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Home My WebLink About3 California Drive - Application.- , BURLING4ME � COMMUNITY DEVELOPMENT DEPARTMENT � SO1 PRIMROSE ROAD • BURLINGAME, CA 9401 O p: 650.558.7250 • f: 650.696.3790 • www.burlingame.org APPLICATION TO THE PLANNING COMMISSION Type of application: ❑ Design Review ❑ Variance ❑ Conditional Use Permit ❑ Special Permit ❑ Parcel #: � Zoning / Other: Administrative Use Permit PROJECT ADDRESS: 3 California Drive, Burlingame, CA 94010 / APN 029-242-240 APPLICANT Name: AT8�T Mobility /}4}n : $rad Nea� Address: 5001 Executive Parkway, 4W550C City/State/Zip: San Ramon, CA 94583 Phone E-mail � Z5 . �l �O3 -13� o I� l� 4q �Q � a-4-�-. cc�w� PROPERTY OWNER Name: 3 California Drive LLC Address: 3 California Drive City/State/Zip: Burlingame, CA 94010 Phone: E-mail: ARCHITECTIDESIGNER �Project Manager/Agent ' Name: Joe Fitzsimons, P.E. Misako Hill, C0�2�, IC1C. �� Address: 2030 Main Street, su�te 200 1075 45th Street, Emeryville, CA 94608 City/State/Zip: Irvine, CA 92614 Phone: 415-533-2540 Fax: 510-350-7289 Pnor,e: csos� 275.9ss '�Email: misako.hill@cortel-Ilc.com � E-mail: joe.fitzsimons@cortel-Ilc.com Burlingame Business License #: 3 � 5(O �- Authorization to Rearoduce Proiect Plans: I hereby grant the City of Burlingame the authority to reproduce upon request and/or post plans submitted with this application on the City's website as part of the Planning approval process and waive any claims against the City arising out of or related to such action. (Initials of ArchitecUDesigner) PROJECT DESCRIPTION: SEE ATTACHED PROJECT DESCRIPTION AFFIDAVIT/SIGNATURE: I hereby certify un r penalty f perjury that the information given herein is true and correct to the best of my knowledge and belief t ApplicanYs signature: Date: �� /_ 3��1 � I am aware of the proposed application and hereby authorize the above applicant to submit this application to the Planning Commission. Property owner's si nature: SEE ATTACHED LETTER OF AUTHORIZATION Date: �� IG431-2e�1(�� Date submitted: OrT � � �� S: �HANDOUTS�PCApplication.doc CITY OF BURLlNGAME CDD-PL.FtiNNING Dfi/. CITY OF BURLINGAME PLANNING DIVISION 501 PRIMROSE ROAD BURLINGAME, CA 94010 (650) 558-7250 www.burlin�ame.or� MEMORANDUM To: 3 California Drive Address File From: Planning Division Subject: Administrative Use Permit—Contact Information Date: May 26, 2017 An Administrative Use Permit to alter an existing wireless communication facility at 3 California Drive was approved effective January 31, 2017. As part of the approval, the following information is required to be provided: Provider: AT&T Mobility Business License: 40766 Applicant: AT&T Mobility 5001 Executive Parkway San Ramon, CA 94583 Alexander Wilson-Desbois (415) 527-9276 Ad122p@att.com Maintenance: Melissa Murphree AT&T Mobility (925) 963-8027 Mm5704@att.com Emergency: (800) 832-6662 or Melissa Murphree Removal Bond: see attached TOWER / STRUCTURE / EQUIPMENT / ANTENNAE REMOVAL BOND Location of tower/structure/equipment: 3 California Drive, Burlingame, CA Site ID: CCU4858 FA # 13424635 Bond Number: 09245268 KNOW ALL MEN BY THESE PRESENTS: THAT New Cingular Wireless PCS, LLC, 2600 Camino Ramon, San Ramon, CA 94583 as Principal, and Fidelity and Deposit Company of Maryland, a corporation duly organized under the laws of the State of Maryland as Surety, are held and firmly bound unto City of Burlingame, 501 Primrose Road, Burlingame, CA 94010 as Obligee, in the penal sum of Thirty-Five Thousand and NO/100 Dollars ($35,000.00) for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents, the liability of the surety being limited to the penal sum of this bond regardless of the number of years the bond is in effect. WHEREAS, the Principal has entered into a written agreement with the property owner for the placement of a tower, structure or equipment furnishing telephone, television or other electronic media service, which agreement sets forth the terms and conditions which govern the use of such towers, structures or equipment and which agreement is hereby specifically referred to and made part hereof, and WHEREAS, the City of Burlingame agreement and/or the property owner, requires the submission of a bond guaranteeing the maintenance, replacement, removal or relocation of said facility, NOW THEREFORE, the condition of this obligation is such, that if the above bounden Principal shall perform in accordance with the aforesaid ordinance and/or agreement, and indemnify the Obligee against all loss caused by Principal's breach of any ordinance or agreement relating to the maintenance, replacement, removal or relocation of a tower, structure or equipment, then this obligation shall be void, otherwise to remain in full force and effect unless cancelled as set forth below. THIS BOND may be cancelled by Surety by giving thirty (30) days written notice to the Obligee by certified mail. Such cancellation shall not affect any liability the surety has incurred under this bond prior to the effective date of the termination. PROVIDED that no action, suit or proceeding shall be maintained against the Surety on this bond unless the action is brought within twelve (12) months of the cancellation date of this bond. SIGNED this 6th day of March, 2017. New Cingular Wireless PCS, LLC Principal: By AT&T Mobility Corporation its manager g`f : . � SurEt�r �� , .. : v_ �`' � , _ : ; � (^ , By: _ ,� Lj h,,; _ . � i�... _ � �=I �1 J .. l Assistant Treasurer Fidelity and Deposit Comp ny of Ma�land - - a. Heidi A. Notheisen, Attorney-in-Fact ACKNOWLEDGMENT BY SURETY S'I':1'1'1�: ()1� 1�lissotiri c<<y- ��r st. [.�u;� (),i this 6th } ss, day� oC March , 2017 , bcforc inc pa-sonall}' ap��carcd Heidi A. Notheisen , k>>o�vi► �o �nc to l>c lhc AUoriicy-i�i-I :ict oC Fidelity and Deposit Company of Maryland , the corporatiou that c�ccutcd tl►c «�itliii� iustru�nciit, aucl ackiio«�lcd�;cd to ►uc tliat sucl� corporatic�n cticcutcd tlic s<unc. IN �ti'Tl'N1�;SS ��'II1�:R1�:O1�, I l�at�c licrctn�to sct my° l�a�ul aucl alll�cd iYiy� �>llicial scal, al ni}' ol�licc iu tl�c aloresaid Count��, tl�c da}' and }'car in this ccrtilicatc first aho��c ��rittcn. My Comiiiissiou l�;�pires: Scptcmhcr 16, 201�) (Scal) � .., � I II�iC� � ...'�� '��?, cf�, ll C^r .,... �.l.l'..!f 10,'' � _'!��T'/. : ,�h ' (_OTh.. , � �� 13i-iu�iuy- ll. Cla�°ii� l�ota►}� Public ii� tlic Statc of Missouri Cowi��• ol� St. Louis Commissio�i # 15fi38�-336 S-0230/GEEF 2/98 ZURICII AMERICAN INSURANCE CO1�tPANY COLONIAL A!�1ERICAN CASUALTY AND SURETY COMPANY FIDELI'fY AND DEPOSIT COMPANY OF MARYI,AND POWER OF AT'fORNEY KNOW ALL MEN HY THESE YRESENTS: That the 'LURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMNANY, a corporation of thc State of Marylanel, and the FIDELITY AND DEPOSIT COMPANY OF MARYLANU a corpoiation of the State of Maryland (hcrein collectively called the "Companics"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-I,aws of said Companies, which are set forth on the re��erse side hercof and �irc hereby cc��ti�ied to bc in full Corce and eflcct on the date hereof, do hereby nominate. constitute, and appoint Pamela A. BEELMAN, Cynthia L. CHOREN, Heidi A. NOTHF,ISEN, Joann R. FRANK, Karen L. ROIDF,R, Debra C. SCHNEIDF.R, Sandra I,. HAM and 13rittany D. CLAVIN, all of St. Louis, Missouri, EACII its u-ue and lawful agcnt and AUorney-in-Fact, to make, execute, seal and dclivcr, for, and u❑ its behalf as sur�ty, and as its ac[ and decd: any and all bonds and undertakings, and the cxccution of such bonds or undertakings in pwsuancc of these presents, shail be as bindin� upon said Companies, as fully und umply, to all intents and purposes, as if they had been duly executed and acknowledaed by the regularly elected officers of the ZLIRICH AMERICAN 1NSl1RANCE COMPANY at its oftice in New York, New Yorh., the re�_ularly clected of�icers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills. Maryland., and the regularly elected officers of the FIllEL[TY AND DEPOS[T COMPANY OF MARYLAND at its office in Owings Mills, Maryland., i�� thcir own proper pcisons. The said Vice President does hereby cerlify that thc extract set forth un the reverse sidc hcreof is a hue copy of Article V, Scction h, oC the By-Laws of said Companies, and is now in force. W WITNESS WHEI2EOF, the s�iid Vice-Yresident has hereunto subscribed his/hcr ��ames and �iffixed the Corporate Seals oF thc s�iid ZURICH AMERICAN INS[7RANCE COb1PANY, COLONIAI, AMF,RICAN CASUALTY AND SURF,'I'Y CONiPANY, .ind FIDF.LI'I'Y AND DEPOSIT COMPANY OF l�1ARYI,AND, this 17th day oPOctober, A.I). ?016. AT'I'Eti7': ZURICH ANIERICAN INSURANCF. COb1PANY COI.ONIAL AMI:RICAN CASUALTY AND SURN"I'Y COb9PANY FIDELITY ANll UEPOSI"C COMPANY OF MAR1'LAND � _ � ��. ��_ <.C,c� � Set'rt�ta r�; Fri� !). �cn�nes �v.41t��4 '�p D(/p�.�� •G�,lNS(��.��, w O ,� }p��Oi�., . 4iQ�:'op�rotir . C�' ` BEAL � � � ` €�;'�_,_�°':�: �.w '7 % �tM � LtJ ;., tpOB j a i � �,�A� q,� 'sb��-•�.*..:*��•' ,•I ~��ry�.�� i Vi�e Yresideni h1i�•hael 6onrl State of Maryland County of Ballimore On �his 17th day ot October. A.D. 2016, befor� the tubscriber, a Notary Public of the State of Maryland, duly commissioned and qualificd, MICHAEL BOND, Vice President, and F,RIC ll. BARNES, Secretary, of the Companics, to me personally known to be the indi�iduals and officers described in and who executed the prcceding instiument, and acknowled�ed the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company� aforesaid, and that the seals aftixcd �o the preceding inslrument are the Corporate Se.�ls of said Companics, and �hat the said Co�porate Seals and the si;nature as such officer were duly aftixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TF.STIMONY WHF.RHOF, 1 I�ave hereunto set my hand and aftixed my Official Seal the day and year tirst abore written. .`��r �! � � �<��''� . ,� .. . � � `:ci:c,ii�,��<�� ! e :, • • `/ �� ' f�`•;i, \ c� F- �'.C�:<<°IIG •��,c.,� ,Q �i,LG ��4i n�i i N� �� Mariu D. Adamski, Notary Nublic My Commissic>n F,xpires: July 8, 2019 POA-F 079-0626B EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Atrornevs-in-Fact. The Chief Executive Officer, the President, or any Executivc Vice President or Vice President may, by written insU-ument under the attestcd corporate seal, appoint attorncys-in-t�1ct with authoriry to execute bonds, policies, recognizances, stipulations, undertakings. or other like instruments on behalf of the Company, and may authorire any ofticer or any such auorney-in-fact to atlix the corporate scal thcreto; and may with or without cause modify of revoke any such appoinunent or authority at any time." CERTIFICATE L the undersigncd, Vicc Vresident of the ZL!RICH AMERICAN INSURANCE COMPANY, the COLOMAL AMERICAN CASUALTY ANU Sl1RETY COMPANY, and the F�IDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foreaoin_ Power of Attorney is still in full force and effect on the date of this certiticate; and 1 do further certify that Article V, Section 8, of thc By-Laws of lhe Companies is still in force. This Power of Attorney and Ccrtiticate rnay be signed by facsimile under and by authority of the following resolution o� the Board of Directors of the 7.URICH AMER[CAN INSURANCE COMPANY at a meeting duly called and held on �he I Sth day of December 1998. RESOLVED: "That the signawre o1'the President or a Vice President and the attesting tignature of a Secretary or an Assistant Secretary and the Seal of the Company may be aftixed by facsimile on any Power of Attorncy...Any such Power or any certificate thercof bearing such facsimilc signature and scal shall be valid and binding on the Company." This Powcr of Attorney and Certiticatc may be signed by facsimile under and by authoiity of the following resolution of the Board of Directors of the COLONIAL AMER[CAN CASUALTY AND SURETY COMPANY at a mecting duly callal and hcld on thc Sth day of May, 1994, and the following resolution of the Roard of Directors of the F[DELITY AND DEYOSIT COMPANY OF MARYLAND at a meetin� duly called and held on the IOth day of May, 1990. RESOLVF.D: "That the facsimile or mechanically reproduced seal of the company and facsimile or mech�inically reproduced signature of any Vice-President, Secretary. or Assistant Secretary of thc Company, whethcr made heretoforc or hereafter, whercvcr appearing upon a certitied copy of a�y power of attorney issued by the Company, shall be valid and bindinU upon the Company with the s�une t�orce and effect as thou��h manually affixcd. IN TESTIMONY WHEREOF, 1 havc hercunto subscribed my name and aftixed thc corporatc scals of thc said C��mpanies. this �� day of jv�r� . 20�_. 0 o[rva .�'�=,!N tN`�'��y. WWI�1 `,��4'I � 4l:' G��J.•.(1 � t `S�.' � •V�.tPY �1r : u» •� =�: �� :�" 8BAL � s . • � � «r '. 1 ••........� � 4 I� y�.�.:t, `�� J-` � � Ei E� ,.; .� . � •� :: �., ^ X�, /J . % % �CR.�.J % -'7L'�/ `J Gerald F. Haley, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED INFORMATION TO: "Lurich American Insurancc Co. Attn: Surety Claims 1299 Zurich Way Schaumhura, IL 60196-1056