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Home My WebLink About01409 .' .. . 1- " APPLICATION FOR ENCROACHMENT PERMIT PERMIT NO.: EN-01409 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: WORLD OF PENETECOST CHURCH 3025 FAIRFAX RD Phone No.872-0334 2. Nature or decription of the encroachment for which this application is made: 8' WATER LINE UNDER SUMP NO FEE PER RAUL ROJAS 3. Location of proposed encroachment is: 3025 FAIRFAX RD BAK 3025 FAIRFAX RD 4. Period of time for which the encroachment is to be maintained: 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: Applican~ acknow~edges th~right C.i~Engin' pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the pernut at any tlllle. If/ ' Date:04/28/1999 '.. ...... . . ...~~ Signature of Applica (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 IS THEREFORE (GRANTED) (DENIED). Said permit shall expire Date:04/28/1999 "1 I' 0~!28(99 .~ 11:34 FAX 805 835 4500 K I A INSURANCE !gJ 0011001 ACORD~ .:l5::r!rr~i~I;:~::I. ::'~;::;A:'~'S;;::;~;E:.:i:I.::;'::i;.'^~ilij:;'I''t::::f*W:;:;I:'id;'ffi:i:;j:;r!'S:~Ai'i':l~::~i~~:SE; :::.. DATI! (MM/DDIYV) . . .:::~.R;:m::\::~i:;.JT.:;::::~.m!y,:)~::\~~}~:;::~:t$!~:J51::1;:,:;T:~i;':,:~:~:~;:~:~:t~:~:Ei~!ft:~:3:: ,.". , 0 4/27/99 ... ..... ..... ............ . ,....... ......... ... THIS (';ERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ~OLDER. THIS CEATIFICATE DO!S NOT AMEND, EXTEND OR AI.TE~ THE COVERAGE AFFORDEC BY THE POI.ICIES eeLOW. COMFlA~.!~S AFFORDING COVERAGE .. PROOUCER KiA ms~CE ASSOCIArrEli, INC. 1601 HEW s~tNm ~OAO SCI~ 230 BAKERSFIStD CA 93309 John HOQ;r:bQ1;Ule PI10MO ~ aOS-B35.:-4.S.j.2 INSURED I':sxNo, 905-935-4500 COMF'ANY A Guidan t Mu. tual Insw:anee Wor~d o~ Penteccst ~ O~ted Pentecostal churCh 2000 I'ai;r:fax lI.oad COMFANY' ,.. Baker8fi.l~ CA 93306 D ..,:.:: :..' 20 ..'. .:.:....,.......... THIS IS TO CI!Rill"Y TH~" THE! ~UOIES OF Ir-lSURANC! LISTiC HAV!! SEEN IEiSUEO TO ,""E INSURED NAMeD AseVE FOFl TH~ PO~JCY ~~IOO INOIOATED, NOTWITI-ISTANl;lINc; ANY REQUIREMEfIIT, TERM OR CONDITION Of: ANY CONTMCr Olll OTHER OOC:UMENT WITH RESPECT TO W,",ICH THIS CER'I'IFIOATE MAY BE ISSUEO OR /MY PiRTAlN, 'rHE IN$URAN~ AJ!lFOIllI:IE!O B,( THE POLICIES D!SCR!8EO HEREIN IS SUBJECT TO ALL THE TERMS. =XCLUSION5 AN!;) CONtlrrlONSl OF SUCH POUClES. UMlTS SI-IOWN MAY P-lAVEl 8EliN REtlUCeD BY PAID CLJI,IMS. '"" .. I r-;;;~~v 6FI'ECilVe POLICY EXl'II~ArION NPI; 01' INSURANce I"~LleV NI,IM;IiR elATE (MMlDDIVV) DATE (MMIDOffYl I , .m 1"eOM~.ANV I tlOMF-A~~ I C co L'lR LIMITS GENE!AAL LIA~~ITY A X COMMI!IlCIAL GeNERA.L 1.IAIOIUN Ii2 -=1 CLAIMS MI\Oe [iJ Q~"CUR OWNliR'S 110 CONTRACTOR'S iI'''-OT - 1177780 10/31{98 GENaw. AGoAE!GATe 10/31/99 I Pr!OCUCTS.(;QMP/.~AOG , PERSONAL 110 AOV INJURY IiiACl-l OCCU~CI: FIRE DAMAGE (Any ~T1O fifll) MeO exI" tAny om perwn) $ 3,000,000 $1,000,000 .!.1,000 000 51,000,000 $1,000,000 ,$ 5,000 AUTOMODtl.! U!lelLI'TY A ~ Am AurO =1 ALL OWNeD AUTOS ! 5CHt5ClVI.iiD AUTOS xl "IREDPlUTOa --= ~ NONoOWNiC AUTOS 1177780 10/31/se lO/3l/99 COMalNI!C SNGI.! UMIT 51,000,000 BOOIL Y INJVl\y (por pol'Son) . $ BOOlL Y INJURY (Per Gooldentl $ JORCPeRTY DANAGI! s EXCESS LIABtUT\' ~ UM!!I'l!U.A I"OIVII --j OTHER THAN UMBRELl./I FORM I WORKEFUi eOMPE!NSA'l'IO~ AND EMPLOYERS' LIABILITY I THli ~C~RI.-rORl RINCL PARTNERs~cunvE OFFlCERSARe E!X1;l. OTHeR AUTO ONL V . EA ACClDI,NT S o'I'I-t!~'l'HANAU'TQ ON,Y; _._~OH AOClbEN'l' $ ACGRGGA Tli 5 EACH OCCURRiiNC5 $ AGGReGATe! t , I ~~lt~lfs I IC~.:::",. 51. EACH ACCIDENT S eL OISI!ASI! ; I"Ol.IeV uMIT $ El. DISEASE. EA EMPl.OYEE ~ ,.... ...., ..... ~RAGELlAeILiTV AAlY AUTO f-- - A ! propel::: _" 1 11777S0 CiE!6e~IP'l'IQN OF OPliRATION$lLOCATICNSIV!iJ.lICLE&lSPliCIAL ITIOMS City of Bakerafi.l~, its,mayor. council, emplc~s, agents mnd VQ1UDtee;r:~ aro n~d as additional ~n8~ :eq.rdinq ~h~ 1ssuanea of an encZ'oachmant pe:m1t fQr church, Qcated iL !l ra1rfax Road., Bakerlljlf.:i.eld, CA *10 day notice of cahdelIa ~Cft appl es ~o noft4Pay.ment of pr~um, 10/!1{98 10/31/99 ;Cafl:TIF.ICAT-g:H~E~::';' , '''' .., ",.... ", '" ",." "",,' ..','.'..",:", :: ,"'::;' <::. .':::',;:: ':::" .. ::;.:{....:......;.::;:" CI'rYOI'B :;:$/Pi;N(l:I;L~~1QN'.::::.;?:':::, . .... ::::. .... .. SHOULD AroN oF' TH~ "'BOVI! oeSOAleI!O I"OLICIS$IlS ePlNCIOLLED BEiFOR.Ei THIO IiXPlitATlCN DATE THEREOF, THE ISSUING COMPANY WILL eJDEAvol'l fo MAIL * 30 DAYS WRrrTEiN NOTlCEi TO TM!! CERTIFICATE HOLDi:R NAMED TO THe LEFT, IilUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABILITY OF AroN KINO \,IF-ON 'TI-{II =MI"ANV, IT$; A~NTS; OR 1'lIiI'RIOSllONTAl1VIOSl. " .'., H"'" ;~;~~;~~;;;::~r:;})~I~ il1., .....:.....~.'. .:..~.'.~','.........P.....o......'b........:.....Cr..,.,1'.0'.: N......:.;',.''''.:.'..c'..c .'.:.:'." .:":'.:,,:::'.:,,'::::.:. .:,., .......,...,...,..,. ...,............. .. "..,..:...."."...".::~:;~~.....H ........"",..:.. .. .' 'V'H. . """" Ci~y of Bakersfiel~ Attn: Ci~ aisk Manage: 1415' TruxtUft Ave BakArS~1el4 CA 93301 ;~P9~D'~~o(l1fi5)t .,........".,...,.,.,..:.":":l::::': "...."......, .:",','.:'.,",". . ,"." , ',".,',',".' .- - "{ - f~'> Jr{ ~\'rfJ ~ . BAKERSFIELD PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Raul M. Rojas, Public Works Director FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: May 4, 1999 SUBJECT: Encroachment Permit Application for 3025 Faiifax Road World of Pentecost Church 8" waterline running under city owned sump for additional fire hydrants for church Engineering and Traffic staff have reviewed the attached encroachment permit to allow the installation of an 8" waterline running under a city owned sump for additional fire hydrants for the church. The site is located at 3025 Fairfax Rd. The applicant has provided proof of appropriate insurance coverage to Risk Management. Based on their review, staff recommends approval of the permit. S:\PERMITS\ENCROACH\3025 Fairfax. wpd -:Jf xc: Applicant Reading File Construction Inspection '9f\~<A, _i'_, A...,..'i' ~.\rQ ~: .~ ~ . - BAKERSFIELD PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Scott Manzer, Risk Manager FROM: John Ussery, Engineering Technician I, Subdivisions DATE: April 29, 1999 SUBJECT: Encroachment Permit Application for 3025 Fairfax Road World of Pentecost Church 8" waterline running under city owned sump for additional fire hydrants for church Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. 0 'K: S" /3 tq 9 ~'~ S:\PERMITS\ENCROACH\INSURANC\3025 Fairfax. wpd J . .~ . - BAKERSFIELD PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ryan Starbuck, Civil Engineer III FROM: Marian P. Shaw, Civil Engineer VI, Subdivisions DATE: April 29, 1999 SUBJECT: Encroachment Permit Application for 3025 Fairfax Road World of Pentecost Church 8" waterline running under city owned sump for additional fire hydrants for church Please review the attached encroachment permit and return to me at your earliest convenience. ()()0S, t~;-S V'L-Fhv(.., It.-hy ta'1,c:sto kl- b-io ~04-- (}V- ~ Y C-bJ\Sf((u.,(,+,oV\ IV\ v^9I:--l,tL\A/u..,y ~ If VW)'1;:;) rV"u..-v/;:tc: V~VIVW N,A., ~ . S)Ji'i7 S: \PERMITS\ENCROACH\TRAFFIC\3025 Fairfax. wpd