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ENC2011-00035
~jrlrtt r'~r~t'i CITY OF CAMPBELL DEPT.OF PUBLIC WORKS 70 North First Street ENCROACHMENT PERMIT (for working within the public right-of-way) r~ ~ 't Permit No C7V ~- ! ~ ~ ~ ^~ O ~ ~5 X-Ref. Fite Application Date. I I f -,..- Campbell, CA 95fl08 I d 3 3 j ~ ~ ~ Application Expiration Date Ph, {408) 866-2750 ssue -`--- ---- APN r~~'~~'«~-~ ' C~ ~~ Fx. (408) 376-0958 - J /~) 12 Permit Expiration Date L , --- -~ APPLICATION -Application is hereby ._ -- . made far a Public Works Permit in accordance with Campbell Municipal Code, Section t t A4. (Application expires in six {6) months if the permit is not issued . Application Fee isnon-refundable.) A. work Address or Tract No.: ~3$4 Pamlar Avenue. Campbell, CA 95008 8. Nature ofwork: Excavate 30' long, Z' wide, 5-T deep trench to install new 4"diameter sewer lateral C Attach four {4) copies of an engineered plan showing the location and extent of the work, and flour (4) Copies of the pmiiminary Engineer's Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by the City Engineer, said plan becomes a part of this permit. D. All work shall Conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Per+nit Conditions fisted on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and provisions may result in Job shutdown and/or #orfeiture of faithful Performance Sureties and cash deposits. (See General Permit Conditions t and 2.) E. The Contractor must have this permit and approved plans at the site and must notify the Public Works Department at least two days before startiny work. Notice must be given to Public Works at least 24 hours before restarting any work. Name of Applicant-. forge Picado (West Valley Sanitation District) Telephone: ~{408) 37$-2407 Address: (100 East Sunnyoaks Avenue. CampbeN, California 4500$ ______________e...,...~___._.___ .__._ -_ E-Mali Address: jpicadoC~westvalleysan,org 2A-HOUR EMERGENCY PHONE NUMBER: (40$} 378-2407 is this work being done by the property owners at their awn residence? ~ yES ~ NO The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City 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. Utility Trench location: jStarting 3' behind the street sidewalk, ending in the middle of the street. The ApplicantlPermittee 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 for any and all damages arising out of the Condition of any private improvements in the public right-of-way. Accepted: (Applicant Permittee) (sign) h'fu+~ .3J Date PpC~a U,7r,~rgrndrl~J Cans>~rvcvfu~t 77fvrsr.! M~f3r~,~v1r~ (-Contractor) (Print Name) D to S~~IAt._PR~VISIONS: ~t. Street shall not be open tut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts m~y~ soecifical{y at2nroved by the Inspector prior to cuttino. ~2. Pavement may be cut for underground installations and must be restored in accordance with the Standard Details Trench Restoration Method "A",unless otherwise approved by the Engineer. ____3. Work to be staked by a licensed Land Surveyor or Civil Engineer and two (2) copies of the cut sheets sent to the Public Works Department before starting work. ~4. 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 has been entered hereon. USA Phone: 1-800-227-2600. USA TICKET NO. ___ 5. Prior to any work, the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way, which shall be retarded. _..___6. Public Notification Requirements:,__-__ 7 SEE PUBLIC WORKS FEE SCti~.~7~!(.E.FQR CURRENT FEES AMOUNT 3 5 D PERMIT APPLICATION FEE 5 PLAN CHECK DEPOSIT $._.__.__.._ SECURITY FOR FAITHFUL PERFORMANCEILA80R & MATERIALS $.._._._._...__............_.___. _____ CONSTRUCTION CASH DEPOSIT 5 _.._...._.... PLAN CHECK & INSPECTION FEE $_~ _ EMERGENCY PERMIT FEE $ ~ S~_____ APPROVED FOR ISSUANCE For City Engineer Permit Expires 12 Months After Date of Issuance RECEIPT N0. Date ~ ~ s ~ l `~ /(S ~ v GENERAL PERMIT CONOlTlONS 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 depositwill 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 {n writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing to the Permittee. S. Maintain safe pedestrian and vehicular crossings and free access to private driveways, bus stops, fire hydrants, and water valves. b. 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 199Q available at Caltrans. Traffic control equipment shall include Type II flashing arrow signs if required. 8. Replace as directed by the City Engfneerany 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. Ail 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 reimburserttent 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 barcicades artd charging the cost tincluding 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 shoutderline which would create a hazardous condition to the public. 15. 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 by law. lb. This permit does not release the Permittee from any liabilities contained in other agreemenu or contracts with the City and any other public agency. 17. This permit is not transferable. Work must be perforated by the Permittee or his designated agent ar contractor as specified thereon. 18. Call back (call out) due to emeregencies regarding this permit shall be at the current ovenime rate with a three (3) hour minimurn 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 Valley Urban Runoff Pollution Prevention Program. 20. If the public,interest requires a modification of, or a departure from the plans and specifications, the lily 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. Permititee must provide advance notification to all parties that may be affetted 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. ti.7ta~e C, , f i~ar~ ~ Lf.~~ J/al/~ ,5`ani~trftG~+ l'~jSt~r'l~c"~„t). 7'hvr~a(t~, Ntr.,.r~h 31, 20IJ Applican# date: )~cxc>,'~iF Undrrray»d Cc~hs>~rycfiart 7'hvts. ~_ Mar'th ,~~, 2d1~ Contractor (Print Name) Date: 1:\FURMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev. 09J70 West Valley Sanitation District 201'1 Sanitary Sewer Repairs WORK ORDER WO No. 11 Issued To: Pacific Underground Inc. Issue Oate: March 31, 2011 Issued By: West Valley Sanitation District Type and Location of Repair: ^ Main Q Lateral ^ 8oth ^ C>ther _ 384 PamlarAvenue. Campbell California 95008 Street Address/Gity (Provide scope of work and map(s) for work ordered. if multiple locations ar routine repair, attach list) Callout Urgency: ^ High Emergency (4 Hr response) ^ Emergency (24 Hr response) QUrgent (96 Hr response) O Routine (14 calendar days) WO Issued By: Edward 4yama Time Issued: 12:00 p.m, March 31. 2011 WO Issued To: Bill Marrow TimelDate On-site: Was Contractor's arrival time on-site within required response? d Yes ^ No Basis for Reimbursement: (Show calculation far each repair location) Install a new lateral and_a new_pr©perty line cleanout. Build the new lateral witty PVC SDR-26 pipe and fittings. Place the new cleanout 2 feet behind the streef sidewalk. Instal! a new lateral connection to the 6" VCP sewer mainline, Mainline is approximately 7 feet deep. The new property line cleanout shall be 5 feet deep. West Valley Sanitation District has applied for a City of Campbell encroachment permit. Contractor needs to call far Underground Service Alert -U.S.A. Repair will be time and material basis. MetroScaxa /Santa Clara (CA) Osuner :Knudsen Robert H Jr/Lynette P CoOwrter ,Site : 383 Pan~lar Ave Campbell 95008 >tilcril :384 Pamlar Ave Campbell Ca 95008 .lfered :08/31/2010 Doc # :20850391 /'rice Deed :Grant Deed LvarrArnt : $417,000 Loarr : Conventional Lender :Wells Fargo Bk Y'estTvp :Married Persons 1ntTjr :Fixed Land Use : 01 kes,Single Family Residence Zoning : R-1-G Res Single Farnily Residence SubPlat :Shady Acres Legal : "I'RAC'1" S 15 SHADY ACRES )300K 34 PAGE 1 Census :Tract :5064.02 Blvck : 4 rLfapGrid :853 F,4 arTi C t a! CC1YxT Y AS Si SSOR ~-- 5AN `A ti Ax A La~]x' ~', t Al! f GANl a. ldkl 1 PAGi ii ~~ 9.... ~_ ~~ 3 u:. . ~. ~. _._ ...._....z _ ~, _ .,....... ~• ~ e p Q 1 1 }---.-_.... NARRISON - __ _. lrwrx.xeon~tGxeYt._..~- __........ .AVENUE Totnl Rms : 7 131cfg SF :1,868 Units }'ear Built :1955 Bedroorrrs : 3 Lot SF :9,750 Patto : lJncovrd E~fYecn•BTt :1955 Bathrooms :1.50 Useable SI' :9,750 Porch. :Yes Cirrragc rSp : 2 Stones : 1 Lot~icres :.22 Elevntvr Garage Sf : 412 flinJng f{I)r I L0l Dirrrerr :78x125 Lease SF Bldg C'Urrd : 6.5 Family ftnr ; 1 Pool : No OfJ7ee SF .Bldg Class : 6.5 Rec Roorrr Fireplace Sprinkler Bldg Shape : li-Shape CrrtlHt/AC :Heat Only 21 20 w Q ~i ti; c Q~ 3~ 4 5 I f nor r ~ :a i _ . _ _ # ! ' t ~ Jn' ~ iT i S ! '>f ~ r 1, ~ @ 9 1 Xr g w 1 ~ ; ~' c9 ~ a,. ~ s i to ~ :r I es ~ zz I za ~ z> zz 3 x~ z ~ > . i n I r r 1 0 .. ~._...; sa - I i~ f Y I~ 1 f ~4 ~ tP 1~ Y.tr ,. L~ iy ~ i~ t~ ~~ L! i~ t.~ ~~ ~7 .~l s 1' 1 ! ~ S t 1 i i 8 ~ i t 6CTJ 9 H 1 M1 i H i 4D ~ 6D I W 1 fi !5 7 {rz} Parcel :279 23 U20 Bldg Id : i Lacrd : $1.96,100 Strucl : $342,900 01her Tvta! : $539,000 O-vned : l0U F.ierrrpt Type Tczr~trea :10025 10-11 Tcu :$6,807.98 MLS area : 15 PhUne Chvner 'E717T'TJ-' ~ x. 1 ~ ~ t SL 1 1$ li C It ,y7 1: != x;! I 1A:~ n ~ a ~ S w u ~I2 +~ ip ~ ~ +S .# 8 3 1 ~ i 1 s> t xr n s;'v co K a J a a w C~ iI N. CENTRAL "»- au oaf rr r $ rar r«r TRACT Nt 472~SNApY AtflE9•-UN. Nr2 -4 - AYE. 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(.,'orel,vgio crakes no representariarrt or rr~arranties as ro the accrzracv or completeness of it farrnatrar container/ irr rhis report.