ENC2008-00145~~ 3~i~ z z, ~~
CITti' flF CAMPBELL ENCROACHMENT P>:RMIT Perrot No~~bt~_." p S~ ~~,~
DEPT. OF P[JBLIC WQRKS
70 North First St. (for worKing within the public
nght-of-wayj (' ~
~/ ~ X-Ref. File
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Campbell, CA 95008 Appiicatiorr Date ~' (O 24/~~
{408j $fib-2:50
Fax{408j:"i6-0958 Issued ~ " .4pplicatior Expiratton Gate ?/~
Perrntt Exptration Date ~'~~ ~G ApN _ ~1,7~~~ .._ ~ ~ ~ -
APPLICATIO'~ - Appiicaurrn is hereb}~ made ipr a Public Vdorks Permit in accordance with Campbell Mun ;cipal Code, Section i ()`'~~ji at ~x~ti~Sf~
rnonGhs if tare ptrmu is no[ issued, Applieataon Pee is non-refundabit.S ~~ ~~/L~.
A. Work address or aacti;,_~ 1a~~ Wl1L.1(.~S ~~E _____ ""~ -~7 r ~ 08
Lif[titV trench
B Nature pf work ~~ ~~ ~~
L ~7v /t/
C. Atwch four {4) copies df an ear nceret3 plan showing the location and extent of the work, and four {4 copits of the preliminary Eaginetr's wstimatt pf wprk. Thr
plans shall show the reflation of the proposed work to exisung surface and underground improvemtnet. When approves; by the City Bnginea, said plan, becomes a
part of this permit.
[~. All work shall conform tp the City of Campbell Standard Specifications and Details far Public Works Cortseructipn: the General Ptrrmt Conditions hsttd on the
reverse srdt: and the Special Provrsrons for this pcmti[, listed Ticiow, Failure tp abide by these conditions and ptnvlsrpns may result in 1oh shutdown andlpr fprferture
of Faithful Ycrfomtanct Sureties and cash deposits tSee Genera3 permrf Conditions 1 and .?
E Tnc Ganzracwr must have this permit and appmvtcl plans at the site and must natit"y the Pubhc Works Department at least twr~ days Uefare starune wark. Ncticc
muse be ryivrn to Puhhc Works a~l~ea~st~2.S hours before res ng any wpsrfk ,+
Name of ,Appiican[__.____...._._._ `..~f~1 ~~~L--~-~~t ~ c / ~ _~__,.__.....~_Tttcphrrne ~U~ .. 1ZJ'Z~C7
_..__
j Jpnnt Warne) t ~~ -~ ~ _ ~ooo
Address__ld9UV ...............3f, ~.._.C_tl~'Lt7W_~__ ?4-HUUREMF.RGET~CYTE..EPH(~NC:.NO_ _.._~_~.._ _,
E~Marf Address ~~ ~ 1 ~ ~~~ ~ ~~
Is this wark being done by the property owners at thtis own eestdence? _y`cs __ _ No
The AppfieandPtrmitteC Trerehy tierces by tiff xing their signature to this permit to hold the.^,ny of Campbeh, tts office. agents and employees free. safe. and harmless
from any :aaim or demand for damages resulting from the work envestd by this permit.
't'he Ap(rlicanUPermittcr: hereby ackncrwledgts that they have read and
information. Applicant is advised teat upon issuance of this permit,
arisin~• pert pf the candihan pf any pnva[e improvements rpthe public r
Accepted
d~ixxh the t`mnt and hack of thrs permit.. and they will rnform 8te~+r contracuxis? ni ttrr
owmer. or prapert} owucr'; successors, shall be responsible far anv and al( dam:r~_et.
-way
dJ~ tv !r, t
... __..
PPhcant f_ art) ;stun; L7att
Contractor iPrnt Name' I)atc ~--~~~-~ -
SPFC:CAL. PROVlSIQNS
1 Street shall oat be open cur far under~>rcrund installations. Minimum cuts may he allowed for epnnetetians ps expiamnon hples. Such cuts rrav
ht snecificaliv approved by the insp,~tos Briar [a cunrng
^_. Pavement may he cut for underground installatipns and must bt restored in accordance with the Standard Details Trench Restorauor, Method
"A", unless n@rerwise apprpved by inspector.
..__:, Wprk to be staked by a hctnsed Laud Surveyor or Civil Engineer and two (21 copits of the cut sheets stet to tt[e Public Works Dtparemcnt
before starr4n4 wark.
_,_4 Per Stenos :215 of the Ciovemment Code this permit is na? valid for excavatrons until tindcreround Scrvrce Aitrt (USA; Was been notified attd
the inquiry identification number has been entered herxan. L'SA Ffiont 1.800•'_2"•260{1. t1SA Tti_KET'JC}.
~- Pr,or u. any work. [hc propene pwn~: sitali cxcc:utc an Agreerner,t far Pnvatc impravtmenta m the T'uhiit Right-pf`-R'nj~, which ;haP be
recordtd.
___.(r Public Natificatian Requu:ments: ~_.~__.__...~. _,_ _
SEE Y1;HI,lC' WnRKS ~w SL,H„F~DiJL~F=fIR ('URRBNT FEi<S Awlt)t1NT RE,t_E1T`~ NO
_______
1
PEFMST APPL1CATfON FBE ,y „~~
V:.AN CHECK DEPOSIT g _ ~ ~"'-__°
_---- -- _
.L'RtTI' FOR FAITHFI:L PERFC)RMA'CE!',..ABOR & 'v1.gTERIALS ,T
CONSTRUCTCC)N CASH DEPOSIT .~
g_ _
PLAN CHECK Q 1NSPECTtO14 PEE g~~
APPRC)VED FOR CSSL;ANCE _ ~0 s pg
For City Engmxr Da e
Permit ExRirts 12 Months After Dale of Issuance
(; ~ tom{ ~ 1 ti J~ ~ ~ ~ V
GENERAL FERMIT CnNDTTIO'~S
__
s
i A Canswcuon Cash C)cposit is requrrcd. Chartres wilt be trade against this dtpostt i# [hue is an cmcrgenty cal!-aut. avertrrse inspecuon ar when City
ordered bamcading ss requued ,Any such costs in excess of the depasi[ will br. billed to the Pcrmitue.
_ A arc-year rnamtcnantc arced and suroty are rtqusred Such pieced will begin ar Batt a` wnrttn atttptantc by the C ttv
Refund of ttst tech atptrsst izaianrx aad Rfund tx ~xstcllatitxr of tits Faizftful Pcrforn°ar=ct Surely wit! be ioiuaacd en tstc ,untters as•~ptancc ci` sw w~&
by t}sc Giry
4 The Pcrltuttee must tr„quest m wnuug a fleet srssa~tttus and atte;staace ot` flit wort: upnts tatxt;ticbcm Acceptance ov tztt ~ .tt~ w°tl: ~c :nariv to w~;tunr tc
Mc Pcrnuttzc
Mamtam safe pcdesman and vehicular crassinRs and fret access to pnva[c dnveways, buss crops, fire hydrants and water valves
G A C:russtruchon Traffic Can¢ai Plan and a Cansuvctsan Schtsfuie arc rtautrcd Yar all lent cicnures. detours and strce:::irx;urc, Tht< pier. nsus be
revrcwcd and appr!~vtd pear to any laac ciasurts
Tnc C'ansttu~aor. Traffr; Czxstroi Ptah shall ;:tit#ixm to tfst Calllatts Manual of Tra,~fte C:c~ttrois #tr '~ottstu:rrca~, and 'vSacn;:rtan r. ~r'...:.. ,' c.r ,tr:tc
'. ~i. avai'tabit at Gltnns Tn£#'tc canna! cs;utprncnt shalt mciu+dc T}'~ Il °aa~sinng arrow ssgns if scqusr~
8 Repiact as directed by the Caty &nginecr any damaged or removed tmpravctncnss in accarttanct with Cat} Standards ana? Spessfa~tsrxt;, x the sate
txpcnsc of the Pcrmtttex.
9 Sawcut far all PCC' ar AC remavals. Ali t'C:C rtmavais shall be u, ncarcst scartmark and sha11 be dtrwcied to existing trnpmvcments
20 Pnar approval of mspectar is rtqusred for any woe! done afar tsc:tmal worksng hours, axs wtxkcnds or h:alidavs and roan r~utre resmburetrtrnt of
tnspetuan trssta at tht torrent avtrtitne eau-
S ; Ada?swtc stgnm~ and oarncadsng ;s rcqusru2 on fist tob stu. Fatlurs tc provsilc suet; caning and barru.-ading tries resuU cr, thr° ;~>t^.. ~-,~. ; nsnt
ana tgmcxics anal enar~mg tht seer[ uacrudtng all tabrn and ;rulc~satss attest the cam dtpwr;
_ Campacuon tcsuag of subgradc. trait rack. and asphalt ttmcratt by Permtnc ss rcqurrtd untr~x, atbrrwst stazrG ay the t: ttv rngtnsct
i3. The Contractor or Pcnnrttec wAi teen['. a supervrsan represantauve availabtc far ctxttact on tttc. pnt2~~ at all umc, dunng uatseructton i xrtractar of
Pcrmtttrx shall pnrvrde a phont numhcr a~ which they can bt caniactrcl nutsidc tlrc terries pf $'(K) a.m to 1 Oil p m
la hu suxage a'. cnatenaks nr eautpnsrnt writ bC allowed near the. cdpe of pavoment. the fravttGLt way, ar withsn flit shaulatrhzse wlsasr~ wr.t;lti ercatc z
haiardcus zandtucrn to tht puhi:c
.~ 1tu:. pcrnut steal: tux i+c rxtttszrucd as authcuutzaaWan for exa -aticxt arc ~ae}m~ cm pnratt iMOk'>Wrty atstac~t ro the. wtxi. ~ ar.. •~,.^ w ~k ;r« vri.;c:. s
separate pemut may he reoumd. nzzr dots is reiccut tht Persnittcr at' any rioisgaztcxt tx3 obcatn ani• ~~ perms[ zeyusrcd b~. tau
i G Tfus permu dots not reteasc the Perm[tte:; from any isabihues ccrosaincci m colter asrcements tx c+murarte wzth the tarty and any rsthes {rubh~ . ~~. ,._,
I? This pcr-mrt is nCU transferahte Wark must ha perfarmect by the Pcmu[tte ar his dtskgttated agtnt or cantractar aa: sptt:ifieti thtrcan
1 h- 0.511 back Icali out? due u> emcrgencscs regardsng thss ptrmst shalt bt at the cuatnt averttmc rare write a their t 3? hour mtnsmum cttarg±c per :r . ~.trrcn..;`
i 4 E'ursuan' se C'haptc• 14,Li~ of thu C:amptx~l Vl:anrc,pa: a adc. appiir„ant cha3t na ,.._ .: .,,..;.r vca atx~ matcrsa: rntc aist mcnc~.a,.l s;::7nr ra., ^:1wc;r~.
srsn~ than stcrrn~ water app+::an^ ih:al; adz.err a the. BFS: 42a`~.AuE!.1~'.: p;:~.. s._`:; .s....s.snc:: n. th» Santa ":az« t,..ic. .ar n•.:,;a:
F:aiu[scan Preversuan Pragratr;
a _ _
=-. :; arc politic mares• rn •mr~ a mrds'ftcauan cr:. or a depacttsrr trrrtrt_ tlt. plans arc spec:mm~a~ms.:nr _ ,r+ snasa tsao<c th. ~._.. =G •_ ;~v.r~ annroce
~.
am mcxitficanon or departure and tar spcctf~ tsrr mannr to whuf! the same s ter "tee mane .ar ,"rt}-r~wTCt; or mamu.nrc: rsc..~: r.~
_, Pemuttec must provide advance nout`ieaticm to all parties [hat trtay be affected t+y the pennn a:.nviucs NatiC:catiart shat; he revicwec h~ ('ity prrt7, to
,aster; utr:,'., and tnclud: dates a# aorm arc ~ contact ram: and phtrne numGt:
applicant snali eK responscbic ear easuzm~ teat all thtxar tavrdsn s=°+•i4t» undo th app;cart err ax~arr .' and un:irstand at ; tn- alhr~. __<._,..
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