ENC2014-00155Print Form
CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No
DEPT. OF PUBLIC WORKS (for working within the public X-Ref. File
70 North First Street �' , t, right-of-way) Application Date �)-Z\ —1 i }
Campbell, CA95008� Jp Issued U 2� Application Expiration Date
Fx. (408) 376-0958 AUK q14 I APN
Permit Expiration Date J
27
APPLICATION - Applic iQn is-her'eIppkm de1�o�r�{P'ub' lic Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application expires in six
(6) months if the perimi 11S not issued. Application Fee is non-refundable.)
A. Work Address orTract No.: Intersection of E Campbell Av and S Bascom AV, Campbell, CA
Utility Trench Location:
B. Nature of work: Excavate Asphalt to lower manhole to existing surface grade. Restore to original or 16
C. Attach four (4) copies of an engineered plan showing the location and extent of the work, and four (4) copies of the preliminary 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 apart of this permit.
D. 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 abide by these conditions and provisions may result
in job shutdown and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions 1 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
starting work. Notice must be given to Public Works at least 24 hours before restarting any work.
Name of Applicant: ATT, ArtCastillo Telephone: 408-635-8812
Address: 870 N McCarthy Blvd, Milpitas, CA
E-Mail Address: ac1634@att.com 24-HOUR EMERGENCY PHONE NUMBER: 408-868-3319 j
Is this work being done by the property owners at their own residence? C 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.
The Applicant/Permittee 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 issua a of i permit, property owner, or property owner's successors, shall be
responsible for any and all damages arising out of the condition�of any p •ivat i prole!ents in the public right-of-way. ,Q
Accepted: l,!
(Applicant Permittee) (sig Date
(Contractor) (Print Name) Date
SPECIAL PROVISIONS:
1. Street shall not be open cut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts may be
specifically approved by the Inspector prior to cutting.
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 4216 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 recorded.
6. Public Notification Requirements:
7. Uh- w n Ci_oSu = C Cty v - 7 LU �'I /NI —3 PM
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT RECEIPT NO.
PERMIT APPLICATION FEE $ 365 C2
PLAN CHECK DEPOSIT $
SECURITY FOR FAITHFUL PERFORMANCE/LABOR & MATERIALS $
CONSTRUCTION CASH DEPOSIT $
PLAN CHECK& INSPECTION FEE $ 1
EMERGENCY PERMIT FEE $
APPROVED FOR ISSUANCE 1� ��7.1I
r City Engineer Date
Permit Expires 12 Months After Date of Issuance
GENERAL PERMIT CONDITIONS
1. 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 deposit will 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. Submit project schedule 10 (ten) days prior to proposed start of work. Special provisions may be required for work within City facilities and
downtown Campbell.
S. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing
to the Permittee.
6. Maintain safe pedestrian and vehicular crossings and free access to private driveways, bus stops, fire hydrants, and water valves.
7. 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.
8. A Construction Traffic Control Plan shall conform to the Caltrans Manual of Traffic Controls for Construction and Maintenance Work Zones, dated
1990, available at Caltrans. Traffic control equipment shall include Type II flashing arrow signs if required.
9. Replace as directed by the City Engineer any damaged or removed improvements in accordance with City Standards and Specifications at the sole
expense of the Permittee.
10. Sawcut for all PCC or AC removals. All PCC removals shall be to the nearest scoremark and shall be doweled to existing improvements.
11. Prior approval of inspector is required for any work done after normal working hours, on weekends or holidays and may require reimbursement of
inspection costs at the current overtime rate.
12. 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 barricades and charging the cost (including all labor and materials) against the cash deposit.
13. Compaction testing of subgrade, base rock, and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer.
14. 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.
15. No storage of materials or equipment will be allowed near the edge of pavement, the traveled way, or within the shoulderline which would create a
hazardous condition to the public.
16. 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.
17. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency.
18. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon.
19. Call back (call out) due to emeregencies regarding this permit shall be at the current overtime rate with a three (3) hour minimum charge per
occurrence.
20. 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.
21. If the public interest requires a modification of, or a departure from the plans and specifications, the City 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.
22. Permitttee must provide advance notification to all parties that may be affected 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.
Applicant Date:
Contractor (Print Name) Date:
J:\FORMS\Templates\Encroachment Perm its\Encroachment Permit STATIC form2.pdf
Rev. 02/14
CONSTRUCTION NOTES
1. PERMIT TO EXCAVATE ASPHALT
TO LOWER EXISTING MANHOLE
TO EXISTING SURFACE GRADE.
2. RESTORE AFFECTED ROAD WORK AREA
TO ORIGINAL OR BETTER CONDITION.
INDEX
1. CO VER
2. LAYOUT PLAN DIG UP
3. TRAFFIC PLAN
J�aut IISSUE
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S. BASCOM
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CAMPBELL, CA
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Services
A FupYwa BUNnase
THIS JOB WAS ENGINEERED AND DRAWN BY DAVID
GARCIA OF AFL TELECOMMUNICATION SERVICES,
INC. UNDER CONTRACT WITH AT&T. FOR QUESTIONS
AND ASSISTANCE ON THIS JOB PLEASE CALL
ENGINEER AS NOTED IN THE TITLE BOX.
1y 1ilAm
SIDEWALK
- - a
a
MEDIAN
0
SIDEWALK
BUILDING
2150
STREETLIGHT
— LOG —
LIP OF GUTTER
FIRE HYDRANT
— S —
SEWER/STORM DRAIN
— C/L —
CENTER LINE
R
CITY MONUMENT
— E —
ELECTRICAL
®
JOINT UTILITY POLE
— TEL —
TELEPHONE
MANHOLES
FENCELINE
P/L
—O—
SIGN
— W —
WATER
BOLLARD
®
STORM DRAIN
BUSH
®
SAI CABINET
TREE
BOW
BACK OF SIDEWALK
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CPC
TYPE C-40 PLASTIC CONDUIT
FOC
FACE OF CURB
SW
SIDEWALK
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CJA,
OTHER UTILITIES THAT ARE NOT
SHOWN MAY EXIST IN WORK AREA.
LOCATION & DEPTH OF EXISTING
SUBSTRUCTURE NOT GUARANTEED.
CALL A TOLL FREE
48 HRS PRIOR TO DIGGING
FOR ALL SUBSTRUCTURE
LOCATIONS
800-227-2600 or 811
ISSUE
aut 1
DATE
8/14
J
AT&T EXISTING MH 34
RAISE EXISTING MANHOLE
W
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TO EXISTING SURFACE GRADE
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21"=20'
20' 40'
SIDEWALK
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MEDIAN
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SIDEWALK C❑NST ARC COMP
QGE❑/C❑
N478
EXCHANGE SNJSCA12
ENGINEER A. CASTI LLO
TELEPHONE (408) 635-8812
ENGR ARC VOKDJW550
TYPE OF C❑NSTRUCTI❑N
PROJECT PERMIT
R❑/EST NO 9254971
DWG 2 ❑F 3 P 504 — -
- 1
NO. F LANES ISSUE DATE
CENOTHER I I LEGEND ���� 1 8/14
RIGHT SIDEWALK CLOSED F-I TYPE III BARRICADE W/SIGN
ROAD ❑ LANE END AHEAD�- I I TYPE II BARRICADE W/O SIGN
WORK IGH LANE CHANNELIZING DEVICE
AHEAD CLOSED CLOSED ROAD WORK CROSS HERE I/ TRAFFIC CONE WITH CLIP ON SIGN
AHEA w20-1 SIGN a r SIGN
G20-2 R9-11 I Q
OSIGNALIZED INTERSECTION
W20-1 C20 C30 I �I ARROW PANEL (FLASHING ARROW) (WHERE REQUIRED)
HIGH LEVEL WARNING DEVICE (FLAGTREE) (OPTIONAL)
JO FLAGGER
Q TANS TOW AWAY NO STOPPING_ TO_(SHOW HOURS)
��( J/� TANSAT TOW AWAY NO STOPPING ANY TIME
® WORK ZONE (ACTIVITY AREA) LIMITS
DIRECTION OF TRAFFIC (NOT PAVEMENT MARKING)
,y, D�❑ O ROADWAY DESIGNATION (A THROUGH D)
0
SIDEWALK
I � I
R9-11 SIGN
— — � W
QV NP R IELL L W[Eo < o
MEDIAN
® •. i� �. H 34
SPEED
LIMIT
35 R9-„ SIGN
NO PARKING
r7SIDEWALK
z z SIDEWALK
in Q
ipl 0 BUILDING La
3 0 0 2150
0 U MEDIAN
250' 250' AV 250' ~ I I = 9_ m o 1EK L _ L� WE ❑
L;�
Q I I SIDEWALK
GENERAL TRAFFIC CONTROL NOTES DATE
C❑NST ARC COMP
TRAFFIC SHALL CONFORM TO THE CALIFORNIA MANUAL ON UNIFORM
TRAFFIC CONTROL DEVICES(MUTCD) AND 2010 CALTRANS STANDARDS. — TABLEA _ I I z GE❑/C❑ N478
MINIMUM RECOMMENDED DELINEATOR/CONE SNJSCA12
NO LANE CLOSURES PERMITTED BEFORE 9:30A AND AFTER 3:30P. to EXCHANGE
&SIGN PLACEMENT I a ENGINEER A. CASTILLO
ACCESS TO DRIVEWAYS SHALL BE MAINTAINED AT ALL TIMES. POSTED SPEED TAPER LENGTH L DELINEATOR SPACING SIGN SPACING S I I / p
LIMIT TAPER TANGENT ADVANCE OF TAPER N TELEPHONE ,j40U) 635-8812
ONE LANE OF TRAFFIC IN EACH DIRECTION AND ALL HIGH VOLUME 8 BETWEEN SIGNS
TURNING LANES SHALL BE MAINTAINED AT ALL TIMES ON ALL STREETS (Km/h) (m) (m) m) m) ENGR ARC
I I VO K DJ W550
AT A MINIMUM LANE WIDTH OF 10 FEET.
25 MPH (40) 125 FT. (40) 25 FT. (B) 50 FT. (15) 100 FT. (45)
ANY CONFLICTING SIGNS, STRIPING AND PAVEMENT MARKINGS SHALL BE 30 MPH (45) 180 FT. (55) 30 FT. (9) 60 FT. (1B) 250 FT. (60) TYPE OF C❑NSTRUCTI❑N
REMOVED OR COVERED BEFORE TRAFFIC CONTROL IS IN PLACE. ANY 35 MPH (50) 245 FT. (75) 35 FT. (11) 70 Ff. (21) 250 FT. (75) PROJECT PERMIT
SIGN, STRIPING OR PAVEMENT MARKING REMOVED OR COVERED SHALL IF-+
BE REPLACED WHEN TRAFFIC CONTROL IS NO LONGER NECESSARY. 40 MPH (60) 320 FT. (100) 40 FT. (12) 80 FT. (24) 250 FT. (105)
45 MPH (70) 540 FT. (165) 45 FT. (14) 90 FT. (27) 350 FT. (170) R❑/EST N❑ 9254971
SAFE PEDESTRIAN ACCESS SHALL BE MAINTAINED AT ALL TIMES. 50 MPH (80) 600 FT. (185) 50 FT. (15) 100 FT. (30) 350 FT. (185)
55+MPH (85) 1000 FT. (305) 50 FT. (15) 100 FT. (30) 1000 FT. (305) SCALE: NONE DWG 3 ❑F 3 P 504 — —