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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 . .
pin number . . . . . .
Property Address . . .
Application description
03 -3 0000025
9567
Date 6/16/03
1191 19TH ST 1712 19th Street
PW - ENCROACHMENT PERMIT
Owner
Contractor
Jack Arian c/o
1401 19TH ST STE 400
BAKERSFIELD CA 93301
OWNER/BUILDER
BAKERSFIELD
CA 93301
----------------------------------------
------------------------------------
Permit . . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
96974
145.00
6/16/03
Valuation
o
Qty Unit Charge Per
1. 00 145.0000 EA PW ENCROACHMENT
Extension
145.00
Special Notes and Comments
INSTALL A PIECE OF ABSTRACT ART ON THE
CORNER OF 19TH ST AND H STREET
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 145.00 145.00 .00 .00
Grand Total 145.00 145.00 .00 .00
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the
permit any time.
/,
Shelly f A,'lt~5
Print Name I
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 ~gineer --
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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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 23,2003
SUBJECT: Encroachment Permit Application for: art sculpture.
Jack Arian
1712 19th Street
Engineering and Traffic staff have reviewed the attached encroachment permit to allow the
installation of an art sculpture. The site is located at 1712 19th Street.
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\02-03 Permits\1712 19th ST.doc
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PAUL UAUBOL, AICBlTBCT
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BA~BISP1BLD. CA 93301
(661) 334-1741
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SCULPTURE
1712 19111 STREET
BAKERSF1B.D. CALFORNIA
05-07-03
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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 undersigned applies for a permit to
place, erect, use and maintain an encroachment on public property or right-of-way as therem defined.
1. Full name of applicant and complete address including phone number: Jack Arian c/o M.D. Atkinson
Company, Inc. 1401 19th Street, suite 400 Bakersfield, CA 93301 334-4800 (Shelly:'Phillips)
2. Nature or description of the encroachment for which this application is made:
Install a piece of abstract art on the corner of 19th & H Streets
3. Location of the proposed encroachment:
Northwest corner of 19th & H Street
4. Period of time for which the encroachment is to be maintained:
Indefinite
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless City, its officers,
agents and employees against .~y an~ allliabil.ity, ~13;ims, ac~o~s, cau~es of action or del!lands, whatsoever ~&ainst them,
or any of them, before admimstratlVe, quasi-Judicial, or JudiCial tnbunals of any kmd whatsoever, ansmg 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 thereofbv the City engineer. applicant will at his own cost end expens~ 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 req..uired by the City Engineer in full force and effect
for however long the encroachment remains. Applicant shall funush 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:
Commercial General Liability $1,000,000 per occurrence, $2,000,000 qeneral Aggregate
see attached.
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke
the permit at any time. .'
Date: 6-4-03
PERMIT
Date:
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
E~~gtJffz?
Signature of City Engineer
No.
G:IGROUPDA T\FonnsIEncroachrnentPennitApp. wpd
aOB: G~e G. h
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CITY OF BAKERSFIELD
DEPARTMENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
We, the undersigned, have no objection to the construction ofa'statue, behind the sidewalk, or other
encroachment as shown on the plot plan:
19th & H St.
(Street)
By: JackArian c/o M.D. Atkinson Co., Inc.
(Owner's Name)
of 1712 19th Street
(Address~
SIGNED:. - .
/!/J ~ ^ ~ .."\
l)Name'-.. ~UL-C .~[j.tAJ
r '" ,(.J-o^> tit C' .4-
11/~1 7- Address 17 / ( I q . 0K. .
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2)Name6_~ ~
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3) Narne7'-k r
4):::ess~~.
Address ) ~ /., / 1'110 5{:'
Phone:
334-4800
Date: '5 b3 (:;t1J3
Date:
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Date:
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Date:
I//I!cY . ...
5) Name
Date:
Address
6) Name
Date:
Address
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 22,2003
SUBJECT: Encroachment Permit Application for 1712 19th Street.
Jack Arian
Sculpture
Please review the attached encroachment permit and return to me at your earliest convenience.
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S:\PERMITS\ENCROACH\TRAFFIC\1712 19th St.doc
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Bi\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORAND"UM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 22,2003
SUBJECT: Encroachment Permit Application for 1712 1rfh Street.
Jack Arian
Sculpture
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
Pf
S:\PERMITS\ENCROACH\INSURANC\1712 19th St.doc
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AOA Risk Services, IDa. of Bouthem Califomia
707 wilshire Boulevard
Suite 6000
LOB Angeles CA 90017-0.'0 USA
PJIOlU. 213 'AX.
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Jack Arian & AsBociates, Inc,
DBA. supply SezgellDt
503 ..Victory Blvd.
Burbank CA 91502 USA
-'DATE'iMif/DDln;.
07109/03
CERTIFICATE IS ISSUED AS A MATI'ER 01' INFOllMATION ONLY
CONnRS NO RlGB'IS UPON TBI carrmCATE HOLDEL THIS
CAn DOES NOT AMlND.I:XTEND OR ALTER TRB
WRAGE AProRDED BY TIlE POUCIES BELOW.
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ANY 1lEQUIREMJlNT. tERM OR CONDmON OF ANY CONl1tAC1" OR 01'HJ!a DOCUMIlNT wrrH RBSPJ!CT TO WHICH THIS cmmFICATB MAY BE ISSUED OR MAY
PIDlTAIN. THE INSURANCE AFFOJU>EI) BY nm POLICIU Ol!SCltIBED HEREIN IS SUBJBCT TO ALL THE TERMS, EXCLUSIONS AND CONDmoNS OF SUCH POLICIES.
AOORIlOATJl LIMITS SHOWN MAY KAVE BEIlN UDUCBD BY PAlDa.AIMS.
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COMBINED 8INOLB UNIT
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DE!CIllP11ON Of OPEIlAl1ON11LOCAnoN!IIYEHICIa/Ea.uSDIS ADDID BY Ill'lDORSIMIlNJPItOVISIONS
"UVISBD" I RH. Statue Installation at Kern Land Building, at:1713 19th St., Bakersfield, CA / City of
Bakerstield. ita mayor, council. agents, employees. volunteers is ~ aB additional inaured .s respects to
operations perfoned by or on behalf of the IUllIlIId. inaured./roJ:1ll CG2010 attached.
City of Bakersfield
City Hall .
1501 Truxtun Ave.
Bakersfield CA 93301 DSA
SBOULDANY OF 11IB AllOY! DIilClUBIlD fOUCIES 11& CANCILLBD UJOIlIl TIll! 1!XPIVt1JON
DAl8 TIlIRIOF. nm ISSUING COMPANY WILl. IlNDEAYOR TO w.n.
JO DA VI wa.n"J1lN NOJICIllO THIt CER.TlFlCAl8 HOLIlO NANIID TO 11111 LB1'T.
BUT FAILtIU TO DO 10 SRAU..lMPOSI! NO 0BlJGA1ION OR IJAJIILITY
01 ANY KIND tlPON 11111 COMPANY. m Aomrrs OR IlEI'IIlSl!NfATIVIIS.
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THIs ENDORSKMENT CHANGES THE POUCY. PLEAsE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSESS OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided UDder the fo11owins:
COMMBltClAL GENBRALlIABJLITY COVERAGE 'AltT.
ScIImVLE
Name .,....... or Oraauizadoa:
City ofBakenfleld
City HaD
1501 Trutun Ave.
BaJr.enfIeld, CA 93301
WHO IS AN lNSUIlED (Sec:tion II) is ameoded 10 iDcluded as an iDsurecl the person or 0f8I'1'li'>'.JI00n sboWll in
die ScheduJe. but only with respect to liability arising out of "your work" for that insured by or for you.
CIty of Babnfleld, its mayor, coaacD. 1pDta, employees and wIwteen are Darned .. additioul
IDsureds.
CG 20 10 11 85
Copyrighl, IDsuraDce Services Office, Inc., 1984
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IRIAN L WARD
STRUCTURAL ENGINEER. INC'.
n ScMIt Real ROId Suite C
BAKERSFIELD, CA 93309
("I) 827.'155 FAX (t'1) IZ7.tJSI
08111:01\'
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31 SoudI Rhl Raid Suite C ~ J
BAkt~SAnl'). CA 93:909 CAlCII&..\T!DaV ~ liJ*. OA" "" -"YJ.:J
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