ENC2010-00017 ~ : Princ Foim
t~1'YtSFCAMPasr~ ENCROAQ~tNtF.M'P~RMtr l
permit No ~'v C~D~7, bQp
DEPT. QF P{lBCtC WORKS
(far working within the public ~Z
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CBrnpbel4 CA 95008 pp
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Fx. (a0g) 376.0959 Issued 2 G
,- Ap(sitcadon F~pEration tom,
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Permit Ert
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APpL1CA't'ION - Appliptlon is hercbymade fora Pubec wort Penult In J~lcard7rnCe with CAmpbell Munkipal Coda
(6) months Il the permit is not issued. Appllcadon nom „ _
A, Work Addn~ss orTrart No:
Utitlty7n:ngh Location:
~~~~xED
-r -- - ,.,,yea c~i- rtwrvsx ~~ ~(' _ -..-
a Nature of work SC7~¢-E $ p~br ~c~ ~! l (o ~t ~/
G Attach four (a) copies nrpn anginetsrad pbn showing the lorauon and extent of the work, and rour[4)~ of t~prcNMlnary Eng3near':
f~titnAte of work 'Cho plans shalt show the rclatlan of the proposed workto exltting surfAeeand under9mtrnd improvements, Whim approved
by the Qty bnglneer.ald plan becomes a part of this permit:
t~, Alt workshall conform to the filly of Campbell 5glndatd Spoclfleudans And liatAllw for Pubic worlts Cortxtructiont the GenarAi Permit Candldohs
listed nn the:pverseyldGand the5pedal Provis(ons forthls parmlt, Ihltad beltriv, FAllure to abide krythalte condidomt and Provlslotat may result
in job shutdown and/or fodekurr of Fahhfui perfonnRrax-+5uret(ospnd cpxh dapod~, r(,~ taanaral Permit Conditions 1 and ~
E 'Che Cantnrctor must hpva thM pormlepnd approved plans at the site and must notlfy the Public Works Department at least two days before
srprting work Natlce must be given to Public works tit least 2a haunt before n~ttArNng anywork.
Name ofApplkarrt ~~~~~ 7eiephone:
Address: rl,ti,~~
.7C/ (~,,~j,~CI~^ST ~' L-~ L, ~ v6~-wto rZ,.6j ~ ~K f'SS~
E-Mall Addresst F.~ . ~~~ 2a-~tOUa F~pGENtY PHONE NUM6~ER.
Is this work bel done the `~~ L~ ~ ~ GT
ng by Property~nentatthairawn reaidencet r yg5 r' Nb
The AppNcAnt/Pennttt~ hereby agrees try afflidng their signatun: to this pertnk to hold the Qty of Campbail, its afficar~, Agemri, And amployoas Frey, zAfe
and harmless from any claim or demand Far damages re5u(ting from theworkeavered bythlx pertnlt
'Cho App1(cpnr/Pemtlttee heroby agknowledges that they have reed and undal~rand both the Front And bpek of thkt permit, and dray will Inform chelr
canuactarfs) of the Inronratlon. Applicant Is aduh,ed thAt upon ktsuAnce of this permit property owner, or Praperq- owner'« wCCawsars, shalt be
responsible for enyand all AmAgas Arising out oFtho wnditlon orany pflvate improvements In the public; dghnalwvay.
Aeosptad: -- - ~ ~ I .y .~ ~
~~~
~~r uara
,,,,,,~1. StreetshMllnotbeopencutForundergroundlnstailatlans. Minimum cuts~ybeallowedFareannectlantormrploratlonhotas, Sucheuts~;
~~` seectRexllvanarovedbv~he,lns eeerlertetrml~n,
.~L~. Pavenrcnt mAy becut tarundarground Installations and must be rertored in s~ermiAnce with the 54tndprd Dewils Trench ResWration Method
"a"~ un1~s atherwlsa approved by the Engineer.
~._,.,9. Work to be staked by a accused Land 5un-eyor or dull I:nginoarAnd twro (2i copies of the cutsheets scat to the Publl[ Works bepartment
borom starting work
a, PgrSettion 4215 arthe Governmtrrrt Coda thkt permit is not vplkJ for ex:;avadons until Undergnwnd 5ervlce Alert (U5A) has been notified and
the inquiry Identlfieatlon number has been entered hereon. USA Phone: 1•BD0.227•I6t]t). USA7iCltt=1' NO.
~.,~. Prlorto arty wartti the ptopurtyowngr«Iwti execvta an Agreement for Private Impravernarrot lei the Pubtk R(ght*oFWay, which shAli ba
reCOrdad.
~6. PublirNodfkAticn Roquk~amentr
~'1, ~ tK b tKIN y w dr a .. w ~L~1--~-~
~~~9 -IC1N0 S>:FF~m+EO 11 KDRCtlppt~"; K S AMOUNT 6da~vc T 7 ~~ mi r+Y~1t7w1 tJ11
PERMITAPPUCATION Fff ~ NO.~
PLAN CHECKDEPO5IT S --
SECURI'tYFOR FArFWFUI. PF.E{FQRMANCFJIABOR & MATERtAL5 S~~
CONStftttt:7'tON CASH DEPO5iC S
PLAN CMECK~r iN5Pt~l'lON FF~ S
~~~..~~
APPROtrED FOR ISSUANCE __- ~- 25 I ~ G
ForQtYfm(dnCer pom `~~~~
Permit fxpites 1x MntrslgAharppcenfiswance
D I~ / ,
V00/200 'd OEL852DZ0~(}fd~) Sire ~5 ~ ~ a
3 igp7 DU ~~0 {0314)0102-U2-83.~
GENERgLIaERMriCtentf~pryp ~
1. A Construction Cash Oeposlt fs roqulrad. Charpat will be made against this deposit If them Ilan emergency call~nue, ovrrelmr insptrtinn nrwhon t:lty
ordered bairlkading Is roqulrad. Any such CDRCi In arkeft of the deposit witl be billed to the Pemtlttee.
~. A artoyvarntolntananra panted and suietyaro required. Such patind will bopln nn data ofwrlecen a~opmnco bytho Glty.
3, liotustd nr thocaxh dopaslt balanrcand rgfurtd tx WnCgltadoft of thq Fahhfui Pgrf'ntmpttCe 5utgtywlll ba Inldatod bytha wrftton aecapurnce of the work
by the City.
4, Thtl Perrnittea nwsr roquast In writing a final inspeetlon and acrapcanre of d+a work upon Cnmpladon, Arrapwr~ by the City wql bo mpdo In wilting
to the Pormlttoa
~. Maintalnsafepedostrlanandvohlcularkiasefnpsandf'raaateesstoprl~atvdrlwlway;,busstops,Aiehydntnes.andwatarvolvas.
6, A ConRtrttetion'Cralfle Control Plan and a t;ettxtruednR;ahgdulearo raquirod for all lanadaxtutx. dotaurx and et-nr clasuras. Thh plan must bo
reviewed and apprrs+rod pdorto arty Ipna Claxurox,
Y. A Consutretlon TraRiCContRll Plan xhall Conform is the Caltrans Mltnue) ofTtafflkCantrdRfar CrxrstnsCtlanand M+dntananee Wark Pones. dated
1990, avollableat Cattrans, TraRtC wntnoi equipment shall IndudtrType II tG7slting arrow slgrn tf tagtrlred.
& RoplaCanydirotttldbydtatltyL•n9lnceranydomagcdorremnvedimprorramaneslnvecnrduneewithClty5tnndnrdsnnd$podfirndonsatthoxolo
e><penxo of the Ponttlttge,
?. 5ttwrut -orali PCC or AC remtwals, A!1 PCG ramaealc shalt be to the nearost scoramark and shalt bedtrwelad to arisdng ImprovemtMts,
t 0, Prlarapproral of inspeCwrlx requlrod fwany workdonoaftor nomrai wwidrty haunt, on woekondx or holktayx and may require reimbuntament of
Inspection costsat the Wnentoverdma rata.
11, Adequate xipnlnpand borrkading ix required nn thgJoh xlto. Faliurerto prcvidgxudt xlsptirxf and baMrading tttay rgxult in the pty'x ptnvldinp xipnlnp
and bartleadoRSrtd eftarpinq ehq rnxc littrludtng all ktbnrand tttatpriatx) agalnxt thq rush depnsly
1 ~. Compttrdon tasdng of wbgratlm hose rael4and aRphalt t:orteroto by Parrrtittae Is required unlesr; othmwise ttpttad by rho aty Engineer,
l3. ~'ItaCnntraCmrorparmlttgawUlhovrasuperylsoryreprescngtly,~.av~~yleforcontaCtontheproJeCtatallUmesduringconstroctlon. Contractoror
Permlttvaxhall provide a phone number et whldt thayean ba contacted outside the hours of t~ a,m. ta4~DO p,m,
Ira, Nostorrgaofmaterlalsorequlpmarr«wlllbealloMwdnearthvodpcerpavamot~tlx~~way.orwlthlnthatsltQUldorllnawhkhwouldcratna
i+a~grdnux rnndltlnn m the public
1S, 1'Itixportttitxftallnotbaeonsetuadasauthorl:atlonforercaaatktn andgradfntlanpri+gttaPmPanYadlaetanttathaworkaranyatherworklorwhleha
MP~tta permit may bo iactultad. nor doss It rClleve the Parmlttatt ofany oblir„pdon to obtain anyotiter permit required by few.
t6, 'ChispannltdttazneltrelvpsatlgparmlLtavfrpmanyUebtlitlntCOniainodinathoraptogmonp~Or~onT7aCtxwlththoCltyafldanyothgrpubll~aytnCy.
t 7. This permit Is not transterabio. work tnuRC be porfanrtad by the hormittoonr hix daxiprwtad apantnrrnntroCrorexapariRad ehgronn,
1 & Callback (raq nod drat to artteregcncies rogerding this permit shall he at the currant oaartlma rata with a three f31 hour minimum dtarpe par
actarrrertCe.
19. PueRUant to Chapter 1AA2 of the Campbell Munklpat Codt,appltCant shbl! not txusa to ba dGtChitrpad any trraterlal Into the munlelpal storm drain
system otharthan xtamt water. Applk;ant shall adhere to the BEST MANAGEMENT PRACTICES astablls3ted by the Santa Cfara valley Urltan Runoff
Pnllutlon Prevention Prognrm.
20. If rite public itrtorottt rgqutros a mtxllfkatlon o(, ore deptarturo from the gloms and RpadRq-tlar,R, rho CItY xhali Nava the authority m tequtro nr approve
any rttodiRCadan ardaporturoand to spgrlfy that nwnner In whkh the same is se be made farGty~awned ar malntalnod fadlldoR.
x1. ParrnltttoatnuxcprovldeadvancenotlfiCatlantaaltpxrtietthatmpybaaffietodbytttat5attrtfcaCdW$as.NnelRcadonshallherewiawedhythgCltyprlor
to dlrttrlbudon and (nrludb dates of wtxkand a contact rtnnte and phone Wombat.
Applicant shall be responsible foronxudnp tiwt tJi thoxq prnv{dinp xarvkos under eha appllcantaro awaro and undarxtand all of the abaw Condhlons.
contractor (PrlntNantq)
I?at~
.~talno~webxiwu.and oe,- rotmslEncraachmone PormttSYA'i'~ tnrnt~,pdf
Ra+-.n>Ir~ros~
000/EOO d OEL8520LOL(Xd3) 'a~]aIge] SOLO (03fh)O102-02-833
~~
CahleCo~
C,~z~~Cam, inc.
$25 Chadbourne Road
RECEIVED
~e z a Boa
'~
1.+airlield, Ca. 94534
'Telephone (707) 759-4070 lynx (?07) 759-574
'T r~ n s m i t~ a l
Date: ~ r ~y" ~ l ~
,~
To: ~ 4 ~~
rrotm: ,~~lr;~ C~'C
lumber Qf Pages: ~ (including cover)
Comments: ~ NC.I~~h~~ VIE ~ ~ _~e~2w~_~-r -~~
C~ideati3liLy n~atice
7'hia tacaimilc CgvCZ aheeC, and a.ay dcCUmCr1Ca which m«~y acaamQany 3c, contain
iatozmazian frwa CablcCom inc. which is intcndcdl Ear uoe only by Cho inrl3.v~,dua.1, to
wham ie ~.s addressed, and t+rhi.eh may conzaia azawC~,an cttae is pxivilsgsd,
car~idcneial and/ar otherw~,ac exempt dram disclo:~uxc uadcx ~agplicatale law. ~~ Gha
rsadcr a~ r1,ia meseags 3s uat the ineendsd zscip~,ent ax the employee ar agsnC
xssnoz~ib~.e iar delivering t2~,a meecage to tYss ir~tsx-dcd zcc~,piene. any review,
di.aclaausa, d3eQemitxatiaa, dicr~ibuciars, capyirrg or athez ueen of ehis message ar iee
~ubatancee in s~xictly prQhipimad. T£ you have scce3.ved this commcatian iz- czrar,
picace naei~- ~ imp-cdiaeely tyy eslephaac to azrsnge i~er the return a~ r.2~it
caomnursicatiori to ua at oux expnnss. chunk you.
U00/l00'd OEl.852VZOZ(XN3) w~Jatpe] UV~LO (03h1)O102-U2-833
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