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APPLICATION FOR ENCROACHMENT PERMIT PERMIT NO.: EN-01520
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 defmed.
I. Full name of applicant and complete address including phone number:
LONG CHARLES W.
424 8TH ST BAKERSFIELD
CA 93304 Phone No.661 3273473
2. Nature or decription of the encroachment for which this application is made:
4' TALL CHAIN LINK FENCE IN FRONT YARD
3. Location of proposed encroachment is :
424 8TH ST BAK
424 8TH ST
4. Period of time for which the encroachment is to be maintained:
PERMENANT
(
Applicant agrees that if this application is granted, applicant will idemnify, 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, 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 mantain 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 publi~
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 insuance evidencing sufficient coverage for bodily injury or property damage liability of 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 to Bakersfield Municipal Code Chapter 12,20 to revoke
the permit at any time.
Date ,03/07/2002 >-2-~f~
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 (I) 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:03/07/2002
.....~........
Signature of City Engineer
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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 4, 2002
SUBJECT:
Encroachment Permit Application for 4' high chain link fence.
Charles W Long
424 8th Street
Engineering and Traffic staff have reviewed the attached encroachment permit to allow the installation of
a 4' high chain link fence. The site is located at 424 8th 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.
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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 defmed.
1. Full name of applicant and complete address including phone number: ~~ \L). 4~.;J
~,~~
2. Nature or description of the encroachment for which this application is made:~~
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3. Location of the proposed encroachment: ~ ~ ._~,~_
4. Period of time for which the encro~chment is $0 be maintained: ~~ ~ ~~~ ~Q p~~
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Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold hannless 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 !!QQ!!
the revocation thereofbvthe CIty engineer. aoolicant will at his own cost and exoense remove the same from the oublic
orooert~ or right of way where the same is located, and restore said public property or ri~t of way to the condition
as near y as that in which it was before the placing, erection, maintenance or existence ot 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 to Bakersfield Municipal Code Chapter 12.20 to
revoke the permit at any time.
Date:
, "RepresentatIve
PERMIT
I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACIS STATED IN THE
FOREGOING APPLICATION AND FIND THAT THE MAINTENANCE OF SAID ENCROACHMENT (1) WILL
(NOT) SUBSTANTIALLY INTERFERE WITH mE 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.
eJ / I()W
CITY 0[, .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.
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(Street fbr pupose'a encroachment)
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. (Address of purposed en'croachment )
I
SIGNED:
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,- ~Allstate~
You're in good hands,
ALLSTATE INDEMNITY COMPANY
CALIFORNIA
Home Office
Northbrook, IL
Applicant Name: CHARLES & NOREEN LONG
Address : 424 8TH ST
City : BAKERSFIELD
Home Phone No.: 661-327-3473
LOCATION OF PROPERTY : SAME
POLICY DISTRIBUTION/BILLING
Policy sent to: INSURED
MORTGAGEE/THIRD PARTY INFORMATION
NONE
ADDITIONAL INSURED INFORMATION : NONE
ADULT OCCUPANTS
Application No. 366366209958532
St.: CA Zip Code: 93304
County: KERN
OCC. OCCUPANT
NO. NAME
1 CHARLES
LONG
2 WILMA
LONG
CHILDREN IN HOUSEHOLD : NONE
Total number of residents in household including children: 2
SOCIAL RELATION BIRTH MARITAL
SEC. NO. TO INS. DATE SEX STATUS OCCUPATION
W 566604467 SA 06/08/1944 M MA EM CABINET MAKER
PRESENT
EMPLOY.
DATE
1992
N 545880795 SP 01/19/1950 F MA RE RETIRED
HOUSEHOLD INFORMATION
Date applicant moved into present residence: 01/1990
Is the residence regularly unoccupied during the day or evening by all
adult occupants in the household?: NO
Number of dogs on premises: NONE Does anyone in the household smoke?: YES
POLICY TYPE - STANDARD
HOMEOWNERS
Paqe 1 of More
R2853-1
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~Allstate@
You're in good hands,
ALLSTATE INDEMNITY COMPANY
CALIFORNIA
Home Office
Northbrook, IL Application No, 366366209958532
HOMEOWNERS POLICY LOSS DEDUCTIBLES APPLIED
The following loss deductibles apply as specified below.
All Peril
$500
HOMEOWNERS POLICY DISCOUNTS APPLIED
The following discounts have been applied to reduce your homeowners
insurance premium.
Home & Auto Discount
VALUE OF PERSONAL PROPERTY - APPROXIMATE VALUE OF PERSONAL PROPERTY IN THE
FOLLOWING CATEGORIES: (Note: The values listed are not an indication of
amount of coverage. You must purchase increased protection for items in
these categories over the dollar amounts specified in the policy in order
to extend the Personal Property Protection Coverage. See the policy for
the coverage limits on these items and see above under the section titled
"Section III Optional Coverages/Increased Coverages Applied" for your
specific increased limits.)
Jewelry:
Silverware:
Watches:
Cameras:
Furs:
Stereo:
IF YOU PURCHASE THE SCHEDULED PERSONAL PROPERTY ENDORSEMENT:
EXCEPT AS OTHERWISE STATED IN THE SCHEDULED PERSONAL PROPERTY
ENDORSEMENT, LOSS OR DAMAGE TO PERSONAL PROPERTY COVERED
UNDER THAT ENDORSEMENT WILL BE SETTLED ON AN ACTUAL CASH VALUE
BASIS (THIS MEANS THERE MAY BE A DEDUCTION FOR DEPRECIATION), AND
PAYMENT WILL NOT EXCEED THE AMOUNT NECESSARY TO REPAIR OR
REPLACE THE DAMAGED ITEM(S) WITH PROPERTY OF LIKE KIND AND
QUALITY, OR THE AMOUNT OF INSURANCE. WHICHEVER IS LESS. THE VALUE
OF THE COVERED PROPERTY WILL BE DETERMINED AT THE TIME OF LOSS.
SEE ENDORSEMENT FOR DETAILS.
PREMIUM INFORMATION
Total Estimated Annual Policy Premium $552.00
Amount Paid $99.00 Check/Money Order
Paqe 3 of More
R2853- 1
~Allstate@
You're in good hands.
ALLSTATE INDEMNITY COMPANY
CALIFORNIA
Home Offi ce
Northbrook. IL
DWELLING INFORMATION
Mo/Year Dwelling Purchased: 01/1990
Purchase Price: $34000
No. Apts./Family Units: 1
No, of Rooms: 5
Construction: FRAME - OTHER
Applicant lives in the building as:
Unit Residence: PRIMARY
Dwelling in Course of Construction:
Application No. 366366209958532
Original Owner: N
Current Market Value: $62000
Roof Type: COMPOSITION
OWNER
Unit type: HOUSE
No
PROTECTIVE DEVICES INSTALLED : NONE
(12) Was residence constructed by a Licensed Contractor?: YES
(13) Does the insured have an alternative or supplemental heating source
(excluding fireplaces)?: NO
(14) Is the property to be insured. or premises of applicant. located on a
farm?: NO
(15) Is there any nonresidential property (schools. churches. stores, gas
stations, etc.) within 40 feet of the property to be insured?: NO
(16) Is there any store. business or professional activity in the building.
at the applicant's premises, or at additional premises owned by the
applicant?: NO
(17) Is the dwelling on a solid and continuous foundation?: YES
(18) Will the residence be occupied within the next 30 days?: YES
5 YEAR LOSS HISTORY (including losses at present and prior residences) NONE
PRIOR PROPERTY INSURANCE : NONE
In the past 5 years have you been rejected. cancelled or nonrenewed
insurance similar to the coverage applied for on this application?: NO
Eff. date of first qualifying Allstate property policy providing
continuous coverage to date: 04/09/2002
OTHER ALLSTATE POLICIES (CROSS INDEX)
Policy No,: 000000627747179 Effect. Date: 11/16 Line: 19 Relationship: MT
REMARKS
HAVE EXPLAINED TO INSURED THERE IS NO WATER DAMAGE COVERAGE.
Paae 4 of More
R2853-1
"
" ~Allstate~
You're in good hands,
ALLSTATE INDEMNITY COMPANY
CALIFORNIA
Home Office
Northbrook, IL
Application No. 366366209958532
NOTICE: As part of Allstate's underwriting/qualification procedure and subject
to applicable laws and regulations, we may obtain information regarding you and
other individuals who may be covered by the insurance you are applying for.
including: (i) driving record. based on state motor vehicle reports and loss
information reports; (ii) your prior insurance record, if any. which will be
obtained from your current or prior carrieres); (iii) financial stability,
which will be assessed by obtaining credit reports; and (iv) claim history.
based on loss information reports.
NOTICE OF INSURANCE INFORMATION PRACTICES
In some insurance transactions. we may not be able to get all the information
we need directly from you. In that case, we may obtain information from
outside sources at our own expense. We would also like to inform you that
without your prior authorization, we may as permitted by law, provide
information about you contained in our records and files to certain persons or
organizations.
You have the right to either personally see, or obtain from us by mail. the
information we have about you in our records or files. If. after receiving
this information. you believe that it is not completely accurate. you also
have the right to request that we correct, amend. or delete any portion of
this information.
If you would like further details on any of the following, please contact our
Customer Service Representative, the address of which can be secured from your
Allstate Agent:
1) the types of information that may be collected and the types of
sources and investigative techniques that may be used;
2) the persons to whom we may disclose information about you and the
circumstances which might warrant such disclosures; and
3) a description of the individual rights pertaining to access and
correction of recorded information.
Paoe 5 of More
R2853- 1
~
Eo ~Allstate~
You're in good hands,
ALLSTATE INDEMNITY COMPANY
CALIFORNIA
Home Office
Northbrook, IL
Application No. 366366209958532
Any insurance bound hereunder shall otherwise be subject in all respects to
the terms and conditions of the regular policy forms of the Company at present
in use and to the statements in this application. Any insurance is bound only
for such items. perils. coverages. forms of coverage. limits of insurance and
amounts of insurance as are indicated on the face hereof, and only those
additional Homeowners coverages are bound for which a premium is indicated.
APPLICABLE TO STANDARD. DELUXE. AND DELUXE PLUS HOMEOWNERS POLICIES ONLY:
I understand that upon issuance of the insurance applied for, the Property
Insurance Adjustment (P.I.A.) condition will apply to the policy. In
accordance with terms of this condition. the limits of liability may be
adjusted at each anniversary of the policy.
BINDER PROVISION - In reliance on the statements in this application and
subject to the terms and conditions of the policy authorized for the Company's
issuance to the applicant. the Company named above binds the insurance applied
for. to
become effective: 01:05 PM 04/11/2002
Transaction time/date: 01:05 PM 04/11/2002
Any insurance bound shall continue in force until terminated by mailing
notice as specified above, or until a policy is issued. notwithstanding the
limitation on the binder period specified above.
To the best of my knowledge the statements made on this application, including
any attachments. are true. I request the Company, in reliance on these
statements, to issue the insurance applied for~ The Company may recompute the
premium shown if the statements made herein are not true. In the event of any
misrepresentation or concealment made by me or with my knowledge in connection
with this application, the Company may deem this binder and any policy issued
pursuant to this application, void from its inception. This means that the
Company will not be liable for any claims or damages which would otherwise be
covered.
Paae 6 of More
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,. ~Allstate@
You're in good hands,
ALLSTATE INDEMNITY COMPANY
CALI FORN IA
Home Office
Northbrook, IL Application No. 366366209958532
I have read this entire application, including the binder provision,
before signing.
Applicant's Signature
Date
) I h ve inspected the premises.
I have not inspected the premises.
070180
501
Number
Location Code
Producer's Signature
SAR203-2H
Paoe 7 of 007
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PUBLIC WORKS DEPARTMENT
MEMORANDUM
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TO: Pat Flaherty, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: April 18, 2002
SUBJECT: ' Encroachment Permit Application for 424 8th Street
Charles W. Long
4' high chain link fence at back of sidewalk along frontage
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
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B A K. E R S FIE L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer VI, Subdivisions
DATE: April 18, 2002
SUBJECT: Encroachment Permit Application for 424 8th Street
Charles W, Long
4' high chain link fence at back of sidewalk
Please review the attached encroachment permit and return to me at your earliest convenience.
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