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ENC2008-0015311f23f2008 21:54 1916381~a94 CABLECOM 03I081 PAGE 02f05 Permit Na ~ ~ ~0 - G ~ CITY QF CAMPBELL ENCROAC!!ML•NT PERMIT X-Ref. File DEPT. OF PUBLIC WORKS (for working within the public t { ~ o 70 NortFt First Street right-of--way) </ Application Date tatmpiSetl, C1- 9SO08 Issued 1 2 5 b b AppGcatian E7 !'~ i n to 2 y o Y Ph.f~)866-z750 APN ~ FX. 1408} 376-0958 1 ~ 2~ ~ !Permit Expiration Qate APPLICATION -Application is hereby made for a Public Works Permit in atcordante with Campbefk Munic)pat Code, Section l 1-ta4. iAppiication expires in s'pr {6) rtpnths if the permit is not issued. Application Fee is non-refundable.} .. «. A, Work Address or Tract No.: ~ ~ ~~ ~' ~, . _ R ~} tears ~~ .IG~ „~ Utility Trench Location: B. Nature of Work: ~ ,r{~/' +~~; ~ ]~ ~ r,~,! I ~ ~ ~ C_ Attach four {4} rnpies of an engineered plan showing the bratlon and of the work, and four {4) copi s of the prelirrtlnary Engineer`s Estimate of work. The plans shalt showthe relation ofthe proposed workto existing surface and underground impravemeMS. When approved by the City Engineer, said plan becantes a part of this permit. p. 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 abkie by these conditions and proViilans may res~~it in jab shutdown and/or farfeiturc of Faithful Performance Sureties and cash deposits. {See Genera) Permit Condtions 1 and 2.} E. The Contractor must have this permft and approved plans at the site and must notify the Public Works Department at Ieasttwo days before starting work. Notice must be given to Public Works at least 24 hours before restarting arty work. Name of Applicant: ~ ~i~-tM I~ ~- Telephone= ~ ~~~^Cr., Address: ~ ~`~~ ~~ `-'L~`ef 1~0 l.1 ~? -~ ~ ~..~' - - _... E-Mail Address: ~ .~,~~ . ~) C?~ l ~ L-,.r ~` 2~4-OUR EMERGENCY PHONE NUMBER: Is this work being clone by the pro cry owners at their o~n refs-i~d~etnce3 ~` YE5 ~NO T'he ApplicanUPermittee hereby agrees by afl~~xing their signature to this permft to hold the City of Campbell, its officers, agents, and employees free, safe and harmless from any claim or demand for damages resulting Pram the work covered by this permit. the Apptlcant/Permittee hereby acknowledges that they have read and understand both the front and balk of this permit, and they will inform their contractors) of the information. Applicant iS advised that upon issuance of this permit, property owner, or progeny owners successors, shall tae responsible for arty did all damages a~3sing out atthe conditlon of any pr~vate improveme ~ts in the public right-0f-way. ~ ' ~ ~ '! Accepted: Pem,ittee) (Contractor) iPrint Name) Date SPE pR0 IONS- 1. Street shall not be open tut for underground installations. Minimum cuts may be aifowed for conrrections or exploration hales. Such cuts ray be soP~iFical anorov~ by the to_srze~'~or arivr to cu~r~o. ~. Pavement maybe cut for underground installations and must be restored in accordance wkh the Standard Details Trench Restoration Method "A", unless otherwise approved by the Engineer. 3. Work to be staked by a licensed Land Surveyor or Chit Engineer and two (2} copies of the cut sheets sent to the Public Wanks Department before starting work. 4. Per Section 4215 of the Governme nt Codethis permit is not valid for excavations until Underground Service Alert {USA) has been notified and the inquiry identifrcation number has been entered hereon. USA Phone: 1.80p-227-2600- il5ATICI~TNO. 5, Prior to any work, the property owner shall execute an Agreement for Private lmprovemerns !n the Public Right~f--Way, which shall be recorded. ~_ Public Noti6catian Requirements:. 7. ES E PU L~ R}CS FEE. ULE F CURRENT FEES AlVl41 atiT 3 2 r7 PERNfl7 APPLICATION FFf $~ --- - PLAN CHECK QEP0517 S SECURITY WR FAITHFUL PERFOftMANCE/L}~BOR & MATERIALS 5 CONSTRtIC"CION CA5H DEPOSIT 5 PLAN CHECK & INSPECTION fEE -~ S~w..S~G ~ ~y °-- APPROVED FOR ISSUANCE aECE1PT No.Q 11~ 25 ~~~ w6__,1 ~.~,. ..~ 1~ ;; ~ U; Lb/lS ,~„ 1112312008 21:54 1916381n~g4 CASLECOM 03I081 PAGE 03/05 ~~ ~~'- ~ ~ ~~~~ ~, ,: ~ ~ ~, l °sp ~ ~ °~ ; ~~ r x ~ ~ sT~ 5~~- t k~3 1 j ~ y ~ 4 "} ` i .~ ' I ~. i O ~ ~ t ~ ~ ~ C ~ ~ ~ ~~ b#~7 d ~ 33 ~ ~i f~l: W~ ~ als ~j ~ i. F- ~~ V (~ ~ ots 3 ~ ~ ~ ~ ~ s~t . ~ ok9~ x.52 ~ -== ~ .3 ~ "~ s ~1n tee- e-+~ 5 ~(s ~ ' ~ -~ ~ $ ~ ~ ~ I ~ t~. ~~ ~ ~ o ~ !~ ~ a W ~ ~- i ~ ~ `~ 1 ~ ~ ~ '~4~ ~ ~ U ~~T 7 ` ~~~~ ~ ~ e ~~ r ~. p9 o p.~-f ~ ° la Yv~ 1 d m+~c~ o s r~ ~~u,~w~ac.~' vlr,,,~~ c~Prn 111231200S 21:54 1916381^"~84 CABLECOM 03I081 PAGE 04105 IYU. V~tly ,`i ;~ ~ ~,~; ; ~ f \ ~w ..~,. ,, .. . ' ~ ~ :.. - ~". ~ ~. - .. 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'' dL j .s. ___- A". ado: nr ....~__ ~~ ~ - l ~. -_- ~, ,.~ . ... •, _ 11,E2312005 21:54 1916381~'~84 Lane Closure an TWvo-Lane Highways 1Jsing Flaggers CABLECOM 03I081 PAGE 05105 TYPE RGApYYAY ~ $IGN . MAXH1lR1M [d ChanAeliur t1E1GFff YIfORK Z01E Cone or Arum fR 7tnck o Mounte r ~rrotter vyo~ d Ampw panel ~ Space '~ ~1 LlNGTN (L) ~.. Flogger t-7~ Trock rL•~ Mauotui ~~+~ protective ' 7'POflab~e tMi. URBAN T Po6t Z Sign Attena atosr{ fl4~A)~Ll~ml Vehicle ~' RURAL UNDIVIDED tr Portahde 3 NtI. 3' Po9t ART ~ ..+ SI ~ ~I F- N ~ ~ {Optlor-al) T si ~ ~ ~ ~._ ~, ~ 1VodES~ 100' ~5 ch2lnnelizt:rs min.) i ,~^t ~ ~ Z A protective vehicle shall be used while warlc is in progress. The protective velrucle should be equipped ~~ lV :~' with a 7'MA and flashing arrow panel and postponed at feast 150 ft. in advance o€ the work space- .L :~ 1~ If a flashing arrow panel is used, the catttton mode shall ~ ~ T•>~. be displayed. ~- i : " ~ When a temporary road closure is needed, both Prot9ct~ve Vehicle Roll-Ahead space s , .. ~ .~' directions may be stopped at the same tirme up to a (J maxltmum of 20 nctinutes. 0 Where operational comditiorts warrant, chanmeliaing devices may be etiminated. .~"~ .. por short duration opesation.s, sigma and chatmclizers f3 ' "~' may be reduced ar elitrtirtated. The protective vehicle 100 (5 chann®lizers min.) Q posy be elizmiraated if adegtcste sight distance exists and the work vehicle uses activated rotating lights or strobe ~ lipktts. ~'• g l:or mobile operations where workers are on £oot and move with the operation, ctlannelizers may be reduced ar eliminated. ~S Additional warning sigtxs shall be erected at each IS (Optlonsl) itttcrsectlozt with unotlter state highway within the warlc l zone. Upon the discretion of the supervisor, additiana! i watttirtg signs Ippay be erecl:ed at other intersections ~$ within the work zone. ~ ~_ For mrobile operations, spacing between flogger and FLAGC3ER AHEAD signs shall not exceed one mile TA-7 ~ • E t; ~ E M { L v 11123,'2008 21:54 1916387 'g4 CABLECOM 03I081 PAGE 01105 ~~~~ _~ ~ ._~~ ~v~~.., ADA,1lNlg ~'~hK~• $^~S8 ~id.ex- Carce~~~ Sac~'ax~~~to, Ca. 9S$ZS ~~-~a~e: 916 3$1-40$0 ~'ag: 91'6 3$1-40$4 4 ~~ ~ ~~~~ ~ I V ~ ~~ . 1.~ Nux7l~her off' pages xncludzng t~iis page;