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APPLICATION FOR ENCROACHMENT PERMIT
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFORNIA:
The location of the ~rRposed encroachment is: -1~CI
-+ \) \3.'\ Be"," t\ 0 t-~ Ice . " .'
Applicant agrees that if this
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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 nearly may be in which it
before the placing, erection, maintenance or existence of said encroachment.
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was
Date: 1;;<- f.:::,... ?O
, ignature of Applicant (Owner or Representative)
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PERMIT
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,/ I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS
STATED IN THE FOREGOING APPLICATION,JU{D 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) ~).
Date: 1-;1.-(P -10 .~ ~.~~, As..,,.,L
Ognature of City Engineer I
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No. /12 t
Distribution: Original - Applicant
Goldenrod - City Clerk
Yellow - Public Works
REV6/90
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