ENC2008-00135~~
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Print Form
CITY OF CAMPBELL ENCROACHMENT PERMIT ~ Permit No ~, V C 2 U ~ ,y -~ ~Q 1~5
DEPT. OF PUBLIC WORKS (for working within the public ~ X-Ref. File
70 North First Street right-of-way) Application Date ~
Campbell, CA 95008 Application Expiration D to 3
Ph. (408) 866-2150 Issued ~ o APN 3 ~ ' ~ ~ ~ U d ~,
Fx. (408) 376-0958 q/Z~ o
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 six
(6) months if the permit is not issued. Application Fee is non-refundable.)
A. work Address or Tract No.: I Merrimac Dr. (in front of 557 Merrimac Dr.)
Utility Trench Location: 285' West of Millich Dr., North & South side of Merrimac Dr. ~~
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B. Nature of Work: Installing irrigation service for County of Santa Clara (See attached maps) ~~~
C. Attach four (4) copies of an engineered plan showing the location and extent ofthe work, and four (4) copies of the preliminary Engineer's
Estimate of work. The plans shall show the relation ofthe proposed work to existing surface and underground improvements. When approved
by the City Engineer, said plan becomes 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 Sureties and cash deposits. (See General Permit Conditions 1 and 2.)
E. The Contractor must have this permit and approved plans at the site and must notify the Public Works Department at least two days before
starting work. Notice must be given to Public Works at least 24 hours before restarting any work.
Name of Applicant: San Jose Water Company Telephone: 408 279-7830
Address: 1265 S. Bascom Av., San Jose, CA. 95128
E-Mail Address: nick_bernhdrdt@sjwater.com 24-HOUR EMERGENCY PHONE NUMBER: 408 279-7900
Is this work being done by the property owners at their own residence? ~ YES r NO
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the Ciry of Campbell, 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/Permittee hereby acknowledges that they have read and understand both the front and back of this permit, and they will inform their
contractor(s) of the information. Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be
responsible f~~o//r any and all damages arising out of the condition of any pnv improvements in the public right-of-way.
Accepted:/t<'lG.E ~'SFir°n/.ylJ~s,L~-~ ~~ L~~~al~ 9~.5 ~Y
(Applicant Permittee) ~ (sign)
(Contractor) (Print Namel ~..,.
7
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT RECEIPT NO.
PERMIT APPLICATION FEE $ ~
PLAN CHECK DEPOSIT 5 r '
SECURITY FOR FAITHFUL PERFORMANCE/LABOR & MATERIALS $ ~ frj~i
CONSTRUCTION CASH DEPOSIT 5 e
PLAN CHECK & INSPECTION FEE 5
APPROVED FOR ISSUANCE ~ ~ q IZ~~a s(
For City Engineer Date
Permit Expires 12 Months After Date of Issuance
Lovhly 6f JL VCvv\ni j
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GENERAL PERMIT CONDITIONS
I. A Construction Cash Deposit is required. Charges will be made against this deposit if there is an emergency call-out, overtime inspection or when City
ordered barricading is required. Any such costs in excess of the deposit will be billed to the Permittee.
2. A one-year maintenance period and surety are required. Such period will begin on date of written acceptance by the City.
3. Refund or the cash deposit balance and refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work
by the City.
4. 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.
5. Maintain safe pedestrian and vehicular crossings and free access to private driveways, bus stops, fire hydrants, and water valves.
6. A Construction Traffic Control Plan and a Construction Schedule are required for all lane closures, detours, and street closures. This plan must be
reviewed and approved prior to any lane closures.
7. A Construction Traffic Control Plan shall conform to the Caltrans Manual ofTraffic Controls for Construction and Maintenance Work Zones, dated
1990, available at Caltrans. Traffic control equipment shall include Type II flashing arrow signs if required.
8. 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.
9. Sawcut for all PCC or AC removals. All PCC removals shall be to the nearest scoremark and shall be doweled to existing improvements.
10. 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.
11. Adequate signing and barricading is required on the job site. Failure to provide such signing and barricading may result in the City's providing signing
and barricades and charging the cost (including all labor and materials) against the cash deposit.
12. Compaction testing of subgrade, base rock, and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer.
13. The Contractor or Permittee will have a supervisory representative available for contact on the project at all times during construction. Contractor or
Permittee shall provide a phone number at which they can be contacted outside the hours of 8:00 a.m. to 4:00 p.m.
14. No storage of materials or equipment will be allowed near the edge of pavement, the traveled way, or within the shoulderline which would create a
hazardous condition to the public.
1 S. 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.
16. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency.
17. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon.
18. Call back (call out) due to emeregencles regarding this permit shall be at the current overtime rate with a three (3) hour minimum charge per
occurrence.
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 Val ley Urban Runoff
Pollution Prevention Program.
20. 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.
21. Permitttee must provide advance notification to all parties that may be affected by the permit activities. Notification shall be reviewed by the City prior
to distribution and include dates of work and a contact name and phone number.
Applicant shall be responsible for ensuring that all those providing services under the applicant are aware and understand all of the above conditions.
Contractor (Print Name)
Date:
1:Reina\Website\Land Dev Forms\Encroachment Permit STATIC form2.pdf
Rev. (11/9/05)
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C:IT~' t~t~ C:AMI}'i3ELL
I'r~hlic: ~K'orks Qc•harhnc~n~
August 11, 2008
Ms. Wanda Folk, Water Services Representative
Water Services Administration
San Jose Water Company
1265 S. Bascom Avenue
San Jose, CA 95128
Subject: San Tomas Expressway & Hamilton Avenue
Intersection Improvements (Irrigation)
Dear Ms. Folk:
We have received and reviewed the letter addressed to Robert Kass, Public Works
Director for the City of Campbell. Regarding the City of Campbell Encroachment
Permit, SJWC is required to submit the encroachment permit application. However, the
City is waiving the $638 application fee associated with this permit. As such, please
revise the total cost for the service connection stated in the service agreement.
Contrastingly, if it is acceptable by the SJWC, I can revise the service agreement and
initial the changes. Please advise.
Sit ~ rely,
`Fredrick Ho
Senior Civil Engineer
cc: Alan Hom/Senior Inspector
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I~~~ fll •+U`7.fii1o ~iSU 1-, ti. ~tlfa. ~I (, it"`~f l~l il+ lU; ~i,i: 'r;'41i
Page 1 of 1
Syed Wahidi
From: Fred Ho
Sent: Friday, September 26, 2008 1:29 PM
To: Matthew Jue; Syed Wahidi
Subject: RE: San Jose Water Agreement for San Tomas Expressway/Hamilton Avenue Project
SJWC just submitted an encroachment permit for this work. ENC 2008-00135.
Syed,
This work is in conjunction with the San Tomas Expressway/Hamilton Landscape Project, which the County is
responsible for construction. Please go ahead and process this application as a no-fee permit. See me if you
need more info.
Matthew,
Does County have a construction schedule yet? SJWC's work should be coordinated with that of the County.
_..
From: Matthew ]ue
Sent: Friday, September 26, 2008 11:04 AM
To: 'Christine Li'
Cc: Fred Ho
Subject: San Jose Water Agreement for San Tomas Expressway/Hamilton Avenue Project
Christine,
The attached letter documents our sending a check with the signed agreement to San Jose Water Company.
Matthew Jue, P.E., T.E.
Campbell Traffic Engineer
9/29/2008
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