HomeMy WebLinkAbout04-30000043
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
ATN (11 Digits) :
Application description
04-30000043 Date
.585020
6301 AMBERGROVE ST
498-431-05-00-6
. . . PW - ENCROACHMENT PERMIT
4/05/04
Owner
Contractor
ARONSON MICHAEL
6301 AMBERGROVE ST
BAKERSFIELD CA 93313
OWNER/BUILDER
BAKERSFIELD
CA 93301
-------------------------------------------------------
Permit . . . . ,
Additional desc .
Phone Access Code
Permit Fee . . .
Issue Date . . .
ENCROACHMENT PERMIT
201129
150.00
4/05/04
Valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
-----------------------------------------------------------------
Special Notes and Comments
BLOCK WALL ALONG WHITE BURCH TO MATCH
NEIGHBORS EXISTING FENCE
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.
Signature of Applicant (Owner/Agent)
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.
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 w~ich 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:
May 17,2004
SUBJECT:
Encroachment Permit Application for 6' block along side yard at back of s/w.
Michael Aronson
6301 Ambergrove Street
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the installation of a
6' block wall along the side yard at the back of the sidewalk. The site is located at 6301 Ambergrove
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 a.E.Proval of the permit.
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S:\PERMITS\ENCROACH\03-04 Pennits\630 I Ambbergrove Sl.doc
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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 therein defined.
1. Full name of applicant and complete address including phone nwnber:
b~1 AMeIif2tJ2/)'tlEST, ~[if)tJ. qg3/3
2. Nature or description of the encroachment for which this application is made:-"^. OUl!JC", WALL
fCDf2.. F-Ei-r LLO ~ TD S I DE W,{Lk.... '
3. Location of the proposed encroachment: b 3D} /tJIlf3[--(2(.JWE ....<;7,. 5kt<E/2sR [-i.IJ
a rq~'5/~
4. Period of time for which the encroachment is to be maintained: . f> E~ TL Y.
Applicant agrees that if this application is granted, ap'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 kine whatsoever, arising
out of, conneded with, or caused by applicant's placement, erection, use (by applicant or any other person or entity)
. ~r maint~nance of said encroaclu;nent. ~e applic~t furth~ <":grees to maintain the aforesaid encroachment during the
hfe of saId encroachmr.::nt or until such tune thCl.t this pemu~ IS revoked. . . .
.' Applicant further agrees that upon the expirat.on of the perrr...\t for which this application is made, if granteli, or !!lliID
the reV(!cation thereofbvthe CIty emzineer. applicant will at his own cost and exoer.se remove the same from the public
prooertl't or right .of w~y ,,:here the same is loca!ed, and r~store s~d public prop~rty or riltht ,of way to the condition
as neany as that m which It was before the placmg, erectIon, mamtenance or eXIstence of saId encroachment. ,
Applic;mt further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect
for however long the encroa:;hment remains. Applicant shall furnish the City Risk Manager with a Certificilte 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:
4- w,rm/X) }tU/7Jf f l..,C<<VW,oO [)IAE/lL-lLA/a!CY
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield M
revoke the permit at any time.
Date:
Code Chapter 12.20 to
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:
SI~Engmee~
No.
"
Policy Change
Declarations
~
~rs.
HOMEOWNERS POLICY
Named Insured
Your Agency's Name and Address
\..~
MICHAEL ARONSON
6301 AMBERGROVE ST.
BAKERSFIELD CA 93313
INSURANCE COUNSELORS INC
1 GE~CO BLVD
FREDtRICKSBURG', VA 22412
Your Policy Number:
Your Account Number:
975110679 633 1
975110679
For Policy Service Call: (800) 841-3005
For Claim Service Call: 1-800-CLAIM33
Policy Period
FROM: 03-12-04 To: 03-12-05 12:01 A.M.
STANDARD TIME AT THE RESIDENCE PREMISES
Location of Residence Premises
6301 AMBERGROVE ST.
BAKERSFIELD CA 93313
Change Effective Date: 03/12/04
No Change in Premium
Reason for Change: Change to Insured Name
Section I . Property Coverages
Limits of
Liability
Premium
A - DWELLING
B - OTHER STROCTURES
C - PERSONAL PROPERTY
D - LOSS OF OSE
'/'
$ 213,000
21,300
149,100
63,900
$
600.00
INCL
INCL
INCL
Section II. Liability Coverages
E - PERSONAL LIABILITY (BODILY INJURY AND
PROPERTY DAMAGE) EACH OCCURRENCE
F - MEDICAL PAYMENTS TO OTHERS-
EACH PERSON
$ 300,000
$
31.00
2,000
INCL
Policy Forms and Endorsements
HO-3 CA (10-92)
HA-300 CA (01-03)
56494 CA (03-99)
56512 CA (03-99)
HO-827 CA (07-02)
372-NS (11-50)
438BFO NS (05-42)
55769 (03-00)
Homeowners 3 Special Form
Special Provisions
Personal Property Replacement Cost
Additional Replacement Cost Protection - Maximum
Additional Amount of Insurance - 25%
Limited Fungi Other Microbes or Rot
Remediation
Limit of Liability: $5,000
MOrtgagee Clause
Lenders Loss Payable Endorsement
Workers Compensation and Employers
Liability Insurance Endorsement
$
71.00
4.00
INCL
Total Premium
$
706.00
Con.tinued on next page
Insur~n I"'n..."
. CITY OF- BAKERSFIELD
DEPARTMENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
t3j..[XJ< wA r.J-
We the undersigned, have no objection to the construction of a~eside the
sidewalk within the public right of way.
be/HI rE [3/frH
(Street for puposed encroachment)
~ \GtAB- A{(OU~
(Owners Name)
of {Y~llt!lIEL-I<b{2{)VE STw .
(Address of purposed encroachment)
Phone: tbi - 34?-DZ I~ tft.. (fd -4S-CJ:Of
SIGNED:
1) Name:
Address:
2) Name.
Address:
. 3) Name:
,Address:
6) Name:
Address:
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Date:
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Date: 4/(; /(>Y
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Date: <-{ - 1- CI(
Date:
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1. ' CITY OF BAKERSFIELD
~ . OEPARTIYIENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
f3J.LXl< wA a..J-
We the undersigned , have no objection to the construction of a ~eside the
sidewalk within the public right of way.
i()HJ7E 8/1[1/
(Street for puposed encroachment)
fu0A \CWAB- ARoll~
(Owners Name)
Phone: tbl- 34'5-D$/l 81... & -hb s-ct:D-/
of b~l Jt!I1Er..f<6I2DVE s.-r~..,
(Address of purposed encroachment)
SIGNED:
1) Name:
Address:
2) Name;
Address:
. 3) Name:
Address:
4) Name:
Address:
5) Name:
Address:
6) Name:
Address:
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Policy Change
Declarations
~.
(, ~, ----,.
HOMEOWNERS POLICY
I ~
Named Insured
Your Agency's Name and Address
MICHAEL ARONSON
6301 AMBERGROVE ST.
BAKERSFIELD CA 93313
INSURANCE COUNSELORS INC
1 GEICO BLVD
FREDERICKSBURG, VA 22412
Your Policy Number:
Your Account Number:
975110679 633 1
975110679
For Policy Service Call: (800) 841-3005
For Claim Service Call: 1-800-CLAIM33
Policy Period
FROM: 03-12-04 To: 03-12-05 12:01 A.M.
STANDARD TIME AT THE RESIDENCE PREMISES
Location of Residence Premises
6301 AMBERGROVE ST.
BAKERSFIELD CA 93313
Change Effective Date: 03/12/04
No Change in Premi urn
Reason for Change: Change to Insured Name
Section I - Property Coverages
Premium
Limits of
Liability
$
600.00
INCL
INCL
INCL
A - DWELLING
B - OTHER STRUCTURES
C - PERSONAL PROPERTY
D - LOSS OF USE
$ 213,000
21,300
149,100
63,900
Section II - Liability Coverages
$ 300,000
31.00
E - PERSONAL LIABILITY (BODILY INJURY AND
PROPERTY DAMAGE) EACH OCCURRENCE
F - MEDICAL PAYMENTS TO OTHERS-
EACH PERSON
2,000
$
INCL
Policy Forms and Endorsements
HO-3 CA
HA-300 CA
56494 CA
56512 CA
Homeowners 3 Special Form
Special Provisions
Personal Property Replacement Cost
Additional Replacement Cost Protection - Maximum
Additional Amount of Insurance - 25%
Limi ted Fungi Other Microbes or Rot
Remediation
Limit of Liability: $5,000
MOrtgagee Clause
Lenders Loss Payable Endorsement
Workers Compensation and Employers
Liability Insurance Endorsement
(10-92)
(01-03)
(03-99)
(03-99)
HO-827 CA (07-02)
372-NS (11-50)
438BFU NS (05-42)
55769 (03-00)
Total Premium
Continued on next page
PL-86521-97 675/081825 DEC#: 6
Insured Copy
003661/01723 F3115AHH 5517 01/29/04
$
71. 00
4.00
INCL
$
706.00
Page 1 of 2
- .\..... ")
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RECEIVED
APR 3 0 2004
RISK MGMT.
~
.
Bj\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: April 28, 2004
SUBJECT: Encroachment Permit Application for 6301 Ambergrove Street.
Michael Aronson
6' block wall along side yard
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
/Jv
S:\PE RMITS\ENCROACH\I NSURANC\630 1 Ambergrove .doc
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Bj\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: April 28, 2004
SUBJECT: Encroachment Permit Application for 6301 Ambergrove Street.
Michael Aronson
6' block wall along side yard.
Please review the attached encroachment permit and return to me at your earliest convenience.
5/0" ldel
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S:\PE RMITS\ENCROACH\ TRAFFI C\630 1 Ambergrove .doc