ENC2010-00006CITY OF CAMPBJrLI, E.^1CROAGHIVIENTPERMTT Permit lain ~n~l.r~~ D'~OD~
DEPT. OF PLT$LIC WORDS {far working wsthin file public ~-lief. F?iie 0
70 Nprth I'irsrSt tight-c+f-way} ~ ' ~ Q ~~
Cam bell, CA 95008 Application Date p
{408} $66-2 LSO Issued. ~ ~ AppIicaaan Expirati I) ~ N 3
Eac (408) 376-098 ~ ~,y
Permit Expiration Data ~ ~ ApN ~,~.,~ +=~
~j 2 Z
APPI.I~ATiON - AgpGeautm is hereby trade fc~ a Public Wot~ks Perntit in accordance with.Catrtpbal[ Municipal-code, Section 71.~Ap_p~t~d ion ~z~. g~{ }
mtutttiS if the gtxmtt is'aotissued. Appticaiion Fee is non-refundabtc:) ~~
A. W ark addeess• or tsact# 5'-J ~1 V V ~ R IV`G Cl~ /y'Y'Ci ~. ~ v t07 _ J -~
Utility trench li
B. T\°ature ctf ~rcii•k-
fi. Attach four 14} copies of an /rt~inccrcd plan showing ffic lp~yion and ext:aittif the work, and four {4} copies of the preliminary Engibeei s Estimatt of work. TtiG
plans shall show Fhc relation of the prapbsad work to existing sarface and andcr~ound impmvcmeuts; When approved by nc~ Cit?~ En~necr, said ptu~ becrarnes a
pan of this permit
I}. Ali wort: shall conform ro the City oT Campbell Standard Specifccanont and Details for Puhiic Works Construction; the Csenecul Permit Ccmditians listtd ou the-
revers: side: and the Special Provisions fnr this permit; lured below. Failure w a$idt by these condicionsand provisions itiny rtsult to job shutdown and/or forfeituirZ
of Faithful Perfrn~manceSurctics'and cash dcposits_ {See General PcrmitConditions 1 and 2.)
;r: Tice Gontracwr must have this pertnit and approved plans at the site and must notify the PtIl/11C Works Department at Iwtst two clays betorxstaxting worlc. NOttGC ,
must be iii ven to Pu c rW/,~orkjs,'at l~ea'se 24 hours before re~s'ta`~rting any worke (` `~ ~j-Q
Naatcof A iicant ~V Y /~ . L/5 ~Cll~l.U C/ (~ j t~ ~'lf G~
pP ~' ~° ~ TclcphcmP ~~ U ~ /
Address `O ~,Q(' ~ ~ (print-uarstG) ~ 'y UG '
~" /_'~\I'Q~"4-HOUR EMERGENCY TELEPIiC)h'E No. D ~t- ~36q
_ >r-Mart Addt~ ~cf ~~ M ,
is ttris work tiding done by the property awtttars aet.theiTr o+vn resirtcnce? Yes ~,~„Na
Ttit ,ApplicanVPcrmittte hi5rtby a~~rcb3 by affixing their Signature to this perrnrt to hold the City of Campbctl, its t3f~rcers, agcntvc and empIOyaes free, safe and harriiicss
from any claim ar demand for darnagxs resulting frorq the work covered by dtis perrmi~
The AppticanVPermi¢ee hucby aci:nowlcdgas [hat they have read and understand.both the frcmt and hack of this perrrnt. andthcy will [nform their ctmtractnt'lc) of the
inYcirmation. Applicant is advised that upon issuance of this permit, property awarer, or property ownu's sucressots. shall oe resportsibla for amy and all damages
a't{'tsirkb ou[ of tht cnrtdition of any private itnpravertunts in the public right-of-way:
Accepted-
(Applicant Pcrminex) (sign)
I'Sat~ .
Cdntractar (Print Natntj Date
$LP,ECI~L PRpV15IOWS .
L: Street shal6noi tin opra ant fDr undtrgtxtrtrd instaliatirur~; Minimum eutrr~;hc allowed for a:tinnccrioas or explanation ha1CS _ Sncb cuts t tav
// b s ccifica!} a rave bv' o f tree ri tq crrttin~.
V Z. Pavemcitt may be ctu forunllcrgrondd instaliatzons and must be restored in accordance with tht Standard Details Trench R '
~~ una crw[sc approved y tnspcttot. --- -_ -
„~~., Work to be staked by a licrnsed Land Surveyor orCivil F.ngint~7 and two {2) copies of the cut sheets sent Io the Public Works De}rartrnFttt
htf(rrt SfarllRp WOrk.
,la, Per 5ecvan 4213 of the Ciovtmmrnt Code this pin"m7t is na, valid fdr excavations antic Uader~,round Service Alert (USA} t:as htcn ratified°atsii
the inquiry rdenrificatioa number has bean rntcred hereon.: USA Pliont I-8Q0-227-2fi0C1: ' USA TICKET NQ.
5 1'ricr LL any wore, t~'zc property owvcr shall cx~.utc an Agrccmc;,: for [avaus irrtprovctnent; in the Publicl'.i 7ht-of-hJay; which shall ba
rccotdctl.
_,:G. PubtiC Notificatioai R~uiremants°
..-?:
S PL!$LIG WORKS FEE SCHEDULE FOR CIJRRENT~,~S AMOUl~t'T' RECglI.*1' hlCj,
PERMIT APPLICATION FirE S 3 3 5 C~
PLAN CHECK DF-.POSIT ~
SECURITY FOR FAITHFUL PERFORMANGFJLABOR ~ MA'T'ERIALS ~
CONSTRUCTION CASH IaEPOSIT ~
PI..AN CHECK dt iNSPBCTIQN FEE
,41'PROVEIy FOR ISSUANCE -, - I~~I ~ p
For City ~agtneer p
Permit Hxniies 1~ Montns Af'tix Date of IS$uaiice
~ Q
.
~g
#. ~~,q# EotisYrur~ioa Caste DtpDBitsi rtr~ttirp3. Charges Witt bc.ma~ tegainst thi{ deparit if t3tere is ati anageney ea##-ate, b~tttime inspection •or whew Ei1y
•a -. • .'CG{ q{lill,g i6 Yl~tiiTUt. /~ny.5t2ih GQStS Ii14'-XCC58::ux f~]l:.t~G~$tE 5Y1!# ~:bY##~ ~(l2~iC.~GT'tIfF~CEG.
w- ~ ~;
,~ ~ _. ~. ~ -yt~r rtrairi ~siiad sad stmty ar_ regtrttett. Stir pt~a win beght ap -aaae te# rte aloe try ttae Csty.
~. ~a ot`' ire caste deposit ioettaace and zdeo~4 ~ ~ ~ Siatsy wig be instia~ted 6y t9ee a ~ ~~se vmcit
by ~ may-
<. The Fie maw[ m is ~eag: ~aT won sod acs.a€ the arork ~ by t);e city wttt be setar~ in, a,
',
5. Mairrtsn safe pcdesai3n anrl'vchicztlar Crossings and fnx tct:tst to ptlva~ driveways, bus Stops; ftre hydtaats and water valves.
6. A Ctmstzueiion "lY•affit Cnntro# P'!au anti a ~'Sxlst;Q4Ye'are rexttiired }iar ~ttl 3aRe ~. iietwtrs and street closttt#. 11is P~ nut be
~ reviewed sad approved Fries to any krtu closusts:
I 7, 7bt ¢ Coutrvt Pfart Shari cuvfoim to the Cntrraaf M>~ d "tkzfi#s Cortuols for ~ reed A~Saittssara~x ~trcul ZCaas, dated
199f1, availa~it: at Gttt»c. T:atintopntrol e~cpetiptrtC'nt stss$ no~ndc Type tI Ming iartw+r segue ~srsgaiKd,
Rt{tisce as direr by tree Cat}' )rrtgineer any, dartsaged or cemnvad mpsv~r~cnts° ie arxord:uce sr4th City Sandals a~ec3 $pe~Giftations ac ~e s
ofi the Prrrgitt~a: .
'i 9, Ssvreut far a[I PG'C ar AC` reawvsls. An PCC:reausvats shah be ta;~iruestsccnenwrk nud's#w;i# be dowefe~. to existiicg imhrovdrrteetis.
~I t{1:. Prior a}spraval ad inspxtar is required for ury seortc darQe air ndRaial wtffikiag harsra, on wmci:ends ar htx~da~•s and may c+Cqu$ts rein, of
asPeetinn o5sts ~ ttx currttu aveniuee
~ _ tl. Aei~quattsi~rrag~rtg is `tired an ma sew 'Ftaihsro to soeA si ane 8aettica~a
fnd bsrrecsxles and lea the met (incfr>~ng aU #aba+r and ~) tgxinsr tAt caLb
i? compaction tesi'eag of snb~ade, baserc~ck. and aspl+ak coeectrre by Peimiuee is requitcel unless tl~thviSe stated by the: City Fxtginecr.
[3a The Cacrnactor or Ptrmit[tc witf Rave a supcrvispry rtpreser~uativt avaitahie for Ct)ritaeh Ott the projerx at alt Umrs dmin~ cti9xt. ~Gattaetp ca
Pormittne shalt pmvidz a ph~c number at which they can be enncscted outside tha ho~us of SiQQ a.m to 4:.pQ p_~.,
I4, No storage of rrwtGisla or'egciipertextt wifl tAe ailow~ed ae~ar ttsC d psveaar4tt, ibc trivt~ way. cx° within rtes si~+aidts3ttbe v+ttiah pKxdd r
haxandous c~andition tici thcpnbl'zt,
1S. Ttus PQeRd stall rtct t+e consuacd se uuutFxx~tooA for accax~iaet aAd gtad~g an Fcirut P3`°~ !e du wtxti a any tatieu~ wexit ~ > a
mggretc peeriit emay ere re~aire@. ewr does it rrlievD t6ef P`er ad axrlr ~ w etxain ~y ttlt+eex pe~xt rctluircd try. taw,
i6~, 'F#da peavetit does neu rtekx~sc~.tlx P't~etitm from an)s tiatiilitit~ caootaiscd in ~ ar vvle6 the Gty ur! any.er'~t1aC,a~t,
17: Tti#s hermit is not rrartsf`a^strk. 1Vtrtk must be performed ¢~ the Prsrnittee or.h3g des#gdatcd agent ar cantrcctrm as sFccified thereon.
l~f Cast ba<3c {call oat} due to enragaodes rr.$ardiag du's pt~uat sttaJ# bt at tleecurnentavertime rate with a ttree (3) M+ur mraimum ctmrgG Far ~-
# 9: P io t:hapttar 14.(l'~ o` tlac IN • . mac, ~xaTi gat caaor~ to be an ~aattxi~ ir~ri tEsr ssorm tlrasm
tl>am snasn tretter. shaII adhere to t3tc B MAMA blvcF.t~i't° PRC.l;S ~ try rte Saeesa t.'.4tta VsHey Lkhm Remnff .
Pd#luuna Pktr~glou Pnagraae. '
2tf. if tt~ publ7c ~ur+ett nx#uitts n modifraareiu ~ yr a de~roere froaa, the glartr and , the r~ny s2atlT have die authairy m~eti;~ a
say modificatiae oc departure and to speafy the maeaaer in which lhE s is to De stack, fear City-rnvn~i ~ nutiutaizrat faca'tlau~.
2#, ° Prxrnitten masc. provide advance noufiauiQn w at# partite that rcisy be a#fdpSkiil'b~ ShC jSeiiAait activities. Notrfigatioit3ksalt ba atvsawed by ~` pritu`: q
distri;xaior3 a;.d fa.:k+3c t:at~ ~ work and a caneact aa#cu. and ghone nttmbtr.
Jet st~l# sec o~oas~te fnr esastartttg that zli dunoe.~ ~~r this , 'see s.r~e of sasfl d atl of ttaw.abtxve troad€ti1~.
1t~pFticant. late
~ootracrirr {Print Narrt~j
.?~m~s~ivipcrm _ ,. ..
R~-*. 11A.4itL~
,~~
~~
/~~
;fiq
~~
~~
~~
,!G~
I( 4
~ti
E'it~
~~
~/~
F~
~d,
I ~~,
i ~~ ~
~~, ~~~~
. ~6
(~R;
~ (d~
~ ~g
4 /l
. ~~;
~~~
~~
fir.
~r
~r
~~
(b
~d
~:a.
r~ ~,~ c c:
x
-
v ~ ,~ O Z
~ +~;
~ D
d c cn p Cn
`` ~ -i ~
i -~
' -< D
i
~ ~ ~
~
~ v_
I R ~
: D
~ .
-c~v io: D' D
c : Z
m
~i Z ~Z ~ ~ •, IR,
.- G` 10 y D im
'c T IRi ~'
r ~
r
_ z r m rn
r c ~ :.
ro Z O
n
m c
o
~ D -
i~ r C f' ~
c z c
m '~ K a
c G'~
~
~' n
r
r a a c
-i - -
D ~ ~ m
- Z = H
v; G 2
- G•
- ~ L^
' L
`°
n
m
"~ ti
¢ ti
a:
n
z
~
`.
J r~\, ~
~
~
~
-
k (.Q
~
~ ~ ~`
~
'.r W
:_T1
WB
~_~
T
D°o
X
~~
~c
a ''"
m m
tS
i
V
"
~~
~. T
V
/~
Q
'~
a- =
~ ~ f f~ r~'r
_~
. l
. ~ ~
.}
, '. "}
. f'~
y ~ ~I
~ ~ ~
yy
o „
(~ r
n
~ T
/
V
2 c
~ a n
1 ~_
''
s
C {
~ Q7
-~ ~ tS~ '.: CG
O ~ O C~ O
.C-. v a% M
v~ j ~ C ~
6Vi CK ~ N
~ ^- `L
~, ~. ~. O ~
~ ~
~~~~°
o m n ~ ~
x o d ~
O_ ~ O ~
C = ~ a v
~ ~ O ~. fD
v ~ '' ~ ~
co ,-: a ~, ~,'
,^.` ~ - ~_
_ ~ ~ ~ r
O ~ rY ~
co ~ o•d a
~ ~ ~~
~ ~? m ~
..~ N, -I O Q
~ ~ -a ~ 61
~'!+
G n r n
~ c~ d d m
O ~.`G .. O
~ n - G1 ~
~d~d
~~' .o ~
m ~ d m
oo~o.~-
O O O O ~.
fD fD .Z +'
~' n ~ K
~ W O y
.. ~
~ C7 J tt f~D
CD •~ 6 ~ m
n~-r N d ~
=•y Cnt
O .a ~ ~ .+
Z ~~ n
O C> n
X fn~
G~ N N ~
CD N
~ O O"
D
w -.:
O ~ v ~ -~ ~
O C
~
J ~ ..
fD _ ~ 2
a~.r ~.~. C 7
O ~ ~_
~
~ ~ ~ ~ ~)
C
) - ~ n
n -z
J ~ fC
v (:
(~ O
m _
~~ :w to N W O
~ a ~~ ca m
O
'~ r"
~ J N N
~'h
~ C ~
~
o J
~
~.Q
v ~ ~'
~ ~
y fD N U
m
~ ~ N
_ A~ y
'G
S O
O fD
~ Z
O
~ ~ O v
fA ~ ~ -,
.
Cfl
n. ~ v ~
.. ~ ~ ~
o ~ fl- o
n t "~ ~
C1 ~ ~ ~"C
~
~ ~
O m n
O
~ O ~
CD L' Cr1
O ~
~
~
~I~~~r-
'. ~ ~.
AF3EAD
I ~~ -~--,
~~+~~
.~t ~i
pp~
~:rd
rte"
~_ ~
pp~~y¢
~:.d
r~
T
D
i
U
G
L' D
r^
C~:
v
F. CD
D ~~
-1
W
u:
a ~
c~
-~
/~/~
lV
r
z ~
0 ~
~ ~
R,i ~
r ~
c
m n
CQ '~
r
Q; _
O ~
~ ~
`< ~
1; p
-~
CD
CD
J_
~ ~
G~ (p
CD
N
T
T I}I Ji D s C ' :31 D '~ :T' C ~~
`~ I 1
~~ it ~ ~. ~ ~~ .., `°' ~. ', .. L..~"f 9 WWW
~u ~ " ~ " ~`
~y~
~~ ~, ~~ ~ ;rte, ~~ ~,n ~ y -~ s 6~- ;_ ~ ~- ... D 6?'
~ X ~ "~ - ~~ "'~
~ ~ ~ ~D ~- :x0 `-- k 0 ' `- D . ~= D `- E CW `-- ~W ~-- .O fTl
T ~ , h
V [ i
~ ~
m ~ ~`` ~z ..~- mss; 4 _ `~ .._: m ~.
~. ~ ~ ~ -~
m 0 -. r ~ ~ -- '~a~,. --, ~ -~ - cn~ ~ -- .~ ~~ ~ ~N ~~ --, .N ~~ ~ ~..
i F...; ~ „
'JC2, ~S.j~, M+
rs ~
ter, J ~ h ~ ~ D ' ~ ~:, ^ ~ ~ ~; --~ N -~ ~ ~ ~
~,.
~ Z ~'.O ` ~ p , ~! D ', ~ D ~ -_O , ~-- ~ C~ - -ate -- = ``.D _ ~ CEl
~ ~ ~~i~ ~ t D ~ `t ~ ~ w ~` ~C.17 ~ '~ ~'~ ~. ~" cL~ 3 (n Fi"D ~ ?N ..J~
n
,= p ~ 6~ '-~ ~ ,- D , ~ , N - N ', N L ~P'
Z L3 ~ °~ _~ ~ : dal ~.
~~ ~ . ~ ~~
~~~~' n , _ s~7~ . .. _,~ ,~ ~ ~,.: ~..~
~ _
D p' I _
_.. - _.
n.
~ .
~~
,,,:}
y>'
C
~ U~
C CD
~ fl:
~ -
~`
~~
~~
~~
~^
~~
~~
~~
n
c; c~
n; ~'
c~ o
~Q
~<
~~
~~
~~
o~
~~
Q~
~- ~~
~~
J
~.
rJ. ~
C~ _~
C
~ ~.
J
-~ L
r~-*
n
~.
~~
:~
J
n
C.
T
X
...~
~
D
G c~
~
rn ~ c C ~
~ r
x
~,
~ ~
o ~ rn
~ c~ w
~ N ~ ~ .
~ o ~ ~ ~
~ ~
~; ~ °
_ rn <
~ ~ ~
~; ~ n
~ ~
~~^
~
{
\
i
~
'
J
~
N
^
' ~ ~- ~/~~~)
rii
~~
o ' cn w rv ,
-n ~
m a :
N
0 o
0 cn.
0 o
0 .
m
~ m
~--r. Z
n :
, -a
O.; _ Z t1T . ~
C,a n ~ .
~, ~
(
\ii
`'~
C