
TABLE OF CONTENTS
IMPORTANT NOTICE - EXCLUSION
PRIVACY AND ITS PROTECTION
SATELLITE DISH EXCLUSION
OCCUPANCY ENDORSEMENT
ANIMAL LIABILITY EXCLUSION
MORTGAGE CLAUSE
MOLD, FUNGUS, ROT DAMAGE $2500
SECTION II-EARTH MQVEMENT EXCL
AMENDATORY ENDORSEMENT
PERS PROP REPL COST AMENDATORY
CALIFORNIA DISCLOSURE NOTICE
IMPORTANT INFO - eA CIGA
CA RESIDENTIAL PROP INS DISCL
CA RESIDENTIAL PROP INS BILL
SPECIAL PROVISIONS-CALIFORNIA
PERS PROP REPLACEMENT COST
MOD FUNCTIONAL REPLACEMNT COST
INFLATION COVERAGE
WATER BACK UP SUMP DISCHARGE
NO COVERAGE HOME DAY CARE BUS
SPEC ADDL AMT OF INS COV A
WORKERS COMP RES EMPL - CA
CALIFORNIA FRAUD STATEMENT
IMPORTANT NOTICE-PROPERTY INSP
PRIVACY STATEMENT
SIGNATURE PAGE
LENDERS LOSS PAYABLE
COUNTERSIGNED BY
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APPLICATION FOR ENCROACHMENT PERMIT
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFOR1~IA:
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.
. 1. Full name of applicant and complete address in~luding phone number: ~v /''d ~ d!'? P-e;1fJ efr/
,yrd/ &'k-ifSS7 jJ/ ,,{'~/ J9?~ ~~~c:7- t?// ~/-:f'I7'-~?rc:
2. Nature or description of the encroachment for which this application is made: ~ A/ C
,5k(?fi h~t?r
./
3. Location of the proposed encroachment:
4. Period of time for which the encroachment is to be maintained:
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless City, its
officers, agents and employees against any and allliabihty, 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 upon
the revocation thereofby 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
Insurance evidencing 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 0 Bakersfield Municipal Code Cha ter 12.20 to
revoke the permit at any time.
Date: ~,-J-t:?~
PERi'\1IT
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:
Signature of CIty Engmeer
No.
I
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;,' CITY OFr 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.
1/)0 { 6M::%!AV II
(Street fo pu1fc>sed encroachment)
of
(Address of purposed encroachment)
SIGNED:
1) Name:
Address:
2) Name:
Address:
3) Name:
Address: 6~ -~IIM tt:tP flZ./
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4) Name: {I ( <::::L<.A f\A/)^J v r l-'1~.A.-lIP
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Address: 4-~rr (;'J-r'lJ9 '7P, Y f1L
6) Name: ~ ~ ~r
Address: 00 Z ~ jJ./,
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By: J)/iv,t cI 8-€fA I
(Owners Name)
Phone:
Date: ~ /~... ~
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Date: @/;O / a;,
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