HomeMy WebLinkAbout04-30000053
ENCROACHMENT PERMIT
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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 . . . . . ( 04-30000053 Date 6/25/04
pin number . . . . . . .961550,
Property Address . . . 2429 0 ST
Application description PW - ENCROACHMENT PERMIT
Owner
Contractor
LEWIS JOHN W JR ET AL
5110 E PANAMA LN
BAKERSFIELD CA 93307
OWNER/BUILDER
BAKERSFIELD
CA 93301
permi t '. . . . .
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date. . .
ENCROACHMENT PERMIT
238097
150.00
6/25/04
Valuation
o
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 150.00 150.00 .00 .00
Grand Total 150.00 150.00 .00 .00
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Qty Unit Charge Per Extension
1.00 150.0000 EA PW ENCROACHMENT ,,150.00
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'<1 DRAINAGE, ELECTRICAL & WATER FOR
PERMANENT DUMPSTER
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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Print Name
L~l~
J 1'<- r
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 Engineer
Additional Terms on the Back
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Applicant agrees that if this application is granted, applicant shall indemnify, defend, and hold hanruess 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 arisinra.
from, the terms and provisions of this permit or the placement, use (by applicant or any other person or entity) or maintenance of sai~
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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