HomeMy WebLinkAbout01452
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APPLICATION FOR ENCROACHMENT PERMIT PERMIT NO.: EN-01452
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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 number:
BERNICE L GO
2121 WILSON RD
CA 93309
BAKERSFIELD
Phone No.831-0878
2. Nature or decription of the encroachment for which this application is made:
INSTALL A 3-4' WROUGHT IRON FENCE
3. Location of proposed encroachment is:
2121 WILSON RD BAK
2121 WILSON RD AND BENTON
OR\G\NAL
4. Period of time for which the encroachment is to be maintained:
PERMANENT
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 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 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:
MERCURY CASUALTY COMPANY
HOMEOWNERS
300,000.00
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke
the permit at any time.
Date:07/05/2000
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Signature of Applicant (Owner/Agent)
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 I
THEREFO (GRANTED
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TO:
FROM:
DATE:
SUBJECT:
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B A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
Ryan Starbuck, Civil Engineer III
Marian P. Shaw, Civil Engineer VI, Subdivisions
July 10, 2000
Encroachment Permit Application for 2 J 2 J Wilson Road.
Btlrkar..a Gg Yama8aki,~N\ct 50
Install 3 to 4.foot wrought ironfence.
Please review the attached encroachment permit and return to me at your earliest convenience.
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B A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
Scott Manzer, Risk Manager
FROM:
Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE:
July 10, 2000
SUBJECT:
Encroachment Permit Application for 2121 Wilson Road.
-Barbara C3 Yamasak.i P.:>.er2.~\c.e..~
Install 3 to 4.foot wrought ironfence,
Please review the insurance certificate with the attached encroachment permit and return to me at your
earliest convenience.
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S:\PERMITS\ENCROACH\INSURANC\2121 Wilson Rd,wpd
APPLICATION FOR ENCROACHMENT PERMIT
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TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFORNIA:
2. Nature or description of the encroachment for which this application is made:
tA.) 'RC11hHT -r:1el"Y\.. -F&/)cE. "'3 - 'I"
3. Location of the proposed encroachment: 02 /::2/ (.~<)J1SCY') ~oacl
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4. Period of time for which the encroachment is to be maintained: ?G-t!nM~~
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, quasi-judical,or judiciahribunals of any kind
whatsoever, arising out of, connected with, or caused by applicant's placement, erection, use (by appliantor 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 pennit is revoked.
Applicant further agrees that upon the expiration of the penn it for which this application is made, if granted. or
upon the revocation thereof bv the City ent:ineer. aoolicant will at his own cost and expense remove the same
from the public prooerty 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 Insurance evidencing sufficent 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 penn it at any time.
Dat~: -;,. 9 - 00
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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 OFTHE
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
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Date:
Signature of City Engineer
No.
,
, CITY OF BAKERSFIELD
DEPARTMENT OF PUBLIC WORKS
TO WHOM IT MAY CONCERN:
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'i~ We, the undersigned. have no objection to the construction of a fence or behind
t~e sidewalk on:
;b/5ontf.oad
,~' 1 (Street)
By:&WA {10 'ffImlJS4Ki
(Owner's Name)
of ~I :LI
(Address)
Phone: - 83/- 84 ~}
SIGNED:
1) Name",rau.-c / ~ugptre.. f)Qv-fd.soYl
Address rl. aO 1 ( lA' ,I :5, Dn Qd
2) Name ~ tJ,.,k...J
Address:J.. ~ &1/ ~ ft./ .
Date:
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Date:
3) Name
Address
Date:
4) Name
Address
Date:
5) Name
Address
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Date:
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6) Name
Address
Date
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,PACIFIC SPECIALTY INSURANCE COMPANY
MNKUOU2 7':) 1-0 I
Item 2, Policy Period: (Mo, Day Yr,)
From: 10/08/1999 To: 10/08/2000
12:01 A.M. standard time at the address of the named insured as stated herein.
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Part Two, This Declarations page with "Policy Provisions - Part One" completes the Polic) n & ..r ' u
DECLARATIONS Policy No, MNROOI d "d~~;a ClZ'~~
B17721 / ~ . , I - L " A. ~~/ i.JaAt~
Item 1. Insured's GO, WILLIAM K. Producer's WILLlJIi C> .,'-tJ V'\./~ f1v{<./ ~-4. ...
Name and Name and ISU WII j/_ cJ 0 C[P IP ~7t.L..aJ /~.
Mailing 1800 WEYBURN Mailing 2469 PO (p 1 .
Address BAKERSFIELD, CA 93309 Address CORON;L i ..l-- i W ~ WJt..,
/79 g Ik~
/97/ ~;~u-tr/
360 I HAYEN AVENUE, MENLO PARK, CA 940
PERSONAL UMBRELLA LIABILITY POl
Term: 12 Months
Item 3. Tbe occupation oftbe insured is:
Item 4. Location of Coverage - if different than mailing address above.
1800 WEYBURN BAKERSFIELD, CA 93309
Insurance is afforded for bodily Injury, Personal Injury, and Property Damage Liability, Uninsured Motorists Coverage, subject to
the limits of the Company's liability (as indicated in item 5 of the Declarations) in excess of the retained limit (as indicated
in item 6 of the DeclaratIOns) or underlying limit (as indicated in item 7 of the Declarations).
Item 5. Limits of Liability
(a) Bodily Injury, Personal Injury, and Property Damage Liability Coverage
(b) Uninsured Motorists Coverage .
$ 1,000,000 each occurrence
$ 25,000 each accident
Item 6, Retained Limit (Selflnsured Retention)
(a) Bodily Injury, Personal Injury, and Property Damage Liability Coverage
(b) Uninsurea Motorists
$ 1,000
See Insuring Agreement II
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Item 7. Schedule of Underlymg Insurance
It is agreed by the insured that insurance policies providing the following coverage (1) are in force and will be maintained
in force (whether collectible or not) for at least the minimum underlying. limits of liability stated hereafter; (2) Insure all
automobiles owned, or leased by or regularly furnished to the insured; (3) Insure all premises owned, leased by or leased
to the insured; (4) Insure all watercraft owned by the insured,
TYPE OF COVERAGE
MINIMUM UNDERLYING LIMITS
(a) Comprehensive Personal Liability or Homeowner's
MERCURY H012027808
Bodily Injury and Property Damage Liability
or both combined -
$300,000
$250,000
$500,000
$100,000
each occurrence
(b) Automobile Liability
MERCURY
MERCURY
AP08228471
AP08228471
Bodily Injury Liability -
each person
each occurrence
each occurrence
Property Damage Liability -
or
Combined Single Limit
Bodily Injury and Property Damage Liability _
each occurrence
(c ) Watercraft Liability
EXCLUDED
Watercraft with inboard or inboard/outboard power
greater than 50 horsepower, outboard power greater
tban 25 horsepower and sailboats (including
auxiliary) 26 feet or more in length -
each occurrence or
the amount insured
on tbe hull,
whichever is greater,
Endorsements forming a part of this policy NR04,NR05,
NYMl ,NRM3,NRM4,NR.M:5,NRM6,NRM7,NRM8,NRM9,NRM IO,NRMll,
Total Premium
Taxes (ifanYI
Fully Earned Policy Fee
Total Policy Premium
I
230.00
35.00
265.00
Date ofIssue 10/05/1999
Countersigned by MCGRAW SPECIALTY INSURANCE SERVICES
Licensed Resident Agent or Authorized Representative
INSURED'S COpy
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California Standard form ~Ire Insurance POliCY
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MERICLJRY CASUALTY COM
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HOME OFFICE · LOS ANGELES, CALIFORNIA
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29'382
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DECLARATIONS
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Named Insured/and A resa (No,. Slreet, Town, County, Slate, Zip Code)
BERNICE K. & WILLI&~ GO
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1800 HEY BURN 'HAY
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BAKERSFIELD, CA 93309
.
Policy.' 8 F
Number
Renews No.:
Agen
Code
Policy Term:
- 36-2
Monlhs
1/29/99
Inception
1/29/02
Explrallon
SECOND TERM EFFECTIVE I.;;?.s
Check No.
I
INSURANCE IS PROVIDED AGAINST ONLY THOSE PERILS AND FOR ONLY THOSE COVERAGES
PERILS AND FOR OTHER COVERAGES ONLY WHEN ENDORSED HEREON OR ADDEO HERETO.
Premium II Paid In Installmenls
Amount Rate Amounl Due at Amount Due al Each
Incepllon Subsequent Annlveru/y
Perll(s) Insured Against and
Coverage(s) Provided
(Insert Name 01 Each)
INDICATED BELOW BY
$ 166,000. $ VRS. $ 328.
xxxxxxxxx $ VRS. $ 40.
$ VRS. $ SUBSEQUENT ANNUAL
INSTALLMENTS WILL BE
$ $ CALCULATED AT THE
$ $ ANNUAL PREMIUM
THEN IN EFFECT
$ $
$
Fire and lightning
Extended Coverage
SPECIAL FORl1
OL & T
$
368 Total Premium for Policy
. on Installment Basis
LOCATION AND DESCRIPTION OF PROPERTY COVERED
Show construction, type 01 rool and occupancy 01 bulldlng(s) covered or
containing lhe property covered, " occupied as a dwelling, Slate No, 01 families.
Item
No.
Amount Fire or Fire
and Extended Cov.
erage. or Other PerIl
1. $ 166,000.
ON A SINGLE Fk~ILY TENANT OCCUPIED DWELLING
LOCATED AT:
2121 HILSON RD.
BAKERSFIELD, CA 93304
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Amount Paid '
Keep Illls stub es your peyment record
Company Code
For Company Use Only
10 - 328
11
12
13
14
35 - 40
RATING INFORMATION
P.C. F C N.F. 0 YB B AT
3 1 1 1 2 59 0 67
TH ER E I S NO CONTENTS COVERAGE
AFFORDED BYTH!S POl\CY
Subject to Form No.(a)
DF3(3/76) MCC10(3/81) MCC19(7/83) MCCOL&T(5/73) 165D(10/65)
Insert form number(s) and edition date(s) ..
Mortgage Clau..: Subject to the provisions of the mortgage clause attached hereto, loss, if any, on building items, shall be payable to:
oun erslgnature Date
Agency at
Agent
.
12/9/9915
In Consideration of the Provisions and Stipulations Herein or Added Herelo and of the Premium Above Specified (or specified in endorsement(s) made a part hereof), Ihis
Company, for the term shown above from inception dale shown above at (12:01 A.M, Standard Time) to expiration date shown above at (12:01 A,M, Standard Time) at
tocatl~n of property involved, to an amount not exceeding the Iiniitof liability above specified, does insure the Insured named In the Declarations above and legal repre-
s~ntatlves, to the ,extent of the actual cash value of the property .at the time of loss, but not exceeding the amount which it would cost to repair or replace the properD'
With material of like kind and quality within a reasonable time after such loss, withciutallowance for any increased cost of repair or reconstruction by reason of any ordl-
~nce or law regulating construction or repair, and without conipensation for loss resulting from interruption of business or manufacture, nor in any event for more than the
mterestof the Insured, against ALL LOSS BY FIRE, LIGHTNING AND OTHER PERILS INSURED AGAINST IN THIS POLICY INCLUDING REMOVAL FROM PREMISES
ENDANGERED BY THE PERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER PROVIDED, .to the property described herein while located or contained as
described in Ihis policy, or pro rata for five days at each proper place to. which any of the property shall necessarily be removed for preservation from the perilS insured
against in this policy, but not elsewhere, .. . . ... .
Assignment of thiS policy shall not be valid exce:Jtwith the written consent of this Company.. . ..
. This policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together
with such other provisions, stipulations and agreements as may be added hereto, as provided in this policy, '
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MERCURY
CASUALTY COMPANY
Pagel of 5
" (The Att<Khing Clause need be completed only when this endorsement Is issued subsequent to preparation of the policy,)
OWN'..:RS', LANDLORDS', AND TENANTS' LIABILITY AND PREMISES MEDICAL PAYMENTS ENDORSEMENT
.CompafJ.y MERCURY CASUALTY COMPANY
Thisendorsementeffective 1/29/99 formsa part of policy no. 8 F 29382
issued to ,BERNICE K. & WILLIAM GO
by
ISU WILLINGHAM INS.SERV.
8-4505-1
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Authorized Representative
The company, in consideration of the payment of the premium, in reliance upon the statements in the declarations made a part hereof and
subject to all the terms of this endorsement, agrees with the insured named in this endorsement (hereinafter called the named insured) as follows:
DECLARA nONS
SAME
Item 1. Named Insured and address (Enter below)
Item 2. Endorsement Period: 1/29/99 TO 1/29/02
This insurance applies only to bodily injury or property damage which occurs on or after the effective date hereof and during the policy period.
Item 3. The Named Insured is:
INDIVIDUAL
I nd ivid ual
Joint Venture
Partnership
Corporation
Other (Describe)
COVERAGES LIMITS OF LIABILITY
A. Bodily Injury liability $ 300.000. IIch occur,.nce
B. Property Damage Liability $ 50.000. each occurrence
$ 50.000. aggregate
E. Premises Medical Payments Insurance $ 1,000. Each Person
$ 10,000. Each Accident
ECLARATlONS (Continued) SCHEDULE - GENERAL LIABILITY HAZARDS
Description of Hazards Code No. Premium Bases Rates Advance Premium
Bodily Injury I Property Damage Bodily Injury I Property Damage
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Premises-Operations (Show (a) locations of an premo (a) Area (sq. ft.) (a) Per 100 sq. ft. of Area .'ndicates Minimum Premium
ises owned by, rented to, or controlled by the named (b) Frontage (b) Per linear ft.
insured (b) interest of named insured in such (c) Admissions (c) Per 100 I
premises; and (e) part occupied by named Inlllred). (d) Receipts (d) Per $100 of Receipts
(e) Units (e) Per Unit
(f) Each HI Per Each
2121 WILSON RD. (e) Units Flat Flat $25. INCL
BAKERSFIELD, CA 93304
Escalators (Number at Premises) Number Insured Per Landing
NOT COVERED - -
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Structural Alterations, New_Construction, Demolition (a) Remuneration (a) Per $100 of Remuneration
(b) Cost (b) Per $100 of Cost
I NOT COVERED - -
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I 'm Numbers of Endorsements Attached And Applicable to This Coverage Part
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OL T TOTALS $ 25. $ INCL
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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 14, 2000
SUBJECT:
Encroachment Permit Application for 4' Wrought /ronfence.
Bernice L. Go
2121 Wilson Road
Engineering and Traffic staff have reviewed the attached encroachment permit to allow the installation of
4' wrought iron fence. The site is located at 2121 Wilson Road.
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 ofthe permit.
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S:\PERMITS\ENCROACH\1111 Wilson Rd,wpd
xc: Applicant
Reading File
Construction Inspection
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