HomeMy WebLinkAbout06-30000011
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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
06-30000011 Date
5728 STINE RD
516-071-13-00-6
PW - ENCROACHMENT PERMIT
4/11/06
Owner
Contractor
MARTIN DEL CAMPO MARIA
5728 STINE RD
BAKERSFIELD CA 93313
OWNER/BUILDER
BAKERSFIELD
CA 93301
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date
ENCROACHMENT PERMIT
531103
150.00
4/11/06
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
ENCROACHMENT TO ALLOW DOOR TO OPEN INTO
THE LANDSCAPE AREA
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.
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Signature of Applicant (Ownerf Agent)
MartIN De/ CaMoo Ma,,/a
Print Name I
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 (N. OT) ~N~E A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE GRANT -' (DENIED). Said permit shall expire on date stated above.
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Signature of cifY 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
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 F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: April 19, 2006
SUBJECT: Encroachment Permit Application for: 5728 Stine Rd.
Name of Applicant: Marlin Del Compo Maria
Description of Encroachment: Encroachment to allow door to open into
landscape area.
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
applicant to build their corner of the garage onto the adjacent slope easement.
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.
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BA..KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
Ryan Starbuck, Civil Engineer III
FROM:
Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE:
April 12, 2006
SUBJECT: Encroachment Permit Application for: 5728 Stine Rd.
Name of Applicant: Martin Del Compo Maria
Description of Encroachment: Encroachment to allow door to open into
landscape area.
Please review the attached encroachment permit and return to ,me at your earliest convenience.
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Bi~KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Luda Fishman, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: April 13, 2006
SUBJECT: Encroachment Permit Application for: 5728 Stine Rd.
Name of Applicant: Martin Del Compo Maria
Description of Encroachment: Encroachment to allow door to open into .
landscape area.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:\PERMITS\ENCROACH\INSURANC\5728 Stine Rd..doc
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04/12/06
To Whom It May Concern:
I, Jose Luis Diaz, gave permission to Dalissa's Bakery to open a new back door size
36x80 and do all necessary adjustments for his location of the bakery at 5728 Stine Rd.
Bakersfield, CA 93313.
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Sincerely,
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APPLICATION FOR ENCROACHMENT PEI,t.\1IT
TO THE CITY ENGINEER OF THE'CITY OF BAKERSFIELD, CALIFORNL-\.:
Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a pennit
to place, erect, use and maintain an encroachment on public property or right-of-way as therein defined.
1. Full name of aooIicant and comole address includin~phonc nwnber:
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2. Nature or description of the encroachment for which this application is made:
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3. Location. of the proposed cncroaclunent:
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4. Period of time for ~hich the encroachment is to be maintained:
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Applicant agrees that if this application is granted, al?plicant shall indemnify, defend and hold hannless City, its
officers, agents and employees against any and allliablhty. 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, cOIll1ected 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 ':IDtil such time that this pennit is revoked. . , .,.,
Applicant' ~rther agrees that upon,th~ expiratio~ of the. p~t [~r ~hich this ap~lication i~ mad~, if granted, or'1mQl1
the revocatIon thereofby the Cltv eosnneer. aoollcant w1l1 at his own cost and exoense remove the same from the oub.lic
prooertv 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. .
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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 cvide!J.cing 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:
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Applicant acknowledges the right of the City Engineer. pursuant to-Ba.lsersfield Munic:ipal.Cgde ...ch.WJcy1.2.20 to
revoke the permit at any time. ,
Date: If -:- / 1>-- c:. L c<... 2...c--~ ~
- ant wner or epresentatlve
PER."IIT
I HEREBY CERTIFY THAT I HAVE MADE A.~ INVESTIGA nON OF THE FACTS STATED, IN THE
FOREGOING APPLICATION AJ.~D FIND m~T THE MAINTENA;.~CE OF SAID ENCROJ\,CHMENT (1) WILL
(NOT) S(IBST.~~TLU.L Y INTERFERE WITH THE USE OF THE PUBLIC PLACE WHJ:RE THE SAME IS TO
BE LOCATED A'ID (2) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PtJBLIC PLACE;
SAID APPLICATION IS THEREFORE (GRA.~TED) (DE~rIED). SAI;D PERMIT SHALL EXPIRE
Date:
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SlgDature of City Engmeer
No.
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- CITY OF. BAKERSFIELD
DEPARTMENT OF PUBLIC WOR~S
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.
tl Cll. Y V ~ S 'gA,
(Street for puposed encroachment)
of S!;.ne 1< cl.- ~:::r,;z?' .
(Address of purposed encroachment)
SIGNED:
1) Name:
Address:
2) Name:
Address:
. 3) Name:
Address:
.4) Name:
Address:
5) Name:
Address:
E) Name:
Address:
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(Owners Name)
Phone: ,,,, - ~ 3 S- 7~ , <1
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Date: {!X~. II ~ 0-6
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Date:
Date:
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PLEASE KEEP THIS PART FOR YOUR REl;UHU::>
STATE FARM GENERAL INSURANCE COMPANY
900 OLD RIVER RD, BAKERSFIELD"CA 93311-6000
POLICY NUMBER
DATE DUE
BALANCE DUE
FULL PAYMENT BY DATE DUE
CONTINUES THIS POLICY TO...
JAN 10 2007
90- XL -4507-3
SEE NOTE
SEE NOTE
MARTIN DEL CAMPO, MARIA
DBA DALISA'S BAKERY
5728 STINE RD
BAKERSFIELD CA 93313-3315
BUSINESS POLICY - SPECIAL FORM 3
SAL BRITO CPCU
Agent (661) 398-5144
_ Telephone
3072-F784 U
PREMIUM $
500.00
NOTE:
Do not pay, Payment is being
made through State Farm Payment
Plan, Account # 1022896812
~ 4721034941
538-181 a,6 Rev, 03-97 Printed in U,S,A,
PLEASE RETURN THIS PART WITH YOUR
CHECK MADE PAYABLE TO STATE FARM
DATE DUE
SEE NOTE
BALANCE DUE
SEE NOTE
INSURED
MARTIN DEL CAMPO, MARIA
POLICY NUMBER
90-XL -4507-3
3072-F784 U
BUSINESS POLICY - SPECIAL FORM 3
1209604206
Prepared
FEB 142006
IF YOU HAVE MOVED, SEE REVERSE SIDE
Regional Office Use Only
0420
400611000000000 590634224507311512>
Policy Number
90-XL-4507-3
DECLARATIONS PAGE
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STATE FARM GENERAL INSURANCE COMPANY
900 OLD RIVER RD, BAKERSFIELD CA 93311-6000
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
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Named Insured and Mailing Address
12-3072-F784 U
MARTIN DEL CAMPO, MARIA
DBA DALlSA'S BAKERY
5728 STINE RD
BAKERSFIELD CA 93313-3315
Cov A -Inflation Coverage Index: N/A
BUSINESS POLlCY - SPECIAL FORM 3 Cov B - Consumer Pricelndex: 199.2
AUTOMATIC RENEWAL - If the POLlCY PERIOD is shown as 12 MONTHS, this policy will be renewed automaticallv
subject to the premiums, rules and forms in effect for each succeeding policy p'eriod. If this policy is terminated, we win
give you and the MortgageelLienholder written notice in compliance W11ti the policy provisions or as required by law.
Policy Period: 12 Months The policy period begins and ends at 12:01 am standard time at the
Effective Date: JAN 102006 premises location,
Expiration Date: JAN 10 2007
Named Insured: Individual
Location of Covered Premises:
5728 STINE RD
BAKERSFIELD CA 93313-3315
Coverages & Property
Section I
A Buildings
B Business Personal Property
C Loss of Income - 12 Months
Limits of Insurance llccupancy: Mercant lle
Excluded
$ 15,000
$ Actual Loss
Section II
L Busi~ss Liability
M MedIcal Payments
Products-Completed Operations
(PCO) Aggregate
General Aggregate (Other
Than POO)
$ 300,000
$ 5 000
$ 600:000
$ 600,000
Deductibles - Section I
$ 500 Basic
In case of loss under this policy, the deductible will be
applied to each occurrence and will be deducted from the
am?unt of the loss. Other deductibles may apply - refer to
polley.
POLICY PREMIUM $ 500.00
Forms, Options, and Endorsements
Special Form 3
Policy Endorsement
Terrorism Insurance Cov Notice
Amendatory Endorsement
Tree Debris Removal
Policy Endorsement-Business
Registered Domestic Partnrship
FP-6143
FE-6506.2
FE-6999
FE-6205
FE-6451
FE-6610
FE-5383
Discounts Applied:
Protective Devices
Continued on Reverse Side of Page
P d OTHER LIMITS AND EXCLUSIONS MAV APPl V . REFER TO YOUR POLICY
repare
. FEB 14 2006 Countersigned
FP-8030.2C BQL3 By
06/1993. . . SAL BRITO CPCU
Vour polley consIsts of thIS page, any endorsements (661) 398.5144
and the policy form. PLEASE KEEP THESE TOGETHER.
Agent
(olf2172b)
P~liCY~ Number
90-XL-4507-3
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CONTINUED FROM FRONT SIDE
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BUSINESS POLICY - SPECIAL FORM 3
Forms,Option~and Endorsements
Business Policy I::ndorsement
Inc Cost and Demolition Cov
Amendatory Collapse
Glass Deductible - Sect I
Additional Insured Endorsement
FE-6464
FE-6587
FE -6551
FE-6538.1
FE -6494
IMPORTANT NOTICE:
California law requires us to provide you with information for filinQ complaints with the State Insurance
Department regarding the coverage and service provided under thiS polley.
Comp-laints should be filed only after you and State Farm or your agent or other company representative
have failed to reach a satisfactory agreement on a problem.
Please forward such complaints to: California Department of Insurance
Consu mer Services Division
300 South Spring Street
Los Angeles, CA 90013
Or call toll free: 1-800-927-HELP
Prepared
FEB 14 2006
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