ENC2014-00091Print Form
CITY OF CAMPBELL R-7 ENCROACHMENT PERMIT Permit No. ~C '~,. )~I - ~o `11
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 `1 IS - 4
Campbell, CA 95008 Application Expiration
Ph. (408) 866-2150 ISSUED: ~' 15 ~ ~ ~ Date ~ ~~ IS~ I ct
Fx. (408) 376-0958 Permit Expiration Date: 115 Irj APN ~l ~y CTiO 1 ~~
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 ~j ~ ~ ~ (.-}~'ZC ~ /~ K S ~ ,
i ' YYrrvl r•'H f
B. Nature of Work: 1 h 5~~~.,' ~ ~~~ t'~'> I) c' Vl 1 h c~ CC t,c, y' ~h S }c' ~ -+~ I~rc vt°mcK~
C. Attach three (3) copies of a drawing showing the location, extent and dimensions of the work. The 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: ~,~\ ~-,~' ,~ \~ 1 V \G r,` O / ~_~ Telephone: ~ O j3 _ ~ cy - ~ j '~'~
Address: ~ 1 ~ \!s1 ~ \• ~ C ~~ ~~~ C,q.,,~ ~' " LL_ c~~
E-Mail Address: yy~ cy ~. ~,~~~ ~ ~ r~ Vv~~St~ 1 . C vv/~
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:
,- ~ -~
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 4216 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, f~~-r~c~~iz T~ G~ ~'-cz~( 1~~s~ r~~ss ~[C,
3.
STANDARD AMOUNT RECEIPT NO.
SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) $ ZOCSO 27 3~'S
R-1 PERMIT FEE $
APPROVED FOR ISSUANCE: ~ ~ I ~ I
for Ci ngineer Date
Permit Expires 6 Months after Date of Issuance.
f ~' `\
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 project 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 the job 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 may be required, nor does it relieve the Permittee of any obligation to obtain any other permit
required bylaw.
14. This permit does not release the Permittee from any liabilities contained in other agreements or contracts 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 inspector 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., _
Applicant
~~15~1`t
Date
J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf
Rev. 02/14
~~I~~'®
TO BE RECORDED WITHOUT FEE ~~' `i ~ 9 ~~~~ DOCUMENT : 2 2 5 810 0 .
SECTION 6103 GOVERNMENT CODE
AT THE REQUEST OF CITY OF CAMPBEL~I-~ CLERK' ~ ®~~~~
Recording Requested By: ~
City of Campbell
70 North First Street
Campbell, CA 95008-1423
After Recording Return To:
Pages b
Fees.... ~ No Fees
Taxes...
Copies..
AMT PAID
REGINA ALCOMENDRAS
SANTA CLARA COUNTY RECORDER
Recorded at the request of
City
City Clerk
City of Campbell
70 North First Street
Campbell. CA 95008-1423
APN: 41440079
Address: 1816 White Oaks Road, Campbell CA 95008
RDE # 001
4/30/2014
10 0o AM
(Space Above for Recorder's Use Only)
AGREEMENT FOR PRIVATE IMPROVEMENTS
IN THE PUBLIC RIGHT-OF-WAY
In consideration for granting permission to construct improvements in the public right-of--way,
Hrayr H. Moroyan (property owner) enters into this Agreement with the City of Campbell. The
improvements contemplated under this permit are for the benefit of the real property commonly known
as 1816 White Oaks Road. The City of Campbell grants such permission to install Extension of Brick
Pavers under Encroachment Permit No. ENC2014-00091 All conditions of Encroachment Permit
ENC2014-00091 remain in full force and effect.
The property owner shall be solely responsible for maintaining the improvements in a good and
safe condition at all times; and the property owner shall indemnify, defend, and hold harmless the City
of Campbell, its officers, officials, agents, volunteers, employees and attorneys from any and all claims,
actions, losses, liabilities and costs (including reasonably incurred attorney's fees) arising out of or
connected with, or alleged to arise out of or be connected with the installation, design or condition of the
improvements, except for any claims, actions, losses, liabilities and costs proximately caused by the sole
negligence or willful misconduct of the City of Campbell, its officers, officials, agents, volunteers,
employees or attorneys. This provision is intended to be the dispositive of all rights of indemnity and
contribution between the parties, and property owner waives and releases ary and all ,-i iT .ts to inde,-rlnity
or contribution from the City of Campbell, in law or equity, arising out of, or connected with any and all
claims, actions, losses, liabilities and costs (including reasonably incurred attorney's fees) for which
property owner is obligated under this paragraph to provide indemnity or defense to the City of
Campbell, its officers, officials, volunteers, employees or attorneys.
The City, in its sole discretion, may revoke the rights granted under Encroachment Permit No.
ENC2014-00091 and remove the improvements installed under Encroachment Permit No. ENC2014-
00091 at any time, without liability to the property owner, or require that the improvements be
removed, and property owner shall have no right to compensation from City in any form.
J:\FORMS\Templates\P.greements & Contracts\Private Improvements Agreement Rev 10 13.doc (Rev. 10/13) Page 1 of 6
In the event that Owner fails to reimburse the City for the costs of removing the improvement
("default") as required by this Agreement, the Ciry shall have and may execute the absolute right, at the
City's option and without demand or notice to Owner, to claim and impose a lien, attached as Exhibit A
and incorporated herein by this reference ("Lien"), on said real property {alsa referred to herein as
"Collateral"). City's failure to exercise this option will not constitute a waiver of the right to exercise it
in the event of any subsequent default.
(a) Amount of Lien: The Lien shall be for the entire amounts then owing under this Agreement.
(b) Recordation: City is authorized to record the Lien in the appropriate Recorder's Office(s).
(c) City shall have full authority to perform all acts and things that City may consider necessary
or advisable to impose, maintain and enforce the Lien.
(d} Debtors' Warranty: OWNERS WARRANT that they are the ov.ners of the Collateral and
Owners have the right to make this Lien Agreement.
(e) Debtors Covenants: Owners agree:
(i) To pay City all amounts payable pursuant to this Agreement on or before the due
date when due and payable, and to perform all terms of this Agreement;
(ii) To defend the Collateral against claims and demands of all persons and entities;
(iii) To keep the Collateral in good condirion; to perform other acts that may be
necessary to preserve the Collateral and protect the Collateral against
unreasonable loss and all hazards, and;
(iv) To immediately notify the City in writing when Owners become aware of any
event that substantially affects the value of the Collateral, or the rights and
remedies of City in relation to the Collateral.
{f) Prohibitions: Without the prior written consent of the City, Owners will not pemut any Liens
or security interests (other than the City's Lien) to attach to the Collateral; pemvt the
Collateral to be levied on under legal process; dispose of the Collateral; or pernlit anything to
be done that may impair the value of the Collateral or of the Lien, which is the subject of this
Agreement.
(g) Notices: Any notice, demand or request required hereunder, or by law, shall be given in
writing (at the addresses set forth below} by any of the following means: {a) personal service;.
(b} facsimile; (c) overnight courier or delivery service; or {d) registered or certified, first
class U.S. mail, return receipt requested.
6tND C: - SNE ;?RlCIncAL
ON FlI_ " _
A'~S ~ .'~AINF 6Y6EE, qTY CLERK
..:: nr !" ~: P t.l.. CA
~ ~ ~C~
J:\FORMS\Templates\Agreements & Contracts\Private Improvements Agreement Rev IO 13.doc (Rev. 10(13) Page 2 of 6
Property owner agrees to maintain homeowners or general liability insurance with a limit of at
least $100,000 for damages arising from the installation, design or condition of the improvements.
This provision shall run with the land and be binding on the property owner's successors.
Executed this ~_ day of t~~ ~'}~~1\ , 20~,_._.
~erty weer \
Property Owner
(Attach Notary Aclatowledgment
For All Parties)
CITY 4F CAMPBELL, a municipal
Corporation
~~~~
Todd Capurso
Public Works Director, City of Campbell
ATTES
~f
fi'` ~,a` ~
Anne Bybee, City erk
J:\FORMS\TemplateslAgreements & Contracts\Private Improvements Agreement Rev 14 13.doc (Rev. 10/13) Page 3 of 6
CALIF ..1RNIA ALL-PURPO ~~
CERTIFICATE OF ACKNOWLEDGMENT
State of California
Count of
On ,~~~; ~ ~5 , Zu 14 before me,
personally appeared t~ '( ~~`y ~
(Here insert name and title of the
,~`~
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to
the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf o=
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
hand and official seal.
Signature of N
(Notary Seal)
JOAAi~11~N T! OMAN SON~~
Conwnislbn +~ 1 S306B2
Notuit Pubtfc - CslMornili ~
Sorts Clan County
Comm. E rss Mu 2@.2015
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of a,(tt~ached document]
-'M~Y~`Jr?ww"~`~`.~ tYl t"i,~b\tCt Y*~ f.' ~<..~~
(Title or description of attached document continued)
Number or Pages Document Date a 1.5" ~ I ~
(Additional information)
CAPACITY CLAIMED BY THE SIGNER
^ Individual (s)
^ Corporate Officer
(Title)
^ Partner(s)
^ Attorney-in-Fact
^ Trustee(s)
^ Other
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to tha[ document. The only exception is if a
document is to be recorded outside of California. In such instances, anv alternative
acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary ir,
California (i. e. certifying the authorized capacity of the signer]. Pleasr check fire
document carefully for proper notarial wording and attach this form if required.
• State and County information must be the State and County where the document
signer(sj personally appeared betbre the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within leis or her
commission followed by a comma and then your title (notary public].
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
#te/she/the}- is /are) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording,
• The notary sea] impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i. e. CEO, CFO, Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com
Exhibit A
Recording Requested By:
City of Campbell
When Recorded Mail To
City Clerk
City of Campbell
70 N. First Street
Campbell, CA 95008
~,pN: Space above this line for Recorder's use only
Address:
CLAIM OF LIEN
I, MICHELLE QUINNEY, City Engineer for the City of Campbell, a Califomia Municipal
Corporation ("City"), do hereby certify:
A. On or about , 20_, ("Debtors"}
executed an Agreement for Private Improvement with the City of Campbell ("Agreement").
B. The Agreement was recorded in the Santa Clara County Recorder's Office on or about
20 Document Number
C. The Agreement allowed the Debtor's to provide, construct, and/or install certain private
improvements in front of their property at ,Campbell, California; at their
own costs and expense. Pursuant to the terms of the Agreement, the Debtors expressly agreed that if
they failed to comply the work the Agreement; the Ciry was authorized to remove said improvements
and recover the full cost and expense thereof from the Debtors or their successors.
D. The Debtors did not remove the improvements after being notified to do so. Therefore,
the Ciry removed said improvements.
E. In , 20^, the City informed the Debtors about the improvements
that would be removed pursuant to the Agreement.
F. The City subsequently completed the work. On or about
City sent the Debtors an invoice for said work in the amount of $
20 ,the
G. Pursuant to the terms of the Agreement, the Debtors expressly agreed that the City is
authorized to, at the City's option and without demand or notice to the Debtors, immediately claim and
impose a lien on the real property commonly known as ,Campbell, California,
APN Number ,for the entire amounts then owing under, or incurred
pursuant to, the Agreement, including without limitation, the entire unpaid principal amount.
J:\FORMS\Templates\Agreements & Contracts\Private Improvements Agreement Rev 10 ] 3.doc (Rev. 16/13) Page 5 of 6
WHEREFORE, the City of Campbell, A California municipal corporation, pursuant to the
Agreement, hereby claims a lien upon the work of improvement and the land upon which it is situated,
namely, the real property commonly known as Campbell;
California, APN Number , in the amount of $ _
and said amount shall constitute a lien against said property until paid in full.
IN WITNESS WHEREOF the City of Campbell, California, a California Municipal Corporation,
has duly authorized the undersigned to execute this instrument in its name.
Dated:
By:
for the CITY OF CAMPBELL, a California municipal corporation
(Notary Acl~towledgement Required for Signatures)
INFORMS\Templates~Agreements & Contracts\Private Improvements Agreement Rev 10 13.doc (Rev. ]0/13) Page 6 of 6
PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT
Effective July 1, 2013
TO: City Clerk PUBLIC WORKS FILE NO. pp~~ C ~ (~ - G C7f ~I I
PROPERTY ADDRESS I V ~~ W I•~ l7 - D~ jGS /~UZ
Please collect & recei t for the followin monies:
'ACCT. ITEM
LAND DEVELOPMENT
__ AMOUNT
_
ncroac ment ermit Ication ee
Non-Utili Encroachment Permit Ma'or ?$10 000 $377.00
Minor Encroachment Permit <$~o,ooo $215.00
Initial R-1 Permit N/C
Subse uent R-1 Permits within Two Year Period $209.00
Ins ection Fee Minimum Char e er Location $377.00
Street Tree Plantin /Removal N/C
2203 $500 er Tree Plantin De osit Re wired $500.00/tree
2203 Plan Check De osit 2% of En ineer's Estimate $500.00 min
Utility and R-1 Permits no deposit required
4722 Gradin & Draina e Plan Review
Sin le Famil Lot $265.00
Site < 10 000 s.f. $795.00
Site ? 10 000 s.f. < 0.5 Acre $1 060.00
Site ? 0.5 Acre $1 590.00
4722 NPDES Review C3 Re uirements
For projects not required to submit numeric sizing $153 00
For projects required to submit numeric sizing
Im ervious Area 10 000 S . Ft to 1 Acre $663.00
Im ervious Area 1 Acre or more $867.00
Plan Check & Ins ection Fee Non-Utilit
4722 En r. Est. u to $250 000 14% of En ineer's Estimate
"2203 En r. Est. ?$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.' c~
2203 Labor and Materials Securit 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 $3 775.00 + $82/lot
4722 Final Tract Ma 5 or More Lots $4 590.00 + $112/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 Hance $1 785.00
4722 Vacation of Public Streets & Easements $2 386.00
4722 Certificate of Com Hance $1 764.00
4722 Certificate of Correction $530.00
4722 A eal Filin Fee $200.00
4722 Nota Fee er si nature $10.00
4722 Assessment Segregation or Reapportionment
First Split
$846.00
_
Each Additional Lot $265.00
511.7424 Postage
:MISCELLANEOUS __
Other Please S eci
'Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work.
"Actual Cost Plus 20% Overhead (Non-Interest bearing deposit) TOTAL
NAME OF APPLICANT ~ YV~.b ~a /~~
$ ~ G~~'
NAME OF PAYOR ~ ~ PHONE
ADDRESS ~ ~ l~ ZIP o
FOR .RECEIVED BY ~~'" W'7 C~ ~ ~ _
CITY CLERK
ONLY
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CHANGE
DECLARATIONS
We will provide the
insurance described in
this policy in return for the premium
and compliance with all applicable
provisions of this policy.
----------------------------------------
05-B7-D327-4 Policy Number
----------------------------------------
Named Insured and Mailing Address
MOROYAN, HRAYR H & VERA Y
1816 WHITE OAKS RD
CAMPBELL, CA 95008-7124
Coverage afforded by this policy is
provided by:
STATE FARM GENERAL INSURANCE COMPANY
900 OLD RIVER ROAD
BAKERSFIELD CA 93311-9501
A Stock Company with Home Offices in
Bloomington, Illinois.
------------------------------------------
The Policy Period begins and ends at -------------------------------------
Automatic Renewal - If the Policy
12:01 a.m. Standard Time at the residence Period is shown as 12 months, this
premises. policy will be renewed auto-
matically subject to the premiums,
06/26/2013 Effective Date rules and forms in effect each
12months-Policy Period succeeding policy period. If this
06/26/2014 Expiration of Policy Period policy is terminated, we will give
------------------------------------------ -you and the Mortgagee/Lienholder
Limit of Liability - Section 1 written notice in compliance with
$ 551,000 Dwelling (Coverage A) Ithe policy provisions or as
required by law.
Deductibles - Section 1 $2000
Policy Type TALL LOSSES In case of loss under
Homeowners Policy this policy, the deductible will be
Dwell Repl Cost - Similar Construction applied per occurrence and will be
Increase Dwlg Up to $110,200 - Option ID deducted from the amount of the
------------------------------------------ - loss. Other deductibles may apply
Location of Premises ~- refer to your policy.
1816 WHITE OAKS RD
CAMPBELL, CA 95008-7124
I-----------------------------------
~Policy Premium $836.00
Forms, Options, & Endorsements
FP- 7955.CA HOMEOWNERS POL OPT JF J&F 2500/5000
LSP Al SMLR CONST-A LSP B1 LMT RPLC COST-B
OPT ID COV A-INCR DWLG OPT OL BLD ORD/LAW-10~
FE- 3422 HO-W POL END FE- 1313 LNDR LOSS PAY
Mortgagee
BANK OF AMERICA NA
ISAOA ATIMA
PO BOX 961291
FORT WORTH, TX 76161-0291
Loan Number: 038354015
Agent Name & Address
HEIDI LANHAM, AGENT
LIC#0578691
EMAIL HEIDI.LANHAM.B773Q
STATEFARM.COM
2542 S BASCOM AV STE 155
CAMPBELL, CA
95008 (408)371-9700
-------------------------------------------------------------------------------
Prepared: April 14, 2014 2704
Agent's Code
559-916.5 MORTGAGEE COPY
PREMIUM NOTICE
STATE FARM INSURANCE COMPANIES
AGENT ISSUED DECLARATIONS
--------------------------------------------------------------
POLICY NUMBER I BILLING PERIOD I AGENT CODE
05-B7-D327-4 I FROM 06/26/2013 ~ TO 06/26/2014 ~ 2704
--------------------------------------------------------------
LOCATION
1816 WHITE OAKS RD
CAMPBELL, CA 95008-7124
INSURED
MOROYAN, HRAYR H & VERA Y
1816 WHITE OAKS RD
CAMPBELL, CA 95008-7124
MORTGAGEE
BANK OF AMERICA NA
ISAOA ATIMA
PO BOX 961291
FORT WORTH, TX 76161-0291
Loan Number: 038354015
PREMIUM $ 836.00
AMOUNT PAID SFPP
AMOUNT DUE SFPP
DATE DUE
AGENT NAME & ADDRESS
HEIDI LANHAM, AGENT
LIC#0578691
EMAIL HEIDI.LANHAM.B773@
STATEFARM.COM
2542 S BASCOM AV STE 155
CAMPBELL, CA
95008 (408)371-9700
This is the only notice you will receive. Please make check payable
to STATE FARM and return it with this notice to the address shown below.
Your canceled check is your receipt. Thanks for letting us serve you.
STATE FARM INSURANCE COMPANIES
900 OLD RIVER ROAD
BAKERSFIELD CA 93311-9501
,y `t':~
~ ~;
..
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SRC}}nN,,.
Public Works Department
August 11, 2015
Hrayr Moroyan
1816 White Oaks Rd.
Campbell, CA 95008
Subject: Permit No. ENC2014-00091
Location: 1816 White Oaks Rd
One Year Maintenance Inspection -Acceptance
Dear Hrayr:
The City of Campbell has made the final one year maintenance inspection of subject
Public Works improvements and finds that no remedial work is required.
Your warranty requirements and any surety, therefore, are hereby released..
h
Sinc rely,
~~,.-°/
~.%~
Syed Wahidi
Public Works Inspecto~°
Cc: Permit: ENC 2014-00091
refw~ds\1 YR Maint Inspection\Whiteoaks1816.Moroyan.doc (Rev.
70 [~Ivrth First Street • Campbell, Califoeraia 95008-1436 • ~-e~ 408.866.2150 • 1'ax 408.376.0958 - Tots 408.866.2790
~ ~'~'
~ r
"~+r ii~~`~D
CITY OF CAMPBELL
Public Worla Department
August 7, 2014
Hrayr H. Moroyan
1816 White Oaks Rd.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2014-00091
1816 White Oaks Rd. Campbell, CA
FINAL INSPECTION AND ACCEPTANCE
Dear Hrayr:
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 in the amount of $2,000.00, 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 2014-00091
Suspense File
70 North First Street Campbell, California 95008-142 ~rta 408.866.21 SU t~nx 408.376.0958 ~r[~o 408.866.2790
CITY OF CAMPBELL
PUBLIC WORKS DEPARTMENT
CLEARANCE FOR FINAL INSPECTION
AND ACCEPTANCE LETTER
Encroachment Permit#: ENC 2014-00091
Name: Hrayr Moroyan
Property Address: 1816 White Oaks Rd
Date of Final Inspection: ~1 ~ ~~~ zv~~
On File: ^ Bonds ^ CD ^ Cash
Faithful Performance: $ 2,000.00
^ Labor and Material: $
^ Construction Cash Deposit to be released: $
^ Other overdue deposits to be released (Description):
Processed by:
ministrator
Reviewed by:
nspector
Reviewed by:
Land Development Engineer
J:UoAnnaT\Deposit refunds\CHECKLISTS\1 Checklist -Final Acceptance.doc (Rev. 10/11)
CITY OF CAMPBELL
VENDOR NO
10012862
CHECK No. 247962
ACCOIIliI Purch.are Order Invoice Number Arnrnrnt Descri lion
LOl 220? CROF30714 2,000.00 P'YS/ENC2014-00091
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CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
HRAYR MOROYAN
1816 WHITE OAKS RD
CAMPBELL CA 95008
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Transmittal
JoAnna T" ~ason
Office Ass. .nt
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: Hrayr Moroyan Date September 2, 2014
Address:
1816 White Oaks Rd.
Re:
Deposit Return for Drive Approach Improvement
^ Urgent ^ For Review ^ Please Comment ^ Please Reply X ^ For Information &
Use
Enclosed please find a check in the amount of $2,000.00 representing the refund of your Faithful
Performance Security Deposit plus any interest due.
J:\FORMS\Template\Administrative\White Oaks1816.Moroyan