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HomeMy WebLinkAbout01303 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 telephone number: r.::I rlH>ri np r.nhh~ 4204 Tyndall. Bakersfield. CA 93313 814-9169 . 2. Nature or description of the encroachment for which this application is made: T n ~ r ::111::1 r; nn n f ::I 6.' },; gh ~hRin link fpnrp ;n frnnr Y::Irrl hpbind ~idewalk 3. Location of the proposed encroachment: 6.104 Tyndall 4. Period of time for which the encroachment is to be maintained: Permanent 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-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 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 the 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 nearty 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 fumish 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: Homeowner's coverage in an amount of at least $300.000 - ~pp RttRrhpn fnr additional insured verbia~e Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. Dat.:_~j-/~ IfPjtJ 'gnature of Applicant (OWner or Representative) I 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 I NDEFI U rTE. Date: Cj, '-" / "l-~ ~ No.J ?:tJ5 4d^- ~ Sign.a(ure of CitY Enaineer MGAIbsb-Sept.ember5,1998 S:\FORMS\ENCROACH,PMT 4204 Tyndall Application for Encroachment Permit Additional Insured Verbiage: The City of Bakersfield, its mayor, council, employees, agents and volunteers are added as additional insureds with respect to the installation of a 4' high chain link fence in front yard behind the sidewalk at 4204 Tyndall. mps:m:\encroachment\insurance\4204tynd,all t: f'!"ITV" 0"(;"' . ", '8 AIzI:'D'.S""1::1 E'ID'........DIZDIl..:I'.''"'rfHADn.'1 ~"A;::ml'ii:..< ".'.',.',....',11 ,~ \.I ,01 , '" ,.. ...,.,','....'d"IXLn ....I3CLI7E.,IYI''''I7I7Li.~_(ld....:.:.) /'11 PLEASE PRINT OR TYPE APPLICATION Project Info, Project Location --jj~OY T~v DA lC f9JIl;- Address 933/3 Suite Number $94-7 Tract Lot Number Owner Ap~ant ? lJ2N (;;!J58S Last ame jue- lid-a vi f'f IV D A. L-L Address Suite Number ~~()) City ~fr State 953)3 ~1L 9/b9 Zip lSh'on: Number Fax Number Contractor Applicant? Y/N Last Name / Company Name First Name Address Suite Number ,\ '~ Contractors Lie. Number Lie. Expiration Date Workers Comp, Carrier Workers Comp Insur No. Workers Comp Expiration Date Arch/Engr Applicant? Last Name / Company Name First Name 'fIN Address Suite Number . City 3tate Zip Phone Number Fax Number Arch/Engr Lic, Number Lie. Expiration Date I OFFICE USE ONLY Permit Info, 96- Buld, Permit No, Mise, Info. 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Si nature fl tI Address Date ~ , r \ 4J()J lYhdal!,4ue Address NOYvY/an '1. R; J1i'}Q Print Name Ii J.'9..~~~'t~"/ (y~cf<[(14r/t" Signature Ad ess 3'4.. -r.v~ Sl~oQ~Q_JkrVlC<.vuQ-e2-- Print Name ,~~HI &21&7P//#~// SIgnature Address g~~N~ fNIDne "/ ' f'.; vA/) dtil #2~7,/pv4a /1/ ~nature , Address' /< WIt. A-~~ Print Name 5. tJ@ ---- ~ 1- ij-Cj0 Date 9 -1-~ ~ Date :?14Y"d Date 9/9'/96 Date .:.\ cl t. ENCROACHMENT PERMIT INSURANCE REQUIREMENTS I) Type and Amount of Insurance Coverage for ~ installation or construction 1) for residences Homeowners coverage in an amount of at least $300,000 2) for businesses Commercial General Liability coverage in an amount of at least $500,000 II) Additional Insured Verbiage The City of Bakersfield, its mayor, council, employees, agents and volunteers are added as additional insureds with respects to (i.e, the installation ofa chain link fence at 1501 Truxtun Ave.). " L ~ . - B A K E R 5 F I E L 0 PUBLIC WORKS DEPARTMENT MEMORANDUM TO: RIM. Rojas, Public Works Director )!f!tI 7: t/ t rV\ 1&0\ ~ FROM: Jacques R. LaRochelle, Engineering Services Manager DATE: September 11, 1996 SUBJECT: Encroachment Permit Application for 4204 Tyndall Avenue Catherine Cobbs Installation of 4 Foot High Chain Link Fence in Front Yard behind Sidewalk Engineering and Traffic staff have reviewed the attached encroachment permit to allow the installation of a 4 foot high chain link fence in front yard behind sidewalk. The site has a single family dwelling upon it and is located mid-block. Based on their review, staff recommends approval of the permit. mps:M:\ENCROACH\4204tynd,all xc: Reading File Project File Marian p, Shaw /)0 ,10 ~':(; \ J