ENC2013-00092Print Form
CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. ~~ ~ZO 13 ~ c=am` } 2
DEPT. OF PUBLIC WORKS (Non-engineered work within the public right-of-way) X-Ref File
70 North First Street ($10,000.00 maximum value of work) Application Date 5 17
Campbell, CA 95008 ~ ~ ~ ,7 ~ ~ ,~ Applicati Datep~ration \ \ 1~ t ~
Ph. (408) 866-2150 ISSUED: APN :~.']~ - ~~<~ 4_ j
Fx. (408) 376-0958 Permit Expiration Date:
APPLICATION -Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04.
(Application expires in 6 months if the permit is not issued.)
A. Work Address: I ~ 2 ~G ~~ ~/~``(W~c~ 1~
B. Nature of Work: V'v y C (' ~ c~t.t~~i ~ \ ~~ Y G C~ C ~ ~ ~t . 2 /__ ~7C' ~' t ('` S_~ c~c
C. Attach three (3) copies of a drawing showing the location, extent and di ~ ensions of the work. ~he drawing shall show the relation of
the proposed work to existing improvements. When approved by the City Engineer, said drawing become a part of this permit.
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit
Conditions listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and
provisions may result in job shutdown and/or forfeiture of Faithful Performance securities.
NAME OF APPLICANT: SQ"!"'~" ~~-l,L~ Telephone: Lt.Og ,p,~ s ~ t lcj Z
Address: ~2-.~~ ~. ~~Ywr~nd _ ~ ~~a SpS~, ~ gS l2, ~_
E-Mail Address: ~C,t.ltr~ Ql~ c~'}''t', ~~^'~-
__ _ __
The Applicant hereby confirms that this work is being done by the property owner/applicant at their own residence.
The Applicant hereby agrees by affixing their signature to this permit to hold the City of Campbell, City of Campbell Redevelopment Agency, its
officers, agents, and employees free, safe and harmless from any claim or demand for damages resulting from the work covered by this permit.
The Applicant hereby acknowledges that they have read and understand both the front and back of this permit, and that they will inform their
contractor(s) of the information.
ACCEPTED: S U~ L
(Applicant/Permitt e) (Sign) Date
NOTES: All work shall conform with the attached approved plans and all applicable Campbell Standard Details and Conditions and applicable
insurance requirements.
The Contractor must have this permit and approved plans and must arrange to meet with the Public Works Inspector at the site at least two days
before starting work. Notice must be given to Public Works at least 24 hours before restarting any work.
Per Section 4215 of the Government Code this permit is not valid for excavations until Underground Service Alert (USA) has been notified and the
inquiry identification number (Ticket No.) has been entered hereon. USA Phone: 1-800-227-2600. Ticket No.:
Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any and all
damages arising out of the design, installation or condition of private improvements in the public right-of-way.
SPECIAL PROVISIONS
1. Prior to any work, the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way, which shall be
recorded.
2.
3.
STANDARD AMOUNT RECEIPT N0.
SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) $ `~~ 2~i ~ `Z~-1(~
R-1 PERMIT FEE $ ,~ _
APPROVED FOR ISSUANCE: ~_ ~ ,l~
for ~ ity Engineer Date
Permit Expires 6 Months after Date of Issuance.
,-- - ~ - ~
~, _ <'
GENERAL PERMIT CONDITIONS
1. Payment of a security to insure faithful performance and completion of the work is required. This security is refundable upon
completion of the work and written acceptance by the City.
2. A one-year maintenance period for all work is required. Such period will begin on date of acceptance by the City. It is the applicant's
responsibility to remove and replace unacceptable improvements within the one-year maintenance period.
3. Refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work by the City.
4. Submit projeil schedule 10 days prior to proposed start of work. Special provisions maybe required for work within City facilities
and downtown Campbell.
5. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be
made in writing to the Permittee.
6. Maintain safe pedestrian and vehicular crossings and free access to private driveways, fire hydrants and water valves.
7. Replace as directed by the City Engineer any damaged or removed improvements in accordance with City Standards and
Specifications at the sole expense of the Permittee.
8. Sawcut for all PCC and AC removals. All PCC removals shall be to nearest scoremark and shall be doweled to existing improvements.
9. Adequate signing and barricading is required on thejob site. Failure to provide such signing and barricading as specified by the City
Engineer may result in the City's providing such signing and barricades and charging the cost to the Permittee.
10. The Contractor or Permittee will have a supervisory respresentative available for contact on the project at all times during
construction.
11. This permit shall be kept at the site of work and must be shown to any authorized representatives of the City of Campbell or any
law enforcement officer upon demand.
12. No storage of materials or equipment will be allowed near the edge of pavement, within the traveled way, or within the shoulderline,
which would create a hazardous condition to the public.
13. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other
work for which a separate permit maybe required, nor does it relieve the Permittee of any obligation to obtain any other permit
required by law.
14. This permit does not release the Permittee from any liabilities contained in other agreements or contrails with the City and any other
public agency.
15. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon.
16. Prior approval of inspeilor is required for any work done after normal working hours, on weekends or holidays and may require
reimbursement of inspection costs at the current overtime rate.
17. Call back (call out) due to emergencies regarding this permit shall be at the current overtime rate with a three (3) hour minimum
charge per occurrence.
18. If the public interest requires a modification of, or a departure from, the plans and specifications, the City shall have the authority to
require or approve any modification or departure and to specify the manner in which the same is to be made for City-owned or
maintained facilities.
19. Pursuant to Chapter 14.02 of the Campbell Municipal Code, applicant shall not cause to be discharged any material into the
municipal storm drain system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by
the Santa Clara Valley Urban Runoff Pollution Prevention Program.
Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above
conditions. ~~~~ ~ ~w /
~~ 1 ~ ~j
Applicant Date
J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf
Rev. 03/13
Page 1 of 2
Syed Wahidi
From: Jeff and Emilie Kriech [kriech@att.net]
Sent: Friday, May 17, 2013 11:42 AM
To: Syed Wahidi
Subject: Re: Permit to Widen Driveway
Attachments: 001.jpg; 002.jpg
Attached is a scan of my home insurance policy. Let me know if this is what you needed.
Jeff
From: Syed Wahidi <syedw@cityofcampbell.com>
To: kriech@att.net
Cc: Joy Francois <JoyF@cityofcampbell.com>; JoAnna Thomason <joannat@cityofcampbell.com>
Sent: Tue, May 14, 2013 11:47:42 AM
Subject: RE: Permit to Widen Driveway
H i Jeff,
For the widening of driveway entrance (dwy approach), City will first
inspect the site to see if widening can be allowed. Then we can issue a
permit.
Each homeowner resident gets one free permit every two years for such
work.
Feel free to call me if you want to proceed. Thanks
Syed Wahidi ~ Public Works Inspector
City of Campbell ~ Public Works Dept.
syedw@cityofcampbel I. com
( 408.866.2165 begin_of_the_skype_highlighting 408.866.2165
end_of the_skype_highlighting ~ 7 408.376-0958
70. N. First Street ~ Campbell, CA 95008
www.CityofCampbell.com
-----Original Message-----
From: Home [mailto:kriech@att.net]
Sent: Saturday, May 11, 2013 7:27 AM
To: Kathleen Overman
Subject: Permit to Widen Driveway
Hi Kathleen,
5/17/2013
PUBLIC WORKS DEPARTMENT LANU utvtwrmtrv t
Effective July 1, 2012
TO: City Clerk PUBLIC WORKS FILE NO. ~ ~ C- ~ ° f 3 "- UCvG~2
PROPERTY ADDRESS 12~ UC `~ Imo' ~ ~~' ~
Please collect &_ recept for the following monies:_ _ __
ACCT-ITEM _ AMOUNT
LAND DEVELOPMENT _
_ - -
ncroac->~Permlt Action ~e
Non-Utili Encroachment Permit Ma'or ?$10 000 $370.00
Minor Encroachment Permit <s~o 000 $210.00
Initial R-1 Permit N/C
Subse uent R-1 Permits within Two Year Period $205.00
Street Tree Plantin /Removal N/C
2203 $500 er Tree Plantin De osit Re uired $500.00/tree
2203 Plan Check De osit 2% of En ineer's Estimate $500.00 min
and R-1 Permits
Utilit no deposit required
4722 y
Gradin & Draina a Plan Review
Sin le Famil Lot $260.00
Site < 10 000 s.f. $780.00
Site z 10 000 s.f. < 0.5 Acre $1 040.00
Site ? 0.5 Acre $1 560.00
4722 NPDES Review C3 Re uirements
rojects not required to submit numeric sizing
For $150 00
p
For protects required to submit numeric sizing
Ft to 1 Acre
Im envious Area 10 000 S 00
$650
.
Im envious Area 1 Acre or more .
$850.00
Plan Check & Ins ection Fee Non-Utili
4722 En r. Est. u to $250 000 14% of En ineer's Estimate
**2203 En r. Est. z$250 000 Actual cost +20% Admin Overhead
Min $35 000 De osit
2203 Emer enc Cash De osit 4% of En r. Est.* $500 min/$10 000 Max
2203 Faithful Performance Securi FPS 100% of ENGR. EST.*
2203 Labor and Materials Securi 100% of ENGR. EST.*
4721 Storm Drainage Area Fee Per Acre R-1 $2 120.00
(Multi-Res $2 385.00)
All Other $2 650.00
4722 Parcel Ma 4 Lots or Less $3 700.00 + $80/lot
4722 Final Tract Ma 5 or More Lots $4 500.00 + $110/lot
2203 Monumentation Securi 100% of ENGR. EST.
4920 Parkland Dedication Fee 75%/25% Due U on Cert. of Occu anc
4722 Lot Line Ad'ustment Includes Certificate of Com liance $1 750.00
4722 Vacation of Public Streets & Easements $2 340.00
4722 Certificate of Com liance $1 765.00
4722 Certificate of Correction $520.00
4722 A eat Filin Fee $200.00
4722 Nota Fee er si nature $10.00
4722 Assessment Segregation or Reapportionment
First Split
$830.00
Each Additional Lot $260.00
511.7424 Postage
U~ _ __ _ ---
-- -
Other Please S eci
*Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. t~-~
**Actual Cost Plus 20% Overhead (Nonrr-Interest bearing deposit) TOTAL $ ./ ~'~
NAME OF APPLICANT ~t'T r l~
NAME OF PAYOR JQ-~ ~ ~~ PHONE 4O~ - ~S-2~`~ 2
ADDRESS ~~--~ ~ S, wov~Q ,~~ S~ ti .Ses.a- C~ ZIP °I S (2 8
FOR IVED BY t~
RECE _ --
CITY CLER
ONLY K ~
___-_
Date Receipt # ~~~
{° _
,.,. -
Date/ dnitlals
J.rFORMS\Tanp4twV~Emini.trtlrvsVt.crp Form Wk DwNOprrien112-1J
Page 2 of 2
I'm not sure if you can answer my question or not, but you can probably
point me in the right direction. I live in Campbell and I'd like to
widen my driveway including the entryway at the street. Would I be able
to get a permit for that?
Thanks,
Jeff Kriech
Sent from my iPad
*** eSafe 8 scanned this email for malicious content ***
*** IMPORTANT: Do not open attachments from unrecognized senders ***
5/17/2013
R, 7p.
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P QO\~~S
1 ~ R S mob` a
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6 OI
~~ MECHANICAL
R SEPARATOR CONSTRUCTION
JOINT
SIDEWALK
SEE NOTE 5 WEAKENED
PLANE JOINT
SIDEWALK ~P~ OR1 ~8 T W pIET
0 2' DEEP
~~ .
WEAKENED PLANE JOINT ~ P
OR CUT JOINT 1/8" WIDE, ~,\~~
2" DEEP 0" \/"
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.~ ~`\C\
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R 10'-0"
4'-6" 5'-6" 2'-0"
+10% MAX 6
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'.•:r. ..~'. •. •:r ..:r.. ..•:r. • '.•.r. • .
-6% MAX •'•..:o.:: • ..~u:: -: •ti:a:: -:'. •...a,. .
6" CLASS A CONCRETE, TYP. ~ ~ ~ •~ • 6"
6" CLASS 2 AGGREGATE BASE, TYP. "~•~•.•a.~.'~,~.•.•.a.'.~.;~.•.•.a.
NOTES SECTION A-A DOWEL
1. WHEN THE DRIVEWAY IS NOT POURED AT THE SAME TIME AS THE CURB AND GUTTER, 12" OF N0. 4 REBAR AT 4'
INTERVALS SHALL BE INSTALLED AS SHOWN (REBARS TO BE BENT DOWN AND COVERED UNTIL USED).
2. SCORE MARKS SHALL NOT EXCEED 4'-O" O.C., AND USE MECHANICAL SEPARATOR AT EVERY OTHER SCORE MARK.
3. DRIVEWAY APPROACHES (EXCEPT SINGLE FAMILY) SHALL HAVE A 6"X6"X10/10 WELDED WIRE FABRIC 3" ABOVE
BOTTOM OF CONCRETE.
4. DOWEL ALL NEW CONCRETE IMPROVEMENTS TO EXISTING CONCRETE IMPROVEMENTS.
5. AT LOCATIONS WHERE NEW SIDEWALK ENDS AND MEETS AN EXISTING SIDEWALK, THE NEW SIDEWALK SHALL
TRANSITION TO MEET THE EXISTING SIDEWALK AS DETERMINED BY THE CITY ENGINEER.
cA CITY OF CAMPBELL REV. DATE BY SCALE:
OF ~A
PUBLIC WORKS DEPARTMENT
~~ - ~ . ~~ Residential N.T.S.
"rs;~ ~ DRAIPN HY: DATE oz~o4 Driveway Detail DETAIL
•'.q p.9 •~ ~ -
' ~ Oa°jy ~ CHECKED BY: DATE
'~~, c1~~ APPxovED HY: (Attached Sidewalk ) N0.
~RCHAR9 H~ _ 6N ~~ J:/Drawings/Std_Details/D15 D 15
Allstate Insurance Company
RENEWAL
Deluxe Plus Homeowners
Policy Declarations
Summary
NAMED INSUREDS) YOUR ALLSTATE AGENT IS: CONTACT YOUR AGENT AT:
Jeffrey Kriech Robert Varich {408) 257-1234
1280 S Ba wood Ave 1125 Saratoga Ave
San Jose CA 95128-3102 San Jose CA 95129
POLICY NUMBER POLICY PERIOD PREMIUM PERIOD
9 04 417895 G5/30 Begins on May 30, 2013 May 3D, 2013 to May 30, 2014
at 12:01 a.m. Pacific Time at 12:01 a.rn. Pacific Time
and continues until cancelled
LUCATiUN OF PRUPERTY INSURED
1280 S Bayvvood Ave: San Jose, CA 95128-3102
MORTGAGEE
• WELL5 FAR60 BANK NA 708 ITS SUCCESSORS
&!OR ASSIGNS
P 0 Box 5708 Springfield OH 45501-5748 Lnaa#J0335J58t58
Total Premium for the Premium Period ; t'oui bill v/iil b2 marred saparateiyJ
Premium for Property Insured S1.D46.00
TOTAL 51,046.00
illllll11911111111111l1111111111111111111111111111191 ~°~'
Allstate Insurance Company
Policy Number. 9 04 417995 05,30 Your Agent: Robert Uarich (d08) 257.1234
For Premium Period Beginning: May 30, 2013
POLICY COVERAGES AND LIMITS OF LIABILITY
COVERAGE AND APPLICABLE DEDUCTIBLES LIMITS OF LIABILITY
]See Policy for Applicable Tarms, Conditans and Exclusions]
Dwelling Protection - uvith Building Structure Reimbursement Extended Limits 5404,860
• 5500 All Peril Deductible Applies
Other Structures Protection 540,488
• 5500 All Peril Deductible Applies
Personal Property Protection -Reimbursement Provision 5303,660
• $500 All Peril DetluctibleApplies
Additional Living Expense Rafer to Policy
Family Liability Protaction $300,000 each occurrence
Guest Medical Protection ~ 51;000 each person
Extended Coveraga on Jewelry, Watches and Furs $20,000 per occurrence
$4,000 per item
• S500 AH Peril Deductible Applies
Building Codes Refer to Policy
Workers' Compensation and Employers' Liability Statutory/See Form
Coverage for Residence Employees
The limit of liability for this structure (Coverage A-Dwelling Protection) is based on an estimate of the cost to
rebuild your horne, including an approximate cost for labor and materials in your area, and specific information
that you have provided about your home.
This policy does not cover earth movement including earthquake
You have elected not to purchase a CEA earthquake policy
DISCOUNTS Your pramium reflects the follovwing discounts on applicable coverage(s}:
Claim Fraa 15 % Home and Auto 20 °o
Protective Davice Rata Applied
RATING INFORMATION
The d~p~elling is of Frama construction and is occupied by 1 family
Pa e 2
CITY OF CAMPBELL
vENDOR No. 10012222
CHECK No. 242503
Account Purettase prder Invoice Number Autount Descri lion
101 2203 CR071113 500.00 DEPOSIT REFUND
10012222 JEFFREY KRIECH
o~'~^~rA CITY OF CAMPBELL 11-24 CHECK DATE CHECK NO.
WELLSFARGO BANK, N.A.
y' ~ 420MONTGOMERY STREET 1210 0722/13 242503
~ t~ 70 NORTH FIRST STREET
C'+ SAN FRANCISCO, CA 94104
CAMPBELL, CALIFORNIA 95008
!,o o AMOUNT ~ *******500.00*
''~ ~~ ~
.oR~~Jenp~ VOID AFTER 90 DAYS
~,
D
PAY THE SUM OF FIVE HUNDRED DOLLARS & ZERO CENTS m'
m
r
r
To THE JEFFREY KRIECH
ORDER 12 8 0 S BAYWOOD AVE ~~~ ~~
SAN JOSE CA 95128
oF~_ L/ ' ' _ o~~~~
11'24250311' ~:L2L000248~: 4~2L8554L511'
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
c
v
JEFFREY KRIECH
1280 S BAYWOOD AVE
SAN JOSE CA 95128
Of CA`l1
A~
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Transmittal
Name: JoAnna Thomason
Title: Office Assistant
City of Campbell
Department of Public Works
70 North First Street
Campbell, CA 95008
Phone: (408) 866-2701
Fax: (408) 376-0958
E-Mail: Joannat@cityofcampbell.com
To: Jeffrey Kriech Date: July 23, 2013
Re: Refund of Construction Deposits. Enc Permit #2013-00092
^ Urgent ^ For Review ^ Please Comment ^ Please Reply ~7 For Information & Use
Enclosed please fmd a check in the amount of $500.00 representing your Faithful Security Deposit
for the Encroachment Permit referenced above.
Thank ---_.~...
JoAnna Tho son
Office Assistant
cc: Project File No. ENC2013-00092
J:\JoAnnaT\Deposit refunds\CHECK REQUESTS\Ck Transmittals\Use this.DOC (Rev. 03/08)
os'~A~~~
~~ ~~
v
.~
CITY of CAMPBELL
Public Works Department
July 24, 2014
Mr. Jeffrey Kriech
1280 S. Baywood Ave.
San Jose, CA 95128
SUBJECT: PERMIT NO. ENC 2013-00092
1280 S. Baywood Ave..
ONE YEAR MAINTENNACE INSPECTION AND ACCEPTANCE
Dear Mr. Kriech:
The City of Campbell has made the final one year maintenance inspection of the subject
Public Works improvements and finds that no remedial work is required.
Your warranty requirements and any surety, therefore, are hereby released.
Sincerely,
~, _ ____
Syed Wahidi
Public works Inspector
Cc: Permit #ENC 2013-00092
70 Noah First Street Campbell, California 95008-1423 ~rei. 408.866.2150 enx 408.376.0958 ~rv~ 408.8(6.2790
~~4 CA~~
~'~ ~d'
J
"~ a n~i~~
CITY of CAMPBELL
Public Works Department
July 10, 2013
Mr. Jeffrey Kriech
1280 S. Baywood Ave.
San Jose, CA 95128
SUBJECT: PERMIT NO. ENC 2013-00092
1280 Baywood Ave., San Jose, CA
FINAL INSPECTION AND ACCEPTANCE
Dear Mr. Kriech:
The City of Campbell has made a final inspection of subject Public Works improvements
and finds the work to be acceptable and in conformance with City standards.
Accordingly, the City Engineer accepts the improvements.
The one year maintenance period stated in the permit begins as of the date of this
acceptance letter. The permittee is responsible for the repair and/or replacement of any
defective work or failures that occur within one year. The City will inspect the
improvements within one year and notify you, in writing, whether or not any repairs are
required.
Your Faithful Security deposit of $500.00, plus any interest due, is now being processed
and will be sent to you under separate cover.
If you have any questions, please call me at (408) 866-2165.
Sincerely,
Syed Wahidi
Public works Inspector
Cc: Inspector file
Permit #ENC 2013-00092
?0 North First Street Campbell, California 95008-1423 re. t. 408.866.21 50 rnx 408.376.0958 inn 408.86(1.2790
CITY OF CAMPBELL
PUBLIC WORKS DEPARTMENT
CLEARANCE FOR FINAL INSPECTION
AND ACCEPTANCE LETTER
Encroachment Permit#: ENC 2013-00092
Name: Jeffrey Kriech
Property Address: 1280 S. Baywood Ave., San ]ose, CA 95128
Date of Final Inspection:
On File: ^ Bonds ^ CD ^ Cash
~. Faithful Performance: $ 500.00
^ Labor and Material: $
^ Construction Cash Deposit to be released: $
^ Other overdue deposits to be released (Description):
Processed by:
Reviewed by:
Reviewed by:
A "nistrator
Inspector
Lan velopment Engineer
~~l~l I
~ i„
~~10~13
J:VoAnnaT~Deposit refunds\CHECKLISTS\Baywood.Kriech.doc (Rev. 10/11)
To: Finance Director
Check Payable To:
Address -Line 1:
Line 2:
City:
Description:
Account Number:
Account Number:
Account Number:
(Finance Dept only)
Total Payable:
Refundable Deposit Check Request
~~\~=
Jeffrey Kriech ~ ~'
4
1280 S. Baywood Ave. ~"
San Jose
101.2203
101.540.7448
Interest Earned
Title: Accounting Clerk II Date:
Title: Accountant Date:
For Handling Che
Purpose: Refund of Faithful Performance Security Deposit
Voucher #: Permit #: ENC 2013-00092
Receipt #: 248246 Date: 5/17/2013
Requested by: r' Title: PW Inspector Date:
Syed Wahidi
Approved by: «~ ~--~"` Title: Sr. Civil Engineer Date: "L
Lisa a sen
Finance Dept Only:
Verified by:
Approved by:
ial Instructi
Mail AS IS: ,F° ~ Mail in Attached Envelope:
Return'To: JoAnna Thomason
(Name)
Other:
(Department)
!3
State: CA Zip: 95128
Amount: $500.00
Amount:
Amount:
(Finance Dept only)
(Exact Amount)
Interim Check:
Needed By:
Public Works
f/n: Forms/excel/chkreq - Revised OS/00
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NOTES SECTION A-A DOWEL
1. WHEN THE DRIVEWAY IS NOT POURED AT THE SAME TIME AS THE CURB AND GUTTER, 12" OF N0. 4 REBAR AT 4'
INTERVALS SHALL BE INSTALLED AS SHOWN (REBARS TO BE BENT DOWN AND COVERED UNTIL USED).
2. SCORE MARKS SHALL NOT EXCEED 4'-0" O.C., AND USE MECHANICAL SEPARATOR AT EVERY OTHER SCORE MARK.
3. DRIVEWAY APPROACHES (EXCEPT SINGLE FAMILY) SHALL HAVE A 6"X6"X10/10 WELDED WIRE FABRIC 3" ABOVE
BOTTOM OF CONCRETE.
4. DOWEL ALL NEW CONCRETE IMPROVEMENTS TO EXISTING CONCRETE IMPROVEMENTS.
5. AT LOCATIONS WHERE NEW SIDEWALK ENDS AND MEETS AN EXISTING SIDEWALK, THE NEW SIDEWALK SHALL
TRANSITION TO MEET THE EXISTING SIDEWALK AS DETERMINED BY THE CITY ENGINEER.
og cA,~ CITY OF CAMPBELL REV. DATE BY SCALE:
~-~ 'O~,F, PUBLIC WORKS DEPARTMENT Residential N•T•S•
..~so~ r DRAWN HY: DATE oz~o4 Driveway Detail DETAIL
.~.qp,a q.;•.
• ••~'°'Dd°~'• CHECKED BY: DATE (Attached Sidewalk ) N0.
~~~ cti~''` APPROVED HY:
~RCg~g9 MCITY ENGII~iE R~ J:/Drawings/Std_Details/D15 D 15
/~~~ MECHANICAL -~
~'~ SEPARATOR
Allstate Insurance Com~,any
Policy Number. 9 04 41 895 05(30 Your Agent: Robett llarrch fd08) 257-1234
For Premium Period Beginning: May 30, 2013
POLICY COVERAGES AND LIMITS OF LIABILITY
COVERAGE AND APPLICABLE DEDUCTIBLES LIMITS OF LIABILITY
t5ze Poricy forRpplicablz Tzrms, Conditans and Exclusions]
Dwelling Protection -with Building Structure Rairnbursement Extended Limits 5404,880
• $500 All Peril Deductible Applies
Other Structures Protection 540,488
• 5500 All Peril Deductible Applies
Personal Property Protection -Reimbursement Provision 5303,b60
• 5500 All Peril Deductible Applies
Additional Living Expense Refer to Policy
Family Liability Protection $30D,OOD each occurrence
Guest Medical Protection ~1;DU0 each person
Extended Coverage on Jewelry, Watches and Furs 520,000 per occurrence
$4,000 per item
• S500 All Peril Deductible Applies
Building Codes ~ Refer to Policy
Workers' Compensation and Employers' Liability Statutory/Sea Form
Coverage for Residence Employees
The limit of liability for this structure (Coverage A-Dwelling Protection) is based an an estimate of the cos# to
rebuild your home, including an approximate cost for labor and materials in your area, and specific information
that you have provided about your home.
This policy does not cover earth movement including earthquake
You have elected not to purchase a CEA earthquake policy
DISCOUNTS Your premium reflects the follotwing discounts on applicable coverages};
Claim Free 15 % Home and Auto 20 °'°
Protective Device Rate Applied
RATING INFORMATION
The dtFlelling is of Frame construction and is occupied by 1 family
Page 2
ivo°m~ti:n s ul
~Ilstate Insurance Company
RENEWAL
Deluxe Plus Homeowners
Policy .Declarations
~'ummery
NAMED INSUREDS) YOUR ALLSTATE AGENT IS: CONTACT YOUR AGENT AT:
JeftYey Kriech Robert Varich (408 257-1234
1286 S Ba~ wood Ave 1125 Saratoga Ave
San Jose CA 95128-3102 San Jose CA 95129
POLICY NUMBER POLICY PERIOD PREMIUM PERIOD
9 04 417895 05/30 Begins on May 30, 2013 May 30, 2013 to May 30, 2014
at 12:01 a.m. Pacific Time at 12:01 a.m. Pacific Time
and continues until cancelled
LOCATION OF PROPERTY INSURED
1280 S Bayvaood Ave.. San Jose, CA 95128-3102
MORTGAGEE
• WELLS FAR6O BANK NA 708 ITS SUCCESSUI3S
&!OR ASSIGNS
P 0 Box 5708 Springfield OH 45501-5708 r oa~~>~J1733505868
TOtel Premium fvr the Premium Period ; >'our 6ii1 vriii he rraai;ed separately)
Premium for Property Insured $1,046.00
TOTAL --------__~__._..-_.,___--
51,046.~0
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