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ENC2010-00026MPR-19-2010{FRI) 07;58 CableCom {FRX)707t1258730 P. 0021006 CITY OF CAMPBELL pEPT. of PUti1Jt WORKS 7o North First 5enet Csmpbeall, CA 95006 Fu. Iaot3) 376-0958 ENCROACHMENT PERMIT ifor warldng whttin the public fight-cFway) 3(2~-~~° Permit Etrpiratbn Rata 2~' ~ ~ ~ Pr11it Form Pamtit N~~ C 2610y DC~11c x-t~e~ Fil Applitbtion Date AppllCatlo ~Im t ^n~/ ,~ M APPLICATION - Appllcatlon Is hamby meda for a publk Works Parrnit )n nrcardanee with Campbell nnunlripnl Code SacUon 11.04, (Appll©Uan expires In six (b1 months If the pertntt is not Issued. App)iwUon Fee k non-refundablal °`6 ~('~ C 1"~ ~..\ ~.C ~1 tL 1 A. Work Address or TraR No,; I ~ ~ ~ ~ ~• ~ ~'~ Ci.r-~~ Utllity'frcnch Loq+tiost: I'-'2 ~"~ ~ ~ ~ PUBLIC WORKS e. Naturaefwark I~~ ~4tGQ.0$5 }.9,2N~~"( 'fP ~t.;;~A~Y~ E'~FkSTt~r CO.~~I-r C. Attach four (4) copies ofan engkteered plan showing the lacatlon and extmtaf the work and four (4) copks of the preliminary Engineer's 6timata of work The pions shall show the retatlon of the proposed work to rxlsting surface and underground impmvemants. When approved by the City Fngkteser, said plan brcomes a pert of this permit 0, All workshall conform to the Cit)r of lampbell 5utndard 5pecliiwtlons and patolls for public Works Constnictlon; Cho General Permit Conditlons Astcd on the reverse side; and the Special Pravbllans forthis pemtlt. Ilsteld below. Fallur4 m abide by thaw canditlons and praulsfarr.'may result In Job shutdown and/arfarteiture of Faithful performance Surt:Uesand cash deposits. (.5as: General Permit londidons 1 and 2,1 E. The Gantractor must have this pe:rmirand approvrd plans at the sltaand mutt notNythe public warlat Rapaltmant at toast two days defora smrUnp work Notlcr must be gi+ren to PubHe works at toastx4 hauls befate rosutrcing anywork ~~_~ 1Vame of Applicant: ~~ 4E. ~O ~ ~ '1 L ~/~ 'Ealephana; X07 • ~ ~ 7Q >~[ +T ~ Z~ Address; ~~~ ^ t.,l ~1' ~ ~~~ l~1NallAddress; •u'IW •LV"0.t/~7rQ.. ~T A-(~IOURENIEtiGk'~tCYpMONENUM~ ~ ~, ~a ' ~OO~Q (,,,1 ~~' Ischisworkbain done the ier~~~~r ~~ CY v g by propmtywmentatt Town real enact ~ ~ YE5 (""' Nb Tha Applkant/PenntGtae hereby agree} by affixing their signature to thi11 permit to hak! the Qty aF Campbatk Its affknra, agents, and employees free, sofa and harmle•.s from any claim ar demand fordamages resuldng from file work covered by thta permit. The Applieant/permlttee hereby at;fatawledges that eheY have rood and underxsnd bath the front and bstk of this permit and they urlii Inform their contractor(s1 of the Mfannadon. Appilr~nt is advised that upon issuance of this permit, Property owner. or property owners successors, shall tae responsible Farany and a!1 damopes adslnp out of condklon any privet provement3 in the pubtk rigltt~ofway. ( ra parmitteel lsk~n) Data iContractar) Narttel 5PECIAL PROtJI51dN5• _I, Street shall not be open ctrc far underground Installation;, Mlnlmum cuts t0;tybe allowed for connetitlans arehrplaration holes. Such cuts ~ ~.nedlksls ly~pea„~~r ~f ~nsnecter nd to evttlne, Y .~. pavement may becut forunderpround Instillatlans Snd~must be n~tored in accordance wilt the Standard DetallsTnxuh Res<taratlon Met)tad "A". urtlasf adtarwlse approved by the Engineer. ~3. warkto ba socked by a licensed Land Surveyor or llvil Englneorand two txi copkas oFtho cut sheetssent to the Public Works Raportmenc beforestsrUng work 4, Per Secdon+Fxt5 atthe Govemmenc lode fhb permtc Is ncnvalld iore,<cavatians until underground Service Alan (uSA) has bean noclllad and the Inquiry IdenUtlcatlan number has been emtarod baleen, USA Phone: t-0oo-?Z'lx60a. uSA TICKET Na „_,_S. Prlar to any work the property owner shall r:ecuto an Agreement for Private Improvements In the Public Rlghraf•Way, which shall be reoordad. ~„",^6. PublicNotltlcaUon Raquire:men~ _7. SFF FI1B1 ~ WDRK5 ~ QED ,ALE FQR CLRRENT FEE PEI)a811'APPLIlAT10N K~ PLAN CWECIC pEPG5CC SECUtiftY FOR FAITHFUI, PERFORAAANCEAJIBOfi& MAT~fuAIS CGNSfRIJ~fION CASH DEPOSIT P1AN CHECK& 11V5P6Cf ION F~ APphovEp KOq ISSLIANC@ Permit EYvtras 1Z issued AMOUNT 3~5 S 5 s s s z o >ir~llri' NC. /ln . ~~c S l f /r S ~ l/ MRR-19-2010(FRI~ 07;58 CableCom (FAH)~074258730 P. 003/006 G L R FT ONQ1 ONS I. a tonxuueUon Cnxh deposh>x resqulrod. ptorgpswill bes ntades npainst thlx dopoRit IFthesre ixan amarponeycalNou4 o~artlme lnspcct{on orwhen Qty otdesresd bart{cpdirrp b resqulrerd, Any such cnxts{n tyn;essx oFthes dopasitwill bo billed to the Pertnlttoa. 2, A ona~year mplrrtartanca period and suety pro regtdred. 5rrch parlad will begin on date of written acceptance by the Ciry. ~. Aefund or the Cash deposit balanea and refund arcaneellatlon of the Faithful Performorxe 5urotywlll ba In{tiatesd lyy the wrhtan pteapranre aF the work by the pty. .t, 'i'he Parrrrittaa mtm requesxt In wAt{np p final Inxpocdan pod acceptances of the work upon complatbn, ACCOptance by the aty will ba mode In wrldng to the Parsnlttaa. S, Mninmin xafa pndeptrlan and vehkulare7assings and frees netpxx m private ddveswayx, bux x:ops, Rro hydrpnpi.and water valwnl. 6. A ComrtrudlonTralfiC Control Plan trod a Constnredon 5chadule are requlrod Carall lane ckasuros,detours, and strcat rJoxunas. 'fhix plan muxt Ise r4wiewerd and approvrd prior to any lase ebwres. J. A Canxtnrcdon ~'roffisCrnrtto) Plan shall Conform to dra Cplttpnx Manual af'fraflle Cantroix For Canxtruetlon and tNAlntanance work Zones.dated i59q, available atCaitnrns, Trafl{C Control aqu{pmant shall IneludaType II llaxhirrr~ anew signs if raqulrad. a, aaplntes ax dlrerCtad by the City Cngineerany dtunaged or eemoved improvomemn in ncenrdane:a with City Standards and SpeclFiwtlanxat thes solo a><pansa of the Pannhtaa 9. S.~wcut Forall PCC arAC removals. AN PCC rarrrava{s xhall bats the nenrast sCOmrnark and shall ba dowalerJ ro ealsting Improvennenb. t 0. Prlorapproval of Inspattcr Ix roqulrod iornny work dana alter normal working hours, an wesgkemdx or I+olidayxand ropy require ralmburxorrrent of inspacdon coxes pt thacunonc orrortlma rata. 11. Adequate signing and barrkading Is requlrod an the Job silo, Fallura to pravlda such signing and barricading may result to the Clry's prrwldinr~ xlgn{ng and bnrriendefs and charging the eau pne)udlnr~ all labor and materials) against thecash deposit t Z. CampaCtlan tasdnp of twbprpdes, bare teCk. and axphpltcotteresto by Parrnittese h required unleaxatherwisastatsd bytha City Engineer. 1~. 'ChaContrnetororpermlttnewlllhaveasupervharyrepresentatireavallableCoreontaetonthaproJeetatalldmasduringcemsttuNnn, t.anttactnrer Pesrmlttara shalt provide a phone number at which they can ha eontae:tnd oublde the hnun nl8xtoa,m.maioo p.m. 14. No storage aF matartalxarequlpntarrt w{II bvallawed noartha odpe al pavamant. the travalad way, ar within the shauldadlMt which would taaote a hourdous eandltlon ro the pubgC. S5. 'Chlspannlcxhalinotpacr,trsttuadnxaudtetl~tndonfnr~nvndnnnndgrndlnnont+ri~nrpraF+anyadJacatKtothaworkaranyatherwarklorwhieha xeparata permit may bo raquiresd, nordaax It rollaw the Pesrmlttoa pF anY obllpadon m obtain env other parm{t raqulrad by krw. t 6, 'i'hix ptmnh does oat release the Pormlttee From any tlohilttiesconralned In otharagroempnn rx gontroeas with thesCity and nnycrdtvr publicapenCy. t~, 'flrlapermitlsnatpanxfarpbla.wotkmuxtbesperrformetdbyshopesrmlttaaorhlxdaxlgnptedagerrtareaxrtraCtoraaspedfkdtharoon. t s. Cell back stall oud due to ertreregerrdes regarding this pemmitshall ba at the current overtimes rote widt a throes q) hour minimum dwtpa per oC4urforlKes. 19. Purwont to Chapter t4.C7 of the Campbell Munklpal Code, appllrant shall not causeto be dischargedany material Into then munldpn) xromr drnkn xyxcam nthar than storm water. Applleantshall adhere to the OG4T NIANAGFJNEIVT PRAt'fltxS mmbllsherd by tha5anta pant Volley Urban Runoff pollutlan Prwendon program, Zo. If the pubNe Interest requires a modlfiCadon of, era departure From the plans and spaclAcatlons,the qty shat! have the authority ro raqulresnrapprova any mndlflKadem ordantprturesand to spexlfy the manner In which thesama is to be mpda krrpty~owrteld or ma{nminetrl Eadlldax, 21. Parmimce rtnntprovide advance notlflCation mall paRkx that Wray ba afFatttad bythe permit aCdvldes. Nodtkadon shell be reviewed by Cher City prior m dixvltw8on and include dotes oFw~rk and a mnsaetname and phone number. Applleane shalt be rasponslbla for ensuring that ati thaw provldinp sarvkax undertha appllCant are aware and underrzprnd all of the above conditions. Coneracmr fP'rEnt IVattres) ~,f~~l~l ~a~ ~~ZrlL~f~~ ~~ d:Hotna\wabsltoll.pnd ISov KorlCroorhmesnc Parmlt SI'A"!'1C fcrmt2.ixlf Aav. p 1IpICS) MAR-19-2010{FRI) 07:58 CableCom ~ 5.~. ~ ~- ~ s ~ ~ N n ~ ~_ ~ ~ ~ ~ ~ ~ ~ ~r ~~~. 1 ~ ~ ~ ¢ ~ f'~ ~ ~ M ~~ ~ S+~ 4 ~ f ~ ~1 1 ~ ~ . ~.~,~ r o o ~ (FAX)7074258730 P. 0041006 ~ w Q Z C~ 4 ~ _ ~ ~o ~ y ~ z0 ~. ~ Z ~ ~.- ~~ ~ ~ ~ ~ `~ ~ ~ '~= ~ u W ~ U '' ~ ~O ~~ ~ U ~ ~ S]. d ~~ ~ ~' - a ~ } ~ ~ ~, ~ r r ^ Pf J ~ ~ ~ 1.~ ? ~! ~ ~ ~ ~ ~ ~ '~ `~ ,~ ~ ~ ~ ~ .. ~~ ~ ~ ~~ MAR-19-2010(FRI) 07;58 CableCom {FRH)707425$730 P. 0051006 ~ ~ 1 ~ s r ~ 2 ~ ~ ~ ~ ~ ~_ ~ _ ~ ~ ~ •. 4 ~ ~ d ~ p ~ ~ ~ r ~ ~ 3 -- j wt~ -" I 0 ~ ¢ ~ . ~'~ ~ P ~ ~ ~ O M - ` ia?.Cj - ~ \s ~ . ~, r A ~ ~ ~ . ~ Q -- ~ n Zn ~ I ~ C ~ O ' _ • ' , ~ ~L.~C~ ~!'j„~~ ~ ~~'P+1Cld1 N V _ ~ o ~ r ~ '.:' ~~ ,~~a7 ~ o r ~ ~ ~ O ~. 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S~5 Chadbourne Load Fairfield, Ca. 94534 Telephone (707) 759-4070 fax (707) 759-5741 'T r a n s m i t t a I Date: / r ~_ . _, From: ~ ~ L.C~..1~°F~•~1 {~,4rtr+r~~I Number Of gages: ~ (including corer) COIDmentS: ^R.C7Ar N' ~P4 Co~~deat3~.i Dtoti,ae phis facs~,u~i,ic caner shear, sad arty aocumeaas which shay accomQaay ir, coatair~ ix~ormaeiaa ~xatn CableCom ~xtc. which is iateaded for use ea,1,y bar the individual to wham it is addscased, and Which may caatt~in 3n~or~tiarl th,~t is privilasted, cantideatial turd/or ethezwise exempt ~rcbt d3sc~,osuxe urtdar appl3cab3,Q ~,am. If t};c reader ox this messaga is not the intended recipiaat or tha ~nployea ox agens respcasible for delivct:ia{~ Chic mcaa~a~te to the ia~ended t:ea3nient, say zeview, diac],oaure, dissemi,aatiaa, d3seributioa, copying or other uses of this massage ar its »ubstax~ces is stricaly prohi,bit~. ~f you have receivQd this commua3caaioa is array, glaase nocixy ~ immediately by telephone to arrange for the zctuzri e~ thio cammua3cation Co us at eux c~anse. Thaab aau. .