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ENC2014-00053
Of ' C F '0 U CITY OF CAMPBELL Public Works Department January 24, 2018 Mack Mohsen Degan Homes, Inc. 2959 Winchester Blvd. Campbell, CA 95008 SUBJECT: . PERMIT NO. ENC 2014-00053 2959 Winchester Blvd., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Mack: The City of Campbell has made the final inspection of the subject Public Works improvements and finds that no remedial work is required. Your warranty requirements and any surety, therefore, are hereby released. Your Maintenance Bond for $106,750.00 is enclosed. t Sincerely, �17 Syed Wahidi Public works Inspector Bond#724444S 70 North First Street Campbell, California 95008-1436 • TEL 408.866.2150 FAX 408.376.0958 • TDD 408.866.2790 wPrint Form ENCROACHMENT PERMIT Permit No CITY OF CAMPBELL X-Ref.File DEPT.OF PUBLIC WORKS (for working within the public 70 North First Street right of-way) Application Date Campbell,CA95008 j Application Expiration Date Ph. (408)866-2150 Issued APN, 4 0 3-10-113 & -114 Fx. (408)376-0958 Permit Expiration Date APPLICATION-Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code,Section 11.04, (Application expires in six (6) months if the permit is not issued. Application Fee is non-refundable.) A. Work Address or Tract No.: 1411 &1421 WESTMONT AVENUE(TRACT 10237) Utility Trench Location: IAT NEW PUBLIC STREET CONNECTION ON WESTMONT AVENUE B. Nature of Work. STREET CONNECTION;CURB,GUTTER,SWALK;DEMO;UTILITY TRENCHES PER PLANS 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 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 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: DEGAN HOMES INC, Telephone: 408-628-0201 Address: 2959-S WINCHESTER BLVD.,SUITE 200A,CAMPBELL,CA E-Mail Address: mack@deganhomes.com 24-HOUR EMERGENCY PHONE NUMBER: 408-828-2895 Is this work being done by the property owners at their own residence? f— YES FX— 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 understan 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 is 7 it, property owner, or property owner's successors, shall be responsible for apnyy and all damages arising out of the condition of any private i is in the publi "ht -way. Accepted: P ( mil (Applicant Permittee) (sign) Date t1 (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 apgroved 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 SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES A ® RECEIPT NO.�� �PERMIT APPLICATION FEE $ z " PLAN CHECK DEPOSIT $ DID f�2 C/i./ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ VO f y 139 t') CeNS-TRIJ (M10,,f{/ f� $ V.tr4, 00 -S-701 PLAN CHECK&INSPECTION FEE $ I., a 1 .90 0 Q 0.111561 o ! EMERGENCY PE�1 9.E9&C,',AS� t'10L'�'4�$l� $ 1 00, 00 'ZI5 6,1 C!1 C.f: D 0,Cl i APPROVED FOR SUA CE 40T t 5 For City Engineer Date Permit Expires 12 Months After Date of Issuance ' t GENERAL PERMIT CONDITIONS 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 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. 5. 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 resp srfblefor a dig that all those providing services under the applicant are aware and understand all of the above conditions. 44 Applicant Date: Contractor (Print Name) Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.02/14 I Encroachment Permit Final Sign Off Encroachment Permit# Utx r—)e t'{ --QC'Gs3 Address: l �j 11�� i 21 W LSTK -W1 A%L Date of Final Inspection and Acceptance: Z `� Inspected by: OK to release deposits: 100% " 75% .Comments: `�(�G�•n� G� �i.1� \}Cam`-) I o�,� 0 U - r Ok CH AO CITY of CAMPBELL Public Works Department January 31, 2017 Mr.Mack Mohsen Degan Development 2959 S. Winchester Blvd., 9200A Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2014-00053 1411/1421 Westmont Ave. FINAL INSPECTION AND ACCEPTANCE Dear Mack: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins 'a'Cany ember 22, 2016 The perinittee is responsible for the repair and/or replacementdefective woor failures that occur within one year. The City will inspect the imptov-ement-s-w:ftlim one -year and notify you, in writing, Whether or not any repairs are required. Your file is being reviewed for any refundable deposits. Any refunds due will be refunded promptly. Your Maintenance Bond#724444S will be kept in force for the one-year maintenance period as stated above. Your Labor;Material/Faithful Performance Bond 4724444S.and Monumentation Bond 4724446S have been released. If you have any questions,please.call me at (408) 866-2165. Sincerely, Syed Wahidii Public Works Inspector Cc: Inspector/Suspense Files Permit File:ENC2014-00053 70 North First Street Campbell, California 95008-1436 TEL 408.866.2150 FAX 408.376.0958 TDD 408.866.2790 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR ONE YEAR MAINTENANCE ACCEPTANCE LETTER Encroachment Permit # ENC2014-00053 Property Address 1411 & 1421 Westmont Ave. Date of Final Inspection:. \-ZAZZ1\r0 On File: Bonds CD Cash r\ Faithful Performance $ Labor and Material $ bo Construction Cash Deposit to be released: $ coo Other overdue deposits to be released (Description): 6 C) Processed by: Administrator Reviewed by: � 3\<« Inspector Reviewed by: Land Development Engineer i I, JAJoAnnaT\Deposit refundsMestmont 1411.1421.doc(Rev. 10/11) i a Encroachment Permit Final Sign Off Encroachment Permit# 5�C 2a1zi_ co6S 3 Address: ESTMeg-g Date of Final Inspection and Acceptance: 14) Inspected by: S\ OK to release deposits: 100% 75% ----vim -. Comments: a low I -�m S-ocpo 0()0 - c� Cx 1/26/2017 Fees Associated With 2:21:37PM < .CCEL../ Case #: ENC2014-00053 Start End _)tans.... Revenue Created` = Ae t Descri tion, B " ,?.Date:Type Date Date p p Code = Account Number Yf Amoun# Due PCDP 7/1/2013 6/30/2014 Plan Chee e�nert----A� 101.2203' JT 3/11/2014 -778-1-5-60- 0.00 AF02 7/l/2013 6/30/2014 PrmtAppFee-Major-Eng E 101.730.4722 JT 3/11/2014 377.00 0.00 GRA4 7/l/2013 6/30/2014 Grdng&Drain Pln Rev>= 101.740.4722 JT 3/11/2014 1,590.00 0.00 SDC 7/1/2013 6/30/2014 Storm Drain Fee-All Oth 209.715.4721 JT 3/11/2014 4,448.00 0.00 FMTM 7/1/2013 6/30/2014 Tract Map Fees-5 or Mor 101.740.4722 JT 3/11/2014 5,598.00 0.00 CASH �7�20'1�3� �613a/20'14 Ens 7Etion-@ash ID.ep© 101.2203 JT 3/11/2014 0.00 UPC2 7/1/2013 6/30/2014 Utilty Cond>500' 1.50/ft 101.740.4722 JT 1/13/2015 -.9,160.00 0.00 CASH QQO-1-3-- . 0720 44 C �D:evosi?�. 101.2203 JT 1/13/2015 -1-A;00"0— 0.00 VACA 7/1/2013 6/30/2014 Vacation of Sts. &Easemf /1 101.740.4722 JF 5/7/2015 1,900.00 0.00 / Total Due: $0.00 Page 1 of 1 CaseFees..rpt 2/8/2017 2:54PM � Payment History For '��-/► Case #: ENC2014-00053 - Recorded x P pe ,Fee ID`# Description Fees Paid Date Paid Check#,` , .:: Recei t# "BY Duet istory,, �. 1 - .P w� � E PCDP 201403110925525900 P1anxG-heck�De'p i 0, 7,815.00 3/10/2014 11 JT §0.00 AF02 201403110927225270 PrmtAppFee-Major-Eng 377.00 377.00 3/10/2014 252504 JT 0.00 Est>=10K GRA4 201403110928024020 Grdng&Drain Pln Rev>= 1,590.00 1,590.00 3/10/2014 252504 JT 0.00 .5 Ac SDC 201403110928325740 Storm Drain Fee-All 4,448.00 4,448.00 3/10/2014 252504 JT 0.00 Others FMTM 201403110929233550 Tract Map Fees-5 or More 5,598.00 5,598.00 3/10/2014 252504 JT 0.00 Lots CASH 2O1403110935316990 Qonnstruction C.as D eposit 1<0,00 3�, 10,000.00 3/10/2014 2�5-5.25Q�4�CFI JT 0.00 UPC2 201501131403175310 Utilty Cond>500' 1.50/ft 69,160.00 . 69,160.00 1/12/2015 256801 JF 0.00 CASH 2O1501131404173750 Co-n� ctiFn sh D'L ep it at14 0.01?04 10,000.00 1/12/2015 q 2558t14 JF 0.00 VACA 201505071314265670 Vacation of Sts.& 1,900.00 1,900.00 5/6/2015 258447 JF 0.00 Easements Total Fees: $110,888.00 Paid:$110,888.00 TOTAL.RENIIAINIINIC DUE: "0.00 C�C)o Page 1 of 1 CasePaymentHistory..rpt Refundable Deposit. Check.Reguest' To: Finance DirectorIj • Check Payable To: . Degan Homes Address-Line 1: 2959-Winchester Blvd. Line-2: -City: Campbell State: :CA Zip: 95008 - Description:. Westmont:1411-1421`_ Account Number: 101.2203-- Amount: $17,815.00 Account Number: - 101.2203. Amount: Account.Number: 101.540.7448 Amount: (Finance Dept only) Interest Earned - (Finance Dept only)' Total Payable.: (Exact Amount) Purpose: Plan check•deposit and erh6rden6v cash deposits,refund., i Permit•#:. ENC 2011-00093. Receipt# 252504 $7,W5.00, Date: '311,0/2014, Receipt#: 256801 $10.000 00'- - Date: 1/12/2015 Requested by:" Title:. Asst.-Engineer Dater 4_0 Do;" i Hoi Jo Approved by: Title: Sr:Engineer Date: Roger Storz Finance,Dept Only: Verified by Title: Accounting Clerk'll Date: Approved by:, Title: - Accountant Date:' _ Special :Instructi:ons .For Handel i�n4 Check mail AS IS: -Mail in Mtached'IE elope - Interim l:neCK: - ;Needed By - - Return To: JOAnnaThomason. Public-Works- (Name) (Department) .Other 'Please retum theck.to JoAnna' - f/n:.Formslexcellcl k'a Rev sad 05/00 Recording Requested by: ) DOCUMENT: 23439173 Pages: 1 Fees. . . . 23.00 CITY OF CAMPBELL ) Taxes. . . Copies— When Recorded, Re L� yaVp AMT PAID 23.00 L0. REGINA ALCOMENDRAS RIDE # 026 City Clerk NOV 16 2016 ) SANTA CLARA COUNTY RECORDER City of Campbell ) Recorded at the request of 9/22/2016 70 North First Stree, _ CLERK'S ®FFICO- First American Title Company 8`47 AM Campbell, CA 95008 ) (SPACE ABOVE THIS LINE FOR RECORDER'S USE) CERTIFICATE OF CORRECTION THE SUBDIVISION KNOWN AS TRACT 10237 — WESTMONT VILLAS, RECORDED IN THE OFFICE OF THE SANTA CLARA COUNTY RECORDER IN BOOK 880 OF MAPS, PAGE(S) 52 THROUGH 54, IS HEREBY CORRECTED IN ACCORDANCE WITH CHAPTER 3, ARTICLE 7, SECTIONS 66469 THROUGH 66472.1 OF THE SUBDIVISION MAP ACT AS FOLLOWS: THE LEGEND ON SHEET 3 NOTED AS: "SET 3/" IP &PLUG (LS 7739), 2 FEET FROM REAR LOT CORNERS ALONG SIDE LOT LINES" SHALL BE CORRECTED TO: "SET 31," IP &PLUG (LS 7739), 3 FEET FROM REAR LOT CORNERS ALONG SIDE LOT LINES" THE OWNERS OF PARCELS AFFECTED BY THIS CORRECTION ARE AS FOLLOWS: DEGAN DEVELOPMENT CORPORATION, A CALIFORNIA CORPORATION ENGINEER/SURVEYO CERTIF ATE r,v� � FL ii p;,t`�'G 1� Prepared By: L.S. No. 7739 <r ��` `"T ':.''�• Printed Name: elmut R. Korstick Expiration Date: 12/31/2017i Date Prepared: August 10, 2016 i �4 U ti CITY ENGINEER CERTIFICATE -g� No.7739 Off' Gp,�-���`<a THI OCUM NT HAS BEE ROVED BY THE CITY OF CAMPBELL. `�-- Amy lay, P.E., Ci Enginier, City of Campbell Date RCE 1922 (Exp. 9/ 0/20 (Rev.03/08) 7,7 �, °1�' e a k;� ';.o-�4 1 - ." i R f _ r Ba k�fllmeric� �5 DEGANHOMES'INC ins a ' �7 t, Igts Ylt 29595 WIDChESt¢IcBIVd $UIEB200Ag a Cambell p CA 95008 1 q 1/612015 - t 1 `: tV# yd k 0S. •,' 4 r" E '� � i a ! r § a f 1 PAY TO THE ta3 r as s�, yG� CC /1 + ORDER OF ° i �+Of Campbell ixY¢ '�, r a�tf d :,, t a ,e&€ j¢9 4'E k u� MElplI t�k t� �pk 4+M1 ti fi i- Y Fg t IP rzlw9��- x ry P 2. s JX y six no Thousand One Hundred Sixty Only****** x DOLLARS a t f City.�f Camp be a �' _ i �� "i iL1 Sir - a}i( �, {sla( d (� s �� fy ti 13t{t �e�b qt � } K� 76 IV' First Street Campbell CA 95008 Jq MEMO 1 r �I� � T A11T1iORl 81 �l meerin Plan Check&I'ns-ection:Fee ���, a �.,a �_ �,ri`' Hk.FI.., Q, 11'00 5 7 1602 1: 1 2 1000 3 5hfo 3 2 500 1 17 2 764118 DEGAN HOMES INC 5 716 City Of Campbell 1/6/2015 Westmont:210 City Fee 69,160.00 G. Degan Homes Checking Engineering Plan Check&Inspection Fee 69,16o.00 DEGAN HOMES INC 5 716 ,City Of Campbell 1/6/2015 Westmont:2io City Fee 69,16o.00 i � t 1 Degan Homes Checking Engineering Plan Check&Inspection Fee 69,16o.00 PRODUCT SSLT103 USE WITH 91663 ENVELOPE DEGAN IiOMES INC i" s t •i,� t ^vat s z@'" �! F, x tg � }f } #j .y } I �• 2959 S Winchester Wd`°Suite 200/l Campbell;CA,95008 3 t a u (408)628 0201` 1 5 �s} 1160015•; 1 .12, PAY TO THE } € 6 t ., ( i I I y ORDER OF City Of Ca�bell' �s � � ki89,8Q1 25 FI}v }i} }i �lE , . , ,E n ! Yil? a oV�Fk�Hk;P x ° }E € '2 o f s E 3 Elghty Nine Thousand Eight'Hundred One and a5fldo oQLLARS l £ i ( 3 Y at v t T + Gty�Of Campbell - I ' E I t E 70 N First Street } _ I Campbell,, A95008E �" �� ' � ed 1,� � €' i �i ✓` FC4 °s I MEMQ y Dsla TURD - O55ss 141 ! E; - o _ klm act Fee '� 1100057 19118 1: L 2 10003581: 3 2500 L L7 276411' °> DEGAN BIOMES INC 5 719 City Of Campbell 1/6/2015 Westmont:210 City Fee 89,8o1.25 Degan Homes Checking Park Impact Fee 89,8o1.25 DEGAN HOMES INC 5 719 City Of Campbell 1/6/2015 Westmont:210 City Fee 89,801.25 Degan Homes Checking Park Impact Fee 89,8o1.25 PRODUCT SSLT103 USE WITH 91663 ENVELOPE ppq l fIT Ydi' 46 DEGAN HOMES�1VC ' �m 1 2959�S Wtnofrester Blvd �LItQ 200A =Cu Cam bell,6A:9500$ (408)628 01 G 4 3 d t $ 1 PAY TO THE � * ORDER OF 884 OQ a ' y Of Campbell I } ,. o49t$':F�'Sk Eight Hundred Eighty Four Ong - �} ®LtAf�S �' City`Of Campbell - oFN First,Street CanipbelJ,`CA 95008 ! a :.t r $ q2�� rj z �' f (vl:r✓ ..�•r L.v� i� t MEMO AUTHORIZED SIGIL E 0 a r 1¢� NROES Plan Review fee " ~@ u300 5 7 L 7112 1: 1 2 1000 3 SB10 3 2 SOO b b ? 2 ?E 4u" DEGAN HOMES INC 5 717 City Of Campbell 1/6f2015 Westmont:210 City Fee 884.00 Degan Homes Checking NPDES Plan Review Fee 884.00 DEGAN HOMES INC 5 717 City Of Campbell 116/2015 Westmont:zio City Fee 884.00 Degan Homes Checking NPDES Plan Review Fee 884.00 PRODUCT SSLT103 USE WITH 91663 ENVELOPE .s% lt.S 9se.��'>aiA�9 �arukodlriner'c�, 572 `x 1 4,ir, Ye, t DLGliltl 1101YH.P�P C a E t ; - i��'��►� .. _ „( n t7 2959 S Winchester Bivd Suite 200A -2 , Campbell CA 95008 n I (408)'628 0201.` I]6/2015'+ r _y PAY 1:0 T -City Of(ampbeil �' � *S 256 i30 ORDER OF Five=Thousand Two'�Hundred Fifty-5lx Only***** DOLLARS City Of Campbell i 70-N Ftrst Street 1 tF Y S 7 I f it fi4 ,'� q L 1 A Campbell,CA 956o8 MEMO o R&D Sl N i Notice Of provement ClbligatlOn l_ II200 5 7 2 bll° A: b 2 L000 3 58t® 3 2 500 & b 7 2 7 E LgI" n DEGANHOMES INC 5721 City Of Campbell 1/6/2015 Westmont:210 City Fee 5,256.00 Degan Homes Checking Notice of Improvement Obligation-(1411) 5,256.00 DEGAN HOMES INC 5721 City Of Campbell 1/6/2015 Westmont:210 City Fee ._.. 5,256.00 Degan Homes Checking Notice of Improvement Obligation-(1411) 5,256.00 PRODUCT SSLT103 USE WITH 91663 ENVELOPE 9 s��f : ,� I a ! �� !g p,,���C7m�pd�' �iV �l .!`'^� DEGAN'.HOMES INC ` o�° ,(( J �'k Campbell CA 95008 { rF (408)J 628 0201% x 4 y1/6 201 �E; .4KPh t{ t t 1j 7y� t� a 3 3� i', �I� d,x � a9 h a{x �t it �l�4,jrriad { � Yi7� �wa RAYTOTHE =t i Of Cam bell ** oRaeR a�—�-Y � FoOrThousand One Hundred Forty One Cfnly *'�*� S ELLS �, x nOLLARS �. � Gty Of Campbell 1 , , ii 'i .` t 70,N First Street aa'• ��' s e MEMO ° r' z �' auTNOR E sicnuTu i e ticeof-.Im roveLilent°.OIJIi''atlori-.; 11000 5 7 2011° 11: h 2 b000 3 580: 3 2 500 b i 4 2 76 4 DEGAN HOMES INC 5720 City Of Campbell 1/6/2015 Westmont:210 City Fee 4,141.00 `1 Degan Homes Checking Notice of improvement Obligation-0421) 4,141.00, DEGAN HOMES INC 5720 City Of,Campbell 1/6/2015 Westmont:210 City Fee 4,141.00 Degan Homes Checking Notice of Improvement Obligation-(1421) 4,141.00 PRODUCT SSLT103 USE V ITH 916W ENVELOPE - i 77�7471 .. .F 3ijiq -71- � x pAkof n C DEG�.ry HOMES a1VC ` 2969.5 Wir,ch'estet Blvd:Suite 200A"s' e 11 35 1210 + try Gampbdll CA 95008 k ! fi (408);628 02ah'i f } '-_ ' ' 1 tr j 3 fi r 1 if PAY TO THE " ! k 4 (O iOOO.00 ORDER OF City Of Campbell T i �. o- •a ti � 5 aM i, u4 } 'a � y{a( 66 w !t �!9 ��� ' it�P flw!i!t° , Ten Thousand Only DOLLARS City:Of,Carripbell r ' n �` �. ]O N.Flrst,5tfeet Campbell,CA 95008 , ,; MEAflO I " Work Rtz�sii Arn TURF i x ) aq ergenc_Cash.Deposit 13 000 5 7 18i10 '1: b 2 1000 3 581: 3 2 500 1 17 2 7 GLOP DEGAN HOMES INC 5 718 City Of Campbell 1/6/2015 Westmont:zio City Fee 10,000.00 Degan Homes Checking Emergency Cash Deposit(MAX) 10,000.00 DEGAN HOMES INC 5 718 City Of Campbell 116/2015 Westmont:210 City Fee 10,000.00 Degan Homes Checking Emergency Cash Deposit(MAX) 10,000.00 PRODUCTSSLT103 USE.WITH 91W3 ENVELOPE 6 1 .OF C4 U ��o r 0 0 e •�RCHAR�• CITY OF CAMPBELL Public Works Department January 31, 2017 Mack Mohsen �/ Degan Development 2959 S. Winchester Blvd. #200A Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2014-00053 1411/1421 Westmont., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Mack: The City of Campbell has made the final one year maintenance inspection of the subject Public Works improvements and finds that no remedial work is required. Your warranty requirements and any surety,therefore, are hereby released. Sincerely, K�• Syed Wahidi Public works Inspector Cc: Permit #ENC 2014-00053 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 •FAX 408.376.0958 TDD 408.866.2790 General Daily Field Report ._._. Date: 6/1512016 o Pr€ject :: 2722 I F i _ Client: rviack i ohsen err�$'rit No.: N/A .o..«.» Or4ject Address: Campbell of s Report Notes: (vis iteu'the fob site on Ct6 15j2i11 at?0. am to observe the paving second Sayer of asphalt with "thickness ess on drive way and part of westmount Ave and also tale density teat with using nuclear Gauge according to fallowing items'. - Manufacture factory was Reed and Garal-sam { The mix was"r2"mediums 1 Max filet densiti was 149 i met city inspector Seed,, 1 Contractor was(ART f took i 1 tests according to drawings below: 3 ( zau5-TI Y Discrepancies-. ' i i I t I Reported by: Ali Tahmasbi Signature: lnspectirn tirne from- 10:30 am To: 4-30 ` m Prepared:9/1012Es'14 Rt?vlsion Sto:1 Re filed:5I/2C35 Act ress:2 55 Autumnvale Drive,Unit 6,San lose,CA 95:1.31,Ph(408)2.17=9174,Fx:(408)217-9632, ww _achieveng.corn t pj NUCLEAR MOISTURE ® DENSITY SHEET , (AASHTO T31 - ASTM D6 38) Date: 06/15/2016 Project No: 2722 Project Name: Degan Costruction Project Address: 1421 Westmount Ave, Campbell Technician; All Gauge No: ; REFERENCE CURVE: . Moisture Standard: Density Standard: TEST NO i 1 2 3 4 5 6 7 8 DATE 06115 06/15 06115 06115 06/15 06/15 06115 06/15 PROBE DEPTH AC At AC AC AC - AC AC AC LO�ATI.ON/LIFT North West North East MI West. M1-East M2-"West M2-East South-West South-East WATER WET DENSITY (pet) 145.4 -146 143 142.5 144 136 144 146.1 MOISTURE(%) 9 1 9.4 10.3 9.9 9.8 9,9 9.8 9.6 DRY DENSITY(pet) COMPACTION 97.5. 98 95 95 96 89-Failed 96 98 REF:CURVE(pet) 149 149 1.49 149 149 149 149 149 TEST NO 9 10 11 6-Retest ._..... _..... PROBE _06L15 ._ .._..m06l.15___..............._.. ..06115....... ....._ _._._. ____......_._._.___..._._. ._._.._ __.___._ .._._. ... .. . _.. BE DEP H AC AC AC AC ; LOCA./ LIFT Westmount westmount Westmount RT-M2-East WATER WET DENSITY (pel) 144.5 143.9 146.9 144 MOISTURE-(°l+,) 8.9 9.3 9.8 9.8 DRY DENSITY(peo COMPACTION 97 97 98 96 REF CURVE a 149 149 149 149 f 2465 Autumnvale Drive, Unit E, San Jose, CA 95131,Tel: 408-217-9174, Fax: 408-217-9632 wvrw.achieveng.com Form#t: 1-28 Date Prepared:11/25/2014 Revision No: Revised: ^_ pF Cq •�kCHAB�• CTI'Y OF CAMPBELL Public Works Department January 31, 2017 Mr.Mack Mohsen Degan Development 2959 S. Winchester Blvd., 4200A Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2014-00053 1411/1421 Westmont Ave. FINAL INSPECTION AND ACCEPTANCE Dear Mack: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins as of December 22, 2016. The permittee is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. Your file is being reviewed for any refundable deposits. Any refunds due will be refunded promptly. Your Maintenance Bond#724444S will be kept in force for the one-year maintenance period as stated above. Your Labor, Material/Faithful Performance Bond 9724444S and Monumentation Bond#724446S have been released. If you have any questions, please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector/Suspense Files Permit File:ENC2014-00053 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 FAX 408.376.0958 TDD 408.866.2790 �l1- �4 aA BOND FOR FAITHFUL PERFORMANCE OF MAINTENANCE PERIOD ENCROACHMENT PERMIT NO. 2014-00053 We, the undersigned DEGAN DEVELOPMENT CORPORATION,A CALIFORNIA CORPORATION (hereinafter "Principal") and INDEMNITY COMPANY OF CALIFORNIA ,a corporation organized under the laws of the State of California ,and authorized to transact business in the State of California,as Surety,are obligated to the City of Campbell(hereinafter"City"),a municipal corporation under the laws of the State of California,in the sum of One Hundred Six Thousand Seven Hundred Fifty Dollars($106,750.00 1 for the payment of which sum we obligate ourselves and our successors and assigns,jointly and severally by the following provisions: The condition of this obligation is that the Principal entered,or is about to enter,into a certain written Contract with the City dated March 10 .2014 and entitled Complete Improvements Specified on Street Improvement Agreement for APN:403-10-125 and 403-10-114 a one year maintenance period of the work described in said Contract,a true and correct copy of which is presently on file in the office of the City Clerk of the City of Campbell,which said agreement is hereby referred to and made a part hereof. And,the City requires a guarantee from the Principal against defective materials and workmanship in connection with that maintenance. Now,therefore, the Principal agrees that it shall make all repairs or replacements necessary during the period of one-year from the date of acceptance of the contract work,by reason of defective materials or workmanship in connection with the Contract. If those defective materials or workmanship occur within that period,the City shall give the Principal and Surety written notice of that defect within 60 days after discovery. When each replacement is made to the satisfaction of the City,the obligation of the Principal and Surety shall be discharged as to that replacement,otherwise to remain in full force and effect,with surety obligated to secure full and faithful performance of all of Principal's obligations under the above-referenced contract. Any repairs or replacements made under this bond shall in like manner be subject'to the terms and conditions of it. No prepayment or delay in payment and no changes,extensions,addition or alteration of any provision of said Contract or in any plans and specifications referred to herein, and no forbearance on the part of the City shall operate to release the Surety from liability on this bond,and consent to make such alterations without further notice to or consent by the Surety is hereby given,and the Surety hereby waives the provisions of Section 2819 of the Civil Code of the State of California. In witness,the parties have executed this agreement as of December 16 .2016 DEGAN DEVE MENT C RPOR�cTION, (Principal) A I NIA CO RAT N By � SEE ATTACHED Title_ 4 Fi-e M ACKNOWLEDGMENT FROM NOTARY (Surety) INDEMNITY COMPANY OF CALIFORNIA By � ✓1� LL—� Susan E. Barrett,Attorney-in-Fact Address of Surety _ (Attach Acknowledgements) 1655 Grant Street 6th Floor Concord, CA 94520 Surety's Bond Number 724444S (Both Principal's and (Accompany this bond with Attorney-in-facts Surety's Attorney in Fact) authority from Surety to execute the bond certified to include the date of the bond.) J:IFORMS1TemplatestEncroacliment PennitstEncroachment Permit Maintenance Bond,doc(Rev.03108) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of Califomia ) County of Cbrit rj /�,, ' ) Christina Chavez, Notary Public On 11Gf'��YYi�°,� �Poefore me, , Date f Jere Insert Name and Title of the Officer personally appeared ? Name of Signer(af who proved to me on the basis of satisfactory evidence to be the personK whose name(g'jir9m subscribed fo the within instrument and acknowl aged to me that executed the`same in 1 t°-authorized capacity('tes`J,and that b is signatu on the instrument the person(t), r the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is:true and correct. CHRISTINA CHAVEZ WITNESS my hand and official seal. Commission# 2028981 a �� •' Notary.Public-California D z `. Yi , Santa Clara County Signatur My Comm.Expires Jun 14,2017 Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Doc m ��� -,�n,�G� Title or Type of Document: ocurnent Date: _12� IFtoNumber of Pages: r-- Signer(s) er< ha a d Above: r Capacity(;es) Claimed by signers) Signer's Name:(�t�tm�,/G Mahe Signer's Name: O Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑Partner — O Limited ❑General ❑Partner— ❑Limited ❑General ®Individual ❑Attorney in Fact ❑Individual 0 Attomey in Fact ❑Trustee ❑Guardian or Conservator O Trustee 11 Guardian or Conservator O Other: D Other: ' Signer Is Representing: Signer Is Representing: + 02014 National Notary Association•www.NationaiNotary.org• 1-800-US NOTARY(1-800-876-6827) Item#15907 1 POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725,IRVINE,CA 92623 (949)263.3300 KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each hereby make,constitute and appoint: ***Nip Pham,Susan E. Barrett,jointly or severally*** as their true and lawful Attomey(s)-in-Fact,to make,execute,deliver and acknowledge,for and on behalf of said corporations,as sureties,bonds,undertakings and contacts of surety- ship giving and granting unto said Attorey(s)-in-Fact full power and authority to do and to perform every act necessary,requisite or proper to be done in connection therewith as each of said corporations could do,but reserving to each of said corporations full power of substitution and revocation,and all of the acts of said Attomey(s)-in-Fact,pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,effective as of January 1st,2008. RESOLVED,that a combination of any two of the Chairman of the Board,the President,Executive Vice-President,Senior Vice-President or any Vice President of the corporations be,and that each of them hereby is,authorized to execute this Power of Attorney,qualifying the attorney(s)named in the Power of Attomey to execute,on behalf of the corporations,bonds,undertakings and contracts of suretyship;and that the Secretary or any Assistant Secretary of either of the corporations be,and each of them hereby is,authorized to attest the execution of any such Power of Attorney; RESOLVED,FURTHER,that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond,undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective officers and attested by their respective Secretary orAssistant Secretary this May 23,2013. D By: Glilu�/ ,,•��t AND/4o,, ��(,pP N Y O. Daniel Young,Senior Vice-President V;`�.>4,•�gpORq� F?> G OPOA9 OCT. 'c s 2 p By: ('r to i 10 L CT.S 0 1936 o s w. 1967 Gregg N.0 ice-President > ; p \ _ �7�0 rOWP,.�aa cq<lFO(R�C State of California County,of Orange On May 23 2013 before me, Gina L.Gamer Notary Public Date Here Insert Name and Title of the Officer personally appeared Daniel Young and Gregg N.Okura Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)istare subscribed to _ the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s),or the entity upon behalf of G(NA L,,GARNER which the person(s)acted,executed the instrument. ' C©MM.#2021213 rNOTARY PUBLIC CAUFORMA I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is t ORANGE COl1NT1! true and correct. f- My.comm.a Oma.May.18,2017't -- WITNESS my hand and official seal. Place Notary Seal Above Signature Gina L.Gamer,Notary Public CERTIFICATE The undersigned,as Secretary or Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine,California,thisl 6 t hay of December, . 2016. By: /' Mark J.Lansd on,Assistant Secretary ID-1380(Rev.05/13) ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Santa Clara ) On `'� 1 before me, N. Pham, Notary Public (insert name and title of the officer) personally appeared Susan E. Barrett who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. R.PHAM Commission#2073391 WITNESS my ha a'd official seal. a:m� �'= Notary PubJJc California i z Santa Clara County My Comm.Expires Jul 30 2016 Signature (Seal) ENC2014-00053 Degan Development Corp Bond for Faithful performance $45,000.00 Bond for Labor and Material $45,000.00 Monumentation Bond $45,000.00 Indemnity Company of California Bond#724446S To Vault 1/23/15 —JoAnna Exchanged for Maintenance Bond 12/22/16 - JoAnna Indemnity Company of California Bond 724444S $106,750.00 . L_- L.. L_____- L_�-___ . i � —j�__—_---_-__'_-_---_----_--_--_—'`--- ---- '_ ��' ---------- ._--_'�-_--_-_��_____-._ /. ' < lOoI3o37 co�cnmo ' ��2O5o C�zz O� CJu������ VENDOR NO.. ` . ` - . ' ^ ' r / 10013237 DEGAN HOMES INC DATE CHECK�N CHECK zBE 262062 RY,STREET EET PBE� CA LlFbRNjA fA 4. ki *See Reverse Side For Easy Opening Instructions* CITY OF CAMPBELL 70 NO RTH FIRST STREET DEGJN HOMES INC / � ] 2959 S. WINcHEaTEa BLVD. cxuweBELu ox 95008 _ ' i ' P dr PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2014 TO: City Clerk PUBLIC WORKS FILE 140. i �JF�j `T '0 09 3 PROPERTY ADDRESS Please collect&receipt for the following monies: A�DEVELO ITEM', :' AMOUNT . • [LANDMENT, roac ment Permit Application -ee Non-Utility Encroachment Permit Major>_$10 000 $385.00 Minor Encroachment Permit<sio,000 $220.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $220.00 Inspection Fee Minimum Charge per Location $385.00 Street Tree Pl anti n /Removal N/C 2203 $500 Rer Tree Planting Deposit Required) $500.00/tree 22031 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 47221 Gradin &Drainage Plan Review Single Family Lot $270.00 Site<10,000 s.f. $810.00 Site>_10,000 s.f. <0.5 Acre $1 081.00 Site>_0.5 Acre $1 621.00 4722 NPDES Review C3 Requirements) For projects not required to submit numeric sizing $156.00 _ For projects required to submit numeric sizing Impervious Area 10 000 S .Ft to 1 Acre $676.00 Impervious Area 1 Acre or more $884.00 4722 For ro'ects sent to Consultant for review Consultant Cost+20% Plan Check&Inspection Fee(Non-Utility) 47221 En r. Est.<$250 000 14%of Engineer's Estimate 22031 En r.Est.2t$250 000 and<$500 000 $35 000+8%of Engineers Estimate 2203 En r.Fst. > 50,000 — $55 000+7%of Engineers Estimate 22031 iE Rem, G�aslh'}~ 6sAN 4%of En r.Est! $500 min/$10 000 Max). tl�-'t► (� �a�s _ ' ; 2203 �FaltlyfTllPerfarman 'Se-qa"rl FF�S w 100%of ENGR.EST.* - 2203 Labor and Materials Security100%of ENGR.EST.* 4721 _Storm Drainage Area Fee Per Acre R-1 $2 120,00 (Multi-Res$2,385.00) All Other$2 650.00 4722 Parcel Ma 4 Lots or Less $3 850.00+ 83/lot 4722aParkland ct Ma 5 or More Lots $4 681.00+$114/lot 2203ntation Securit 100%of Cit 's Monumentation Estimate 4920 Dedication Fee 75%/25% Due U on Cert,of Occupancy) gp 4722Ad'ustment Includes Certificate of Com liance $1 820.00 4722 of Public Streets&Easements $2 434.00 4722 Certificate of Compliance $1 800.00 4722 Certificate of Correction $540.00 4722 Appeal Filing Fee $200.00 4722 Notary Fee er si nature $10.00 4722 Assessment Segreqation or Reapportionment First Split _ $860.00 Each Additional Lot $270.00 511.7424 Postage,_ r. MISCELLANEOUS` Uthdr tPlease S eci *Engineer's Estimate shall be jars approved by the City Engineer and shall include all items of work. TOTAL $ NAME OF APPLICANT ! Oi l'e& NAME OF PAYOR PHONE g ^Q2 D ADDRESS 2�5 �(I )t/ a A 2 P zip 5 qb.. ;.ti ±, r 7.... f FOR RECEIVED B CITY CLERK ONLY Date l. :a-ZZ .. ::. P. t# �t� ..: •. - _.d `;°' Date/,Initials ^ :aonMsm..:w.ie.udmw,v.s.ewece:Pi Form i...a o...k„„,.i u+s 5717 1/6/2015 w 884.00 CITY OF s;AMPBELL FcEG�rI? ICY: ,AYOP: BEGAN ;TOMES 10 ;ODAY'S DATE: 01,11211 REGISTER DATE, OU1 /15 TIME. 1 :59 DESCRIPTION AMOUNT ENOR & SUDDIV FILING; F $884.00 CUST IIs: 1411 WESsTi ONT fit' 14-053 REF F�EFCST:7 1Is1. 6 ,16D.O . :w Fee 884.00 LUST ID: EN WI-000 3 REF DEPOSIT, 7'101 �10x000,00 1/PC CUST Ili„ ENC2014.000 53 PARKLAND DEDICATION FE $ 9.801.25' 5 717 WST Ills 2,014-00053 1/6/2015 ENSR � SUDDIG FILING F $4.14 i.DO 884.00 CUST III: W0 3 ENOR SUBDIV FILING E t5,256.Da OUST ,TTo: 14-01 TOTAL DUE. 17 ,2 25 CHECK PAID: W9,242.25 CI4ECK NO: 5717 iIIE;ri 557,21 MOVED- $17 -24a.2�5 CHANGE; $.00 Vegan homes Checking NPDES Plan keview Fee 884.00 PRpOUCT SSLT103 USE WITH 91663 ENVELOPE 9 CONFORMED COPY_This dow t h. nolb—c-p—d wiUt the original. SANTA CLAM COUNTY-CLERK-RECORDER OWNER'S STATEMENT Oocn: 226575BI OWNER'S ACKNOWLEDGMENT TRACT T� wry+ �11^1 �pT�, vl6/2015 2:45 PH WE HEREBY STATE THAT WEARE THE OWNERS OF OR HAVE SOME RIGHT,TITLE OR NOTA 11,1IC OR OTHER OFFICER COMPLETING THIS CERTIFICATE VERIFIES ONLY THEIDEN7/7Y 1�YAC 1023 - WESTMONT VILLAS- INTERESTINANDTO THE REAL PROPERTYINCLUDEDW/TH/N THE SUBDMSIONSHOWN OFTHEINDMDUAL WHO SIGNED THE DOCUMENT TO WHICH THIS CERTIFICATE IS ATTACHED,AND A NINE LOT SUBDIVISION,CONSISTING OF THREE SHEETS ON THIS MAP;THAT WEARE THE ONLY PERSONS WHOSE CONSENT IS NECESSARY TO IIOT THE TRUTHFULNESS,ACCURACY,OR VALIDITY OF THAT DOCUMENT. BEING A SUBDIVISION OF THE LANDS OF DEGAN DEVELOPMENT PASS CLEAR TIRE TO SAID REAL PROPERTY,•AND THAT WE HEREBYCONSENTTO THE MAKINGAND RECORDING OFSAIDMAPAND SUBDIVISIONAS SHOWN WITHIN THE STATE OFCALIFORNIA )SS. CORPORATION AS DESCRIBED IN THE GRANT DEED RECORDED DISTINCTIVE BORDER LINE. COUNTY OFSANTA CLARA CO.W C_�,; DECEMBER 24TH,2013 IN SERIES 2013-22480597 IN ADDITION TO WE HEREBYOFFER FORDEOICA710N IN FEE SIMPLE TO PUBLIC USEALL 5TREETSANO ON S• I BEFORE ME " ANoiARrpuBLIc1NAND FGR SlJD STATE, THE LANDS AS DESCRIBED IN THE GRANT DEED RECORDED PORTIONS OFSTREETSNOTPREWOUSLY EXISTING AS SHOWN ON THEMAP WRHINSAID PER NALLYAPPFARED S I A MA�I`) WHO SEPTEMBER 27TH,20131N SERIES 2013-22398592 SUBDIVISIONANDALSO DEDICATE To PUBLIC USE&SEUENTS FOR ANYANDALL PUBLIC PROVED TO ME ON THE BASIS OFSATISFACTORYEVIDENCETOBE THE PERSON WHOSENAMEN SANTA CLARA COUNTY RECORDS. USES UNDER,UPONAND OVER SAID STREETS AND SAID PORTIONS THEREOF. ISIARE SUBSCRIBED TO THE WITHIN INSTRUMENT ANDACKNOWLEDGED TOME THAT HE/SHEI TH€Y EXECUTED THE SAME IN HISMBRQIJE)RAUTHORIZED CAPACITY(IES),AND THATBYHISlNB1WHEiR CITY OF CAMPBELL WEALSO HEREBYOEDICATETO PUBLIC USE EASEMENTS,TOGETHER WITH THE RIGHT SIGNATURE(S)ON THE INSTRUMENT THE PERSONN,OR THE ENTITY UPON BEHALF OF WHICH THE COUNTY OF SANTA CLARA,STATE OF CALIFORNIA OFINGRESS AND EGRESS,FORANYANDALL PUBLIC SERVICEFACILITIES INCLUDING PERSON(S)ACTED,EXECUTED THE INSTRUMENT. BUT NOT LIMITED TO THEFOLLOWING:POLES,WIRES,CONDUITS,STORM SEWERS, SAN/TARYSEWERS,GAS,WATERANDALL PUBLIC U77UTIESANDANYANDALL I CERTIFYUNDER PENALTY OFPERJURY UNDER THELAWS OF THE STATE OF CALIFORNIA THATTHE STERLING CONSULTANTS APPURTENANCES TO TfiEABOVE,UNDER,UPON,OR OVER THOSE CERTAINPORTIONS FOREGOING PARAGRAPHIS TRUEAND CORRECT. _ OFLAND DELINEATEDANO DESIGNATED AS'P.S.E.'(PUBLICSERVICE EASEMENT).SAID ENGINEERING■SURVEYING■CONSTRUCTION SUPPORT PUBLIC SERVICE EASEMENTS ARE TO BE KEPTOPENAND FREE FROM BUILDINGSAND WITNESSMYHAND STRUCTURES OFANYKIND EXCEPT PUBLIC SERVICE STRUCTURES,IRRIGATION SYSTEMS I I SAN RAMON, CALIFORNIA ANDAPPURTENANCES THERETO,LAWFUL FENCES ANDALL LAWFUL UNSUPPORTED NOTARY'S SIGNATURE JANUARY 2015 ROOF OVERHANGS. PRINTED NOTARY'S NAME Cq RoL E e..EE 1 S u AIv L( CERTIFICATE SHEET WEALSO HEREBYDEOlCATE TO PUBLIC USE EASEMENTS FOR STORM DRAINAGE PURPOSES UNDER,ON,OR OVER THOSE CERTAIN STRIPS OF LAND DESIGNATED AND NOTARY'S PRINCIPAL PLACE OF BUSINESS khscic {OS;- C4, DEUNEATEDAS'S.D.E'(STORM DRAINAGE EASEMENT)SAID EASEMENTS TO BE KEPI SURVEYOR'S STATEMENT OPENAND FREE FROMALL BUILDINGSAND STRUCTURES OFANYKIND EXCEPT EXPIRATION OF NOTARY'S COMMISSION a•91I' IS LAWFULIRRIGAT7UUNSUPPORTED ROOF OVERHANGSSYSTEMSANDAPPURTENANCESTHEREiO,LAWFUL FENCESAND ALL NOTARY'S COMMISSION NUMBER S3 VA THIS MAP WAS PREPARED BY ME OR UNDER MY DIRECTION AND IS BASED UPON A FIELD SURVEY IN CONFORMANCE WITH THE REQUIREMENTS OF THE OWNER: SUBDIVISION MAP ACTAND LOCAL ORDINANCE AT THE REQUEST OF DEGAN DEVELOPMENT CORPORATION IN MARCH2O14.I HEREBY STATE THAT THE j BENEFICIARY'SACKNOWLEDGMENT SURVEY IS TRUE AND COMPLETE AS SHOWN,THATALL THE MONUMENTS BY: ARE OF THE CHARACTERAND OCCUPY THEPOSITIONS INDICATED,OR THAT - SIAMAKMOHSEN,PRESIDENT ANOTARYPUBLIC OR OTHER OFFICER COMPLETING THIS CERTIFICATE VERIFIES ONLY THEIDENTITY THEY WILL BESETIN THOSE POSITIONS ON OR BEFORE DECEMBER31 DEGAN DEVELOPMENT CORPORAUON OF THEIN D'11AL,WHO SIGNED THEDOCUMENTTO WHICH THIS CERTIFICATE IS ATTACHED,AND 2015,'THAT MONUMENTS ARE,OR WILL BE,SUFFICIENT TO ENABLE THE .SZ OT THE TRUTHFULNESS,ACCURACY,OR VALIDITY OF THAT DOCUMENT. SURVEY TO BE RETRACED,AND THAT THIS FINAL MAP SUBSTANTIALLY CONFORMS TO THE APPROVED OR CONDITIONALLY APPROVED TENTATIVE BENEFICIARY..- STATE OF CALIFORNIA AS. MAP,IFANY. COUNTY OF SANTA CLARA a LAND s BANKOFTHEWEST L-QX pynA0O, W H R•Koq..A CALIFORNIA CORPORATION O BQQEME, TAR , 0 WmInt aA PROVED TOME ON THE BASIS OF SATISFACTORYEVIOENCE TO BE THE PERSON($I WHOSE NAMEN HLMUTR.KORSTICK,LS 7739 DAE # "# IS64RESUBSCRIBED TO THE WITHININSTRUMEMANDACKNOWLEDGED TOMETHATHE/SH59HEY EXP•12131115 ,�• rao.nss ITS: llct p7'Csitwl FXECUTEDTHESAMEINHIS/HER?±ORAUTHORIZED CAPACITY#EGj AND TFWTBYHIS/NEWioR 9�OF CAI"gp2 SIGNATUREN ON THE INSTRUMENT THE PERSON(V,OR THE ENTRY UPON BEHALF OF WHICH THE SOIL REPORT PERSON(S)ACTED,EXECUTED THE INSTRUMENT. CITY ENGINEER'S STATEMENT I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF I HEREBY STATE THAT HAVE EXAMINED THE WITHIN TRACTMAP,THAT THE ! A SOILS REPORT WAS PREPARED BYAMERICAN SOIL TESTING,INC.,DATED JULY 11, MAP IS SUBSTANTIALLY THE SAME AS ITAPPEARED ON THE TENTATIVE MAP, 2014,AND SIGNED BYANDREWA.GHOFRANI,P.E.AND IS ON FILEAT THE OFFICE OF FOREGOING PARAGRAPH IS TRUE AND CORRECT. AND ANYAPPROVED ALTERATIONS THEREOF,AND THATALL PROVISIONS OF THE CITY ENGINEER. THECALIFORN14 SUBDIVISION AMP ACTAND ANYLOCAL ORDINANCE WITNESS MY HAND APPUCABLEAT THE TIME OFAPPROVAL OF THE TENTATIVE MAP,IF REQUIRED,HAVE BEEN COMPLIED WITH. BASIS OF BEARINGS NOTARY'S SIGNATURE �"�T"-�-� M't--- - THE BEARING OF NO2'05'00"W BETWEEN THE FOUND MONUMENTAT THE PRINTED NOTARY'S NAME CA kkI&J SF 6HArl•h/ OO�y INTERSECTION OF WESTMONT AVENUE AND HARRIETAVENUE AND THE FOUND �p ��L }}� 2-/Z-/S `�_ MONUMENT AT THE INTERSECTION OF HARP AND ADRIAN DRIVE AS NOTARY'S PRINCIPAL PLACE OF BUSINESS 99.u1JD-r ZS # o c•1�^<# SHOWN ON THE RECORD OF SURVEY RECORDED DECEMBER 6,1979 IN BOOK 1 B MICHELLE QUINNEY,R.GE 44W DATE 455 OF MAPS AT PAGE IZ SANTA CLARA COUNTY RECORDS EXPIRATION OFNpTARY'S COMMISSION 6' 9• I$ CEXP.06GINEER W15 '� 0r DF CAII� CITY CLERKS STATEMENT N07ARYS COMMISSION NUMBER ao553�� IHEREBY STATE THAT THIS MAP,DESIGNATED AS TRACT 10237,CONSISTING OF THREE CITY SURVEYORS STATEMENT SHEET(S),WAS APPROVED BY THE CITY COUNCIL OF THE CITY OF CAMPBELL AT A I AM SATISFIED THAT THE WITHIN TRACTMAP IS TECHNICALLY CORRECT MEETING OF SAID COUNCIL HELD ON THE DAY OF .20 AND RECORDER'S STATEMENT THATSAID COUNCIL ACCEPTED,SUBJECT TO IMPROVEMENT,ON BEHALF OF THE PUBLIC, FILE NO. FEES]7•/QPAID ACCEPTED FOR RECORDAND FILED THIS O . SE kP THE DEDICATION OFALL STREETSANO EASEMENTS OFFERED FOR DEDICATION,AS ZZ�,J]SDI oLAROs` l8 DAYOF rua 201.CA72' mINBOOK 790 OF MAPS, .O�g Rlggf SHOWN ON SAID h1AP WITHIN SAID SUBDIVISION,IN CONFORMINWI7NTHETERMS OF �.� ATPAGES_EZ S3 11A iHEREOUEST OF STERLING CONSULTANTS. THE OFFER OFDEDICATION. Cl RUS IA OUR,L.S.7515 DATE #u p REGINA ALCOMENDRAS,COUNTY RECORDER CLERK OF�iME CITY�(1FCAMPBELL SANTA CLARA COUNTY,CALIFORN14 EXP.1 31/1 y' Ro.�sts p2v er.• �/J�/1,v. [QG�{Y/."'-' �1S er ANNEBYBEE DATE - DE UTY SHEET IOF3 Z 9S7-T 8/ Sl CONFORMED COPY'TTdfido,Gm Gthas noI 6c.compared with the original, SANTA rn1ho3ECLDDL_RECORDER Oacp+ 22857581 2/18/2015 2:45 PH - BOUNDARYSHEET TRACT 10237-WESTMONT VaLAS A NINE LOT SUBDIVISION,CONSISTING OF THREE SHEETS FNO 1'OD IP(HELD AS WE SW CqE CDR OF THE 2.51 A PARCEL(LANDS OF,ONES)AS SHOWN ON(RB)) BEING A SUBDIVISION OF THE LANDS OF DEGAN DEVELOPMENT ALSO BNO THE BE CDR OF PARCEL 8 AS SHOWN ON(R9) CORPORATION AS DESCRIBED IN THE GRANT DEED RECORDED EBI'3726'W 246.64'(M)(M-M)TO IP AT NE BOUMAR1 CORNER(NSI'3)'45'E 246.93•(RI)) GRAPHIC SCALC I I IP Is Ls•BELOW GROUND EVE, DECEMBER 24TH,2013 IN SERIES 2013-22480597IN ADDITION TO THE LANDS AS DESCRIBED IN THE GRANT DEED RECORDED --�® FIND DR O IF RCE 15)fib(HELD E WE PAN NILUAM AND BETTY 1821SENEE IITD,TRUSTEES AS .OF THE 0.)5]7 NET ACRE PARCEL SEPTEMBER 277H,20131N SERIES 2013-22398592 zoos-OF MAPS SCCR as sIIDWN ON(mU SANTA CLARA COUNTY RECORDS. (w EERI) /APN 40]-lO L 8 SCCR I ROS BOON 32 3-MAPS AT PAGE 4 SCCN (PIPE IS ON BDUN—,UNE) t Inch=BO (L R9 PARCEL B APN 40J-10-0)0 SCCR 05 CITY OF CAMPB= $BI,J'02'W 104. '(MJ(M-M)\ 661']0'S0'W IOJ.BO'(.)(ND) v \ / \\1` 116,64'(M) COUNTY OF SANTA CLARA,STATE OF CALIFORNIA 07 ME 3/4-P NT(HELD AS THE W COR RB PARCEL B) NBl'36'O6•E I1fi.6]]((R{,ft)) D 1'W IF NT(HEIR AS WE NE CDR OF Z P IS V BELOW GROUND EVELKELD FOR NLY BOUNDARY E E%TENSION SEE DETAIL 8 - ON NBI'3> E 1 5(Rl) (W))(HEIDENs SUBDINSON ACRE PARCEL MR;HOWN / NBI�J^OB'Ev206.41 �� STERLING CONSULTANTS NaY39'Oo'E 6.40'(R4 CALC)J ENGINIEERONG■SURVEYIN'G■CONSTRUCTION SUPPORT SMF IP AT THE NE CDR OF R2 PTN.LOT 2 OF LOVFlI.TRACT / , i NBI'J6'OS'E 276.{B'(A T) - LANOS OF REECANT EVELDPMENT SAN RAMON, CALIFORNIA 1 CORPORpi10NIpER(R4) / I (EASTERLY 2,PARLELS) ;• JANUARY2015 AP N 403-IW123 BOUNDARY SHEET IT REFERENCES ADRIEN DRIVE •FND I'IF IN WELL MON RCE B)IB -�, -��V I I Ha �, (RI) RECORD OF SWM1RY BOOK 455 OF MAPS AT PAGE I2,SCCR (N10TH VARIES) I(HEAD AS THE INTERSECRON MONUMENT AS SHOWN ON(R2)) 3 u N I ry n > U (RI) RECORD OF SURVEY BOOK 280 OF I,PS AT PACE 24,SCCR (BEING RIE BASS OF BEARINGS AS SHOWN ON(W)) q g^ n I H L+ (RJ) SERIES 100J-17028469 SCCR !!y (4) zo3-2.0SCOR SBl'3B'00'W B>,{B(-xR4)(R7) (R SERES 0 97 sCEIi (RB) SEERIES 2013-22]96592 SCCR - , 04, n n Ie 41 0 (R7) SMES 2013-22MO596 SCCR L1�R / '= $ , a 8� S"o In / Yi Z ,SCER (R9) RET:OldO OF SURVEY BOd(11B OF MAPS ATRECORD BF SURVEY�M OF MAPS AT PPGOE'I 5,,, aR g �O S P n M f (RIO)SERIES 2003-16ST_SCCR m" ^ J z•i g •� ,go&d ABBREVIATIONS g n`�/ a 4 1. I ° xkgR m ev eaAxr osK _ CL CINIFRUN£ a ?ti n4 ggwen s [NLC WRASAIFD VALUE SUBD.ICONTAINS n o«ry a GUR IXCM` 80,487"50,FT. a +�nP ggm END FDNNv 1.85'ACRESt °find [ LO`�`G41� Boo ODD a\Y 20'FROM � n Pn / I &�� W 3� Lu LDr u1e ApIUS,NENr an MD 341'IP NT(IN-B AS ryW OR I (Nf I/fA544m .636 NET AREA PMCEL PER(R2 I I SEE DETAIL Al D 316'REBAR NT(HELD AS ME Y-N LA2NUV.9V!ID LLONWfT✓r I f SE COR OF THE 0.)53]NET ACTS PARCEL AIDE NOR£OR[65 -� NBI']3'14'E TO.03'(MJ IT IT;J I 11 AS SNOWN ON(RI)) W NC AYW7NFRLY N8172'OB'E)0.00'(R2) 1 ,n1j / NE NDPIt 5'J 10 7D'1A(RJ(()•w 19.81q(MJ(R4j AT hD FAG N61'32.20'E 511.01"(M) Stll'.1Z'2.W .f18' p NW AVRRWVEBT NBI'J2"E 5)1.00_(Rt)� N W PER RS3 00 0!/15/DF LWNELER N13200 E 8121 (M) N.I.A� PGRNEPLY LEUM AM N P/N. PoRROA' iL\ 22 NBI'32'00"E.2BI.21'(k1) ___— NBI'J2'20'E 601.46' M T (WIDTH VARIES) RW/pL Pflt FS RE (nU REFERENCE KIP OR OflD N(LNBER MD 1'P IN NEE MON RCE 8718 N91']2'00'E 601.98'((R)) NB3IJ'1)'E 261.JB(T—��-� ,{YlS REEY/RD tY ALRVEY AS SHOWN ON(N1)AND(R2) FND J/a'IP(BENYI LOG.AMS OF P.T. RW PARCEL A$PER BOON F-85 PAGE 382 SCCR ROT ROWN, HELD AS SE OR ,6J6 NET AREA PARCEL PER(R2) FND 1/1'IP ROE 187"(HELD AS WE RW RIGM OP'WAY RD 1 1/1'BO IN WELL NON S02T4'44"E 6.00'FROM COR(M) SW COR OF THE O.75M)NET ACRE PARCEL S= SOMA CZARA LOVER R=?RS RCE I4901 AT THE CENT BB0 AS SIDNN ON(RI)) OF NESRIONT AVE.AND ABBOTi qVE 5£ SiR/FNEASr (UNNNOYM ORIGW) HEIR M AT 30.16'FROM THE FOUND 3/4'IP RCE FND BD IN WELL MON LS 6084 SENF S,_E'fDR AM1q rvar FOUMJ 18)fi4 AT ME SW CUR OF THE.7537 ACRE PARCEL (UNWiOWN DRICW) SW SOU)KAESJ AS SHOWN ON RI AND ON UNE FROM THE FOUND SN.Fl. SOGWf fEF/ ]/N4'IF RCE 1)4 AT THE NVI IM OF SAN PARCEL SURD, 50UWSVSGM ION N L AND SHINER SFNF PER(RI) U) IDTAL DETAIL A e BASIS OF BEARINGS WAY DETAIL B IFES>Fa2v 1=2p n„ NOT TO SCALE THE BEARING OF NO2"05.00 W BETWEEN THE FOUND MONUMENT AT n THE INTERSECTI ON OF WESTMONT AVENUE AND HARRIET AVENUE AND THE FOUND MONUMENT AT THE INTERSECT70N OF LEGEND AND A W.A. RIET AVENUE DRIAN DRIVE AS SHOWN ON THE RECORD �NO2 A (1.09'(M) OF SURVEY RECORDED DECEMBER 6, 1979 IN BOOK 455 OF MAPS • FOUND Nav1RIENr,AS-M 2 �R4 Poe _ - AT PAGE 12,SANTA CLARA COUNTY RECORDS ■,�\ • ..�. 0 SET.F/*•a'o-am 2s n'S) 1'32-O-15..BB-(M 'e'` NBI' '06'E C T15Y0'E 4.ILY Pe-M) -\L � AD/OWfF!PARGQ ONES Sam—RO.Ppm LME/60UNMRY _ NOTES EM69A5,WShfT -WAY cnvFra uNE FROM MINI A AT 7.ALL DLSfMCES AND DIMENSIONS ARE IN FEET AND DECIMALS WEFCOF. HARRIET AVE. `=a o � —�——— NONUNEM PE NBI'32'20'E 511_01' THE AREA OF ME LAND WRHIN WE D6RNCINE BORDER UNE IS -----------------OLD EOT[MIES B0,467f SQUARE FEET. J.THE OLSR I—BORDER UE DENOTES IHE BOUNDARY OF WE SLBDMSIOK SHEET 2 OF 3 � � 015- 71y F/ �z 7 L CONFORMED COPY:This document has mt been mmpamd with the original. SAN- ' ��22851561 rr c v'RECORDER 2/18/2015 2:45 PM °BASIS OF BEARINGS" N 02'05'10°w TRACT 10237-WESTMONT VILLAS - - NI- - A NE LOT SUBDIVISION,CONSISTING OF THREE SHEETS j�_ HARRIET AVENUE BEING A SUBDIVISION OF THE LANDS OF DEGAN DEVELOPMENT Z I (m001 VARIES) CORPORATION AS DESCRIBED IN THE GRANT DEED RECORDED w DECEMBER 24TH,20131N SERIES 2013-22480597IN ADDITION k TO THE LANDS AS DESCRIBED IN THE GRANT DEED RECORDED il SEPTEMBER 27TH,2013 IN SERIES 2013-22398592 Iz SANTA CLARA COUNTY RECORDS. � e CITY OF CAWBELL COUNTY OF SANTA CLARA,STATE OF CALIFORNIA S T TERLING CONSULTANTS I ENGINEERING■SURVEYING■CONMUC11ON SUPPORT - I�i APN 403-10-117 APN 403-10-052 SAN RAMON, CALIFORNIA JANUARY 2015 14 iz.00'- 0,Fo' o 0.00'- --sa.7o' i3%ov--- SUBDIVISION SHEET I o LEGEND 26.00' I I Y SE �� 0 05� I M-M MONUMENT TO MONUMENT LOT 4 3 �; I (R) RAD14L w I SF SQUARE FEET LOT 1 LOT S LOT 3 6,002 SF ,$ PS£ PUBLIC SERYLCE EISEMENT LOT 5 6,751 SF 6,173 SF 6,173 SF 6,781 SF x 3 v N46U5'01°E h I iH I zp 3 z e• 8.00 +m ye''' o I SDE STORM DRAW FASEpIENT (ppp 2�yyy C4 S1 Qi FOUNO SID.57AEET MONUMENT,AS NOTED ON SM.7 6 q L9 APN 403-10-070 SET CITY SW STREET MONUMENT(L5 7739) \ 6,OT SF OO O SET 3/4-/P&PLUG(LS 7739) U_ 304' I� R'� I( SET 3/4"/P&PLUG(LS 77J9),2 FEET FROM y H ei 4' s ,A� LG uq, REAR LOT CORNERS ALONG S/OE LOT LINES •;II 42.62'- -60.00' -__ -6o.00' o a^ F�Lip O Im. --- O/SBNCTA'E"BORDER UNE/BOUNDARY 1 G2 `rP q N 0724'45°E - CENTER LINE W N'02T1510 W 165.66' /A/ I06.07' JASMINE COURT al ,,01", I I _--_ LOT LINE NeT54'50"E �✓Q II1111 °41 DEDICATED HEREIN oN1 C7 EASEMENT LINE IB5.66' 65.52' (17,179 SF)(56'WIDE) I 1&50 tsq ------- TIE LIME _ _ \�yR 1- N 02US 1o'w z7z.1o'7M-�- �-„ �' LOT'7 I • ~> 1 0l \• 7.105 SF NO 5• ZOo 26.00' r� HI �CB Cy'S" yJJ «I 1. 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RADIUS DELTA LENGTH I F pND ObERL4ND n" t o 5'SUE BY SEP�ARATE INSTRUMENT 0 CATED N C1 20.00' 83'37'30" 29.19' ooc9 228 -c'>2® I wl ;� c2 30.00• 58'5447" 30.85' of C3 46.50' 15'2621" 12.53' _ C4 38.50• 44'01'56" 29.59• 1 SAN"' Ds 3B.50• 38'08'00" 25.62' CCARAPN(40L�E) IyATER D/STR/ V0 •E WI C7 36.50' 39'01'34" 26.22' 403-10-115 - C8 38.50' 39-01.34" 26.22' I a�B299� C9 38.50• 24'34'17" 16.51' (C1j 38.50' 223'48'56" 150.39• • Ci ' ' " 18.00' 1926146.11' GRAPHIC SCALE I beeh=3011L SHEET 3 OF 3 rt ° T TRACT_1 r lA AR�fET AYf��� _: ��' Z M1 (Ma07N uw.�",� AMINE LOT SUBPtV46d T � BEING A SUBDMStON �• C5431STlNG OF THREE-ri_evs y "•� t f ';.- 001RPOFoT)OM AS O HE L.gryDS OF D'c DE4Ei.o'PMEN1' "q k �''`� l DECE(vYBEf'+'ZCTH.2C�g�N ED fN THE GRANTGAN DEED RECORDED T4 THE LANDS AS Drzso,Sf kES 2013".22d80597 IN AOD T10N SEPTEM'SSR 2? IN THE GRANT„DESP fYECO'RDEY1 , -SANTk`^•.20131N SERIES 2043-2239s&92 "" ,.: � COUNTY RECORDS.Y COUNTYA SM �Ct-AWy STAYS OF GAItFORNtA MPy«T- t.y 3�tvat���, ,Y�sOmiarnpscsza�swea�e Y .d t� � �•r1'`ssv�o'.� � ',� �� � � `� s°� •`�n:sy ' �' i�Avax"�a%t4-g �Ws�aMonr:'esuF'cRr+vi ."" !�;' _ �1�jAUARY 2615,.E kk,a a-'-0• s;'y r' f, off isror — r ' A 11 r �s s Q�fi, ;' LQT 3 z ufi13DIViS1C1N 3iEE�k t, v' !� i�-�.. '� 4n '.• e. } _ LEGEND , ^�.i ��,:. / �� $ lza � - i's' a.•v; `n"do+ivak'nn'roeloWumexr Y ' +, w n•s1 '^ S �4,. V' �A ^m 6•>oi' vt a 5�.. sDua¢F FfEr �"'x: r - LMa.8,aat•-� ' r"*.'n: '"'1 _ N.a2'asly= _..:. �`"FF-, ,as NarEaorwsr �. ,n: i 1 `r RDo.,�„> _r •:'.;1 as sMar eroxuv€NT LOT B„ - nru•rod-s{yo a�q _® 'F crrc.9'± - s7'+aoNs7u>;xn'G- rr,.ak sr;" z ':.7 3% 7F SC ALUG'{LS R739�- r - AEpjGI pEly r'QLJR7`of ? o_ r�oz _s�.sE• Cans , 1 N 05.sa'ds' ,.a [ � •""^---_.--, e "R^a2'SS"tFi - e rae a> - ... �.s- t,sra+am�E'eoROFR r a�aa v }2ro C�r�rej-1— sSss18� r� !-1 -"` a ` arr.7O s n a°L' . • 77cRS�'sF �pri'C1P rir ^rahc' APN tuz..r0.y2s _�r 1 ", ,a0cr ON"TOP OF CURS ATE , :: - /• _. `,� �'�_` _ � @�: c,l� �' r40T SIDE iE5 FOR ALL FRONT i.OT CORN, "oN \ F �cfµ w N r \v UN ^ETPEFZPI NDtatiLnR To sfREET c rrcEs Now- r rvs1rE i II SF � oos> z. rs U .' GUR 8� l UN� QTRERWISS �.rwr-4 C� ME RAntus 1 � gr. � ✓.,_-"""_-,-_.......•:� �9�CEy \m 4 .' tRr. q.6 f3 �D 3� `b622 .4pM��a.fj ��TAR r J``'`�•"� ro 3 A 6- :'s r R n �a. F 4M1 p t t i CF _ Xis' .:�r _ 'i WORKS DEPARTMENT LAND DEVELOPMEN' Effective July 1,2014 TO: City Clerk PUBLIC WORKS FILE NO. PROPERTY ADDRESS M se collect&receipt for the followingmonies: AMOUNT MT ment ermlt (cation ee -Utilit Encroachment Permit Ma or>_$10000or Encroachment Permit<$1 0,000 $220.00 l R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $220.00 Inspection Fee Minimum Char e per Location $385.00 Street Tree Planting/Rem oval N/C 2203 $500 per Tree Planting Deposit Re uired $500.00ltree 2203 Plan Check Deposit 2% of Engineer's Estimate $500.00 min Utility and R 1 Permits no deposit required 4722 Grading &Drainage Plan Review Single Family Lot - $ 0.00 Site< 10,000 s.f. $810.00 Site>_ 10,000 s.f. <0.5 Acre $1 081.00 Site>_0.5 Acre $1 621.00 4722 NPDES Review C3 Re uirements For projects not required to submit numeric sizing .156.00 For projects required to submit numeric sizing Impervious Area 10,000 S . Ft to 1 Acre $676.00 Impervious Area 1 Acre or more $884.00 4722 For proiects sent to Consultant for review Consultant Cost+20% Plan Check&Inspection Fee Non-Utility) 47221 En r. Est. <$250 000 14%of En ineer's Estimate 22031 En r. Est.?$250,000 and<$500 000 $35 000+8% of En ineers Estimate 22031 En r. Est. >_$500 000 $55,000+_ 7 0 of En ineers Estimate 22031 Emergency Cash Deposit 4%of En r. Est! $500 min/$10 000 Max 2203 Faithful Performance Security FPS 100% of ENGR.EST.' 2203 Labor and Materials Security100%of ENGR.EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2 120.00 (Multi-Res$2 385 00) All Other$2,650.00 _ 4722 Parcel Ma 4 Lots or Less) $3 850.00+ —,./lot 4722 Final Tract Ma 5 or More Lots $4 681.00+.$114/1ot 2203 Monumentation Securit 100%of Cit 's Monumentation Estimate 4920 Parkland Dedication Fee 75%/25% Due Upon Cert.of Occupancy) 4722 Lot Line Adjustment Includes Certificate of Com liance $1 820.00 — 4722 Vacation of Public Streets&Easements $2 434.00 Ajj 4722 Certificate of Compliance $1 800.00 4722 Certificate of Correction $540.00 4722 Appeal Filing Fee $200.00 4722 Notary Fee(per si nature $10.00 4722 Assessment Seqreqation or Reapportionment First Split $860.00 Each Additional Lot $270.00 5117424 Postage MISCELLANEOUS. . Other(Please S eci 'Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ NAME OF APPLICANT an PHONE NAME OF PAYOR Lx� ADDRESS ZIP 1 FOR RECEIVE Y n q CITY CLERK At Q 6 701 ONLY Date.J Recei t#- . Date! Initials J:IFORM51TampelesWdmirtislreW,kR—c l Fmm Lend 0e1e11pment-15 . . � P3 y: GmIG 0 1001 39584 147 /am= RkN mJs mm9e PATE. rgww i RSISq ke; 7G&w SME Sd2 +kSAlm qm» EN.— -- SSmF 6.mam qy D, RGdlRMJ IaR«m #/m.m $»; «m . . ' PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT " Effective July 1,2014 I/ , TO: City Clerk PUBLIC WORKS FILE NO. . PROPERTY ADDRESS Please collect&receipt for the following monies: ACCT ITEM.:. AMOUNT LANlDDEVEL"OPMENT :i 2 ncroac ment erml Ica Ion-Fee Non-Utility Encroachment Permit Major>$10 000 $385.00 Minor Encroachment Permit<$1o,000 $220.00 Initial R-1 Permit N/C Subse uent R-1 Permits within Two Year Period $220.00 Ins ection Fee Minimum Charge per Location $385.00 Street Tree Plantin /Removal N/C 2203 $500 per Tree Planting Deposit Required) $500.00/tree 2203 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Gradiri-q &Drainage Plan Review Single Family Lot $270.00 Site< 10,000 s.f. $810.00 Site>_ 10,000 s.f. <0.5 Acre $1 081.00 Site>_0.5 Acre $1 621.00 R4722PDES Review C3 Re uirements.For projects not required to submit numeric sizing $156.00 Forprojects required to submit numeric sizing Im ervious Area 10 000 S . Ft to 1 Acre $676.00 Im ervious Area 1 Acre or more $884.00For ro'ects sent to Consultant for review Consultant Cost+20%an Check&Inspection Fee(Non-Utility) 4722 En r. Est. -$250 000 14%of Engineer's Estimate -22" En r:Est. >_$250,000 and<$500,000 $35 000+8%of Engineers Estimate o. on 2-2U3 En r. Est. >_$500 000 $55,000+7%of Engineers Estimate fo. 2203 Emer enc Cash De osit 4%of En r. Est! $500 min/$10,000 Max p -2203 Faithful Performance SecurityFPS 100%of ENGR.EST.* 2203 Labor and Materials Security100%of ENGR.EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2 120.00 (Multi-Res$2,385.00) All Other$2,650.00 4722 Parcel Ma 4 Lots or Less $3,850.00+$83/lot 4722 Final Tract Ma 5 or More Lots $4,681.00+$114/lot 2203 Monumentation Security 100%of Cit 's Monumentation Estimate 4920 Parkland Dedication Fee 75%/25% Due Upon Cert.of Occupancy) 4722 Lot Line Ad"ustment Includes Certificate of Compliance) $1 820.00 4722 Vacation of Public Streets&Easements $2,434.00 4722 Certificate of Compliance $1 800.00 4722 Certificate of Correction $540.00 4722 Appeal Filing Fee $200.00 4722 Notary Fee(per si nature $10.00 4722 Assessment Segregation or Reapportionment First Split $860.00 Each Additional Lot $270.00 511 7424 Postage MIS.CELLANE.O,US? Oth r(Please S ecI S "Engineer's Estimate shall be yyass approved by the City Engineer and shall include all items of work. TOTAL $ 9 � , NAME OF APPLICANT l�� iV NAME OF PAYOR PHONE TX S- ^QZO f ADDRESS 2959 ADIACIV AIV zip smQj FOR RECEIVED B CITY CLERK ONLY Date �`� Recel t# Date/.Initials J:IFORMSITamplelesl4dminisVefrveVieceryl Force Lend oevelapmeet 14.15 5717 1/6/Z015 • 884.00 CITY OF CAMPBELL _ RE 1. • t e CASHIER L�5 i3i. •4v�1 . u; - 15 REGISTER DATE: 01/12/15 TIME. 16�--59 DESCRIPTION �` FILING ill�+tii:-1 0, 884.00 RE DEPOSIT T 101 $69 16 .M eve Fee REF DEPOSIT - 01 -_01GOLi OID- 5 717 lfss- 2L14-T=iLT_53 884.00 CU i ENOR .. JUBDIV FILING F r 41.L';1 - (EST .F±.o 14-05- TOTAL DUE: $1791242.27a TENDERED: $179,242.25 Vegan monies uiecKmg Ni�Vt--,r,a„ —eve Fee 884.00 PRODUCT SSLT103 USE WITH 91663 ENVELOPE. WORKERS' COMPENSATION INSURANCE INFORMATION The following.worker's compensation insurance information is required for all Applicants and Contractors. One of the following items for each Applicant and Contractor must be submitted prior to working under a Public Works permit orcontract. WORKERS' COMPENSATION INFORMATION: Name of Contractor/ApplicantI)-0 A/1?117 o 11 ❑ A Certificate of Consent to Self-Insure issued by the Director of Industrial Relations: OR ❑ A Certificate of Workers' Compensation Insurance Insurance Co. .. Policy No. Expiration Date : OR A signed Certificate of Exemption from the Workers' Compensation laws as printed below. CERTIFICATE OF EXEMPTION I certify that in the performance of the work for this contract, I shall not employ any person in a.manner so . o me sub'ect to e Workers' Compensation Laws of California. Signed, r ate a' Title vvso NOTICE TO APPLICANT/CONTRACTOR: If after signing this Certificate of Exemption, you should become subject to the Workers' Compensation provision of the Labor Code, you must forthwith comply with such provisions or the permit or Contract will be cancelled or revoked. C:\Users\Mack\AppData\Local\Microsoft\Windows\Temporary Internet .Files\Content.Outlook\PSG76VLC\Workers Comp Waiver.doc(Rev 9/11) ��..•� DEGAN-1 OP ID: RA DATE(M M/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 05/05/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 800-989-8712 NAME: Bozzuto&Associates Insurance 408 429 8460 PHONE FAx 34 S.Second St AIc No Ext: A/C No): Campbell,CA 95008 ADDRESS: Jennifer Mullins INSURERS AFFORDING COVERAGE NAIC# INSURER A.United Specialty Insurance Com 12537 INSURED Degan Development Corporation INSURER B: 2959 S Winchester Blvd 200A Campbell,CA 96008 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXP INSR TYPE OF INSURANCE INSRADDL SWVDJUB POLICY NUMBER MM DDPOLICYIYYYY M EFF M DDY/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY X BT01417010 07/03/14 07/03/16 DAMAGE TO RENTED EXCLUDED PREMISES Ea occurrence $ CLAIMS-MADE FxI OCCUR MED EXP(Any one person) $ EXCLUDED X Project Specific PERSONAL&ADV INJURY $ 2,000,000 GENERALAGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 3,000,000 X POLICY PE OT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A X EXCESS LIAB CLAIMS-MADE BU01412915 07/03/14 07/03/16 AGGREGATE $ 2,000,000 DED I X I RETENTION$ Nil Products $ 2,000,000 WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN T RY LIMITS R ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: Encroachment Permit ENC2014-53 ` j Q 5��1 1411 & 1421 Westmont Ave., Campbell, CA 95008. `� ��� 1 w The City, its officers, employees and volunteers are additionally insured per attached endorsement. The insurance afforded to the Additional Insured is primary insurance. Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy previsions. E�Jcaotq - w_-65 CERTIFICATE HOLDER CANCELLATION CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Campbell THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y p ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department 70 North First Street AUTHORIZED REPRESENTATIVE Campbell,CA 95008-1423 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD "� ® DATE(MM/DD/YYYY) VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE 0 510 51201 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. This form is used to report coverages provided to a single specific vehicle or equipment.Do not use this form to report liability coverage provided to multiple vehicles under a single policy.Use ACORD 25 for that-purpose. PRODUCER .COME CT Djedra Elieh 6i`L rJ'1'i'i1 ANGELA FRANGIEH INSURANCE AGENCY,INC. q No Ext: 408-793-8300 FA AC ; 408 793 8309 ( ANGELA FRANGIEH AGENT ADDRESS: Djedra.elieh.d82w@statefarm.com 1465 PARK AVE PRODUCER CUSTOMER ID#; SAN-JOSE CA 95126 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:.State Farm Mutual Automobile Insurance Company 25178 DEGAN DEVELOPMENT CORPORATION INSURER B: 7167 RED HOLLY CT INSURERC: SAN JOSE,CA 95120-5612 INSURER D:. INSURER E: DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE I'MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NU MBER 2014 JEEP GR.CHEROKE SPORT WG 1 C4RJFCTXEC233127 DESCRIPTION SERIAL NUMBER COVERAGES CERTIFICATE NUMBER, REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICY(IES)OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S)INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICY(IES)DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF�SUCH POLICY(IES). INSR ADDT POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDO(YYYY) DATE(MMIDDIYYYY) LIMITS X I VEHICLE LIABILITY COMBINED SINGLE LIMIT $ A 314 4462-F27-05A 12/27/2014 06/27/2015 BODILY INJURY(Per person) S 1,000,000 BODILY INJURY(Per accident) $ 1,000,000 PROPERTY DAMAGE $ 1,000,000 GENERAL LIABILITY EACH OCCURENCE $ OCCURRENCE I GENERAL AGGREGATE $ CLAIMS MADE $ INSR Loss POLICY EFFECTIVE POLICY EXPIRATION LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MMID DIYYYY) DATE(MMIDWYYYY) LIMITS I DEDUCTIBLE VEH COLLISION LOSS' [�ACV ❑AGREED ANT $500 LIMIT A 314 4462-F27-05A 12/27/2014 06(27/2015 ❑ ❑STATED ANT S - DED A X VEH COMP I Lj VEH OTC 314 4462-F27-05A 12/27/2014 06/27/2015 ACV ❑AGREED AMT $250 LIMIT ❑ ❑STATED ANT $ DED PROPERTY ❑ACV ❑AGREED ANT BASIC BROAD []RC ❑STATED AMT $ LIMIT SPECIAL F1 $ DED REMARKS(INCLUDING SPECIAL CONDITIONS.f OTHER.COVERAGES)(Attach ACORD 101,Additional RemarksSchedule,if more space Is required) 14 L --O'j � \Lk ADDITIONAL INTEREST CANCELLATION Select one of the following: SHOULD ANY:OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The additional Interest described below has-been added to the policy(ies)listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE A request has been submitted to add the additional Interest described below to the pollcy(ies) DELIVERED IN ACCORDANCE WITH THE:POLICY PROVISIONS. listed herein by nolicynumbers. VEHICLE.I EQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST NAME AND ADDRESS,OF ADDITIONAL INTEREST -1 ADDITIONAL INSURED HLOSSPAYEE Doris C.Quai Hoi I Assistant Engineer LENDER'S LOSS PAYEE City of Campbell I Public Works:Dept. LOAN I LEASE NUMBER 70 N.First Street j Campbell,CA 95008 AUTHORIZED REPRESENTATIVE ©1997-2010 ACORD CORPORATION.All rights reserved. ACORD 23(2010/O5) The ACORD name and logo are registered marks of ACORD 1004361 142987.2 01-28-2013 J INSURANCE REQUIREMENTS CHECKLIST /till Permit# CIP Project"A WONL��'r Consultant/Contractor: ev t The following insurance is required of all consultants/contractors working in the City of Campbell public right-of-way. Insurance certificates must be accepted by City staff before work can-begin. These insurance requirements apply to work being performed under an Encroachment Permit and work being performed under contract for Capital Improvement Projects. Limits Commercial General Liability for bodily, personal injury and property damage: k $1,000,000 per occurrence, and ❑ $1,000,000 general aggregate limit applying separately to the project, or � $2,000,000 general aggregate limit. Policy expiration date 7 Automotive Liability: _�� q� ❑ "Any Auto" checked on certificate �See 6 b. $1,000,000 per accident for bodily injury and propert damage Policy expiration date i �elZ-� ,s Workers' Compensation and Employer's Liability �� ❑ Waiver of Subrogation clause ❑ $1,000,000 per accident for bodily injury or disease o Policy expiration date Course of Construction (if required in Special Provisions) ❑ Completed value of the project ❑ Policy expiration date Repaired Endorsements to General Liability and Automobile Liability Policies Additional Insured Endorsement: \� ❑ The City, its officers, employees and volunteers are named as additional insured. (Reference Project Location/Permit Number) e levlC2 IW(,e S S The insurance coverage afforded to the Additional Insured is primary insurance. �� �.�.� Cancellation area: ❑ Cancellation area of certificate edited to delete "endeavor to" and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives". OR should say: X'\S any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. ❑ Workers' Compensation Insurance Sheet Submitted ❑ For Genera[Contractor ❑ For Developer or Owner J:\FORMS\Templates\Insurance Requirements\Insurance Requirements Cklist.doc (Rev 62 14) Page 1 Acceptability of Insurer(s) ❑ Insurer(s) has current A.M. Best Rating of A:VII and is authorized to transact business in the State of California. ec`�� Rating:Name: y'n ��� � �'�� NAIC# Rating: Authorized In CA: Name: 4 NAIC#ZS'17d Rating: Authorized in CA. Name: NAIC# Rating: Authorized in CA: Name: NAIC# Rating: Authorized in CA: Campbell Business License Expiration: ❑ Contractors License# Class: Expiration: S Insurance Certificate Reviewed 5/ in ials Date Copy of Insurance Certificate placed in tickler file one month prior to expiration. J:\FORMS\Templates\Insurance Requirements\Insurance Requirements Cklist.doc (Rev 08 14) Page 2 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 12 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: State Or Governmental Agency Or Subdivision Or Political Subdivision: Blanket Information required to complete this Schedule, if not shown above,will be shown in the Declarations. i COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Section II —Who Is An Insured is amended to include as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule,subject to the following provisions: 1. This insurance applies only with respect to opera- tions performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or au- thorization. 2. This insurance does not apply to: a. 'Bodily injury", "property damage"or"personal and advertising injury"arising out of operations performed for the federal government, state or municipality; or b. 'Bodily injury"or"property damage" included within the"products-completed operations hazard". CG 20 12 05 09 ©Insurance Services Office, Inc.,2008 Page 1 of 1 g �I BONY.)FOR LABOR AND MATERIAL ENCROACE MENT PERMIT NO. 2014-00053 DEGAN DEVELOPMENT CORPORATION, We,the undersigned A CALIFORNIA CORPORATION ,(hereinafter"Principal")andINDEMNITY COMPANY OF.CALIFORNIA a corporation organized under the laws of the State of California , and authorized to transact business in the State of California, as Surety, are obligated to the City of Campbell (hereinafter "City"), a municipal corporation under the laws of the State of California, in the sum of Four Hundred Twenty Seven Thousand Dollars ($427,000.00 )for the payment of which sum we obligate ourselves and our successors and assigns,jointly and severally by the following provisions: The condition of this obligation is that the Principal entered,or is about to enter,into a certain written Encroachment Permit-with the City dated March 10 2014. which said Encroachment Permit No. is hereby referred to and made a part hereof. ENC2014-00053 Because Principal is required to furnish a bond in connection with the Encroachment Permit, providing that if Principal,or any of its subcontractors,shall fail to pay for any materials,or other supplies,or for any work or labor on the permitted work of any kind,or for amounts due under the unemployment insurance act with respect to any work or labor on this project,the Surety on this bond will pay for the debt,in an amount pot exceeding the sum specified in this bond,and also,in case suit is brought upon the bond,a reasonable attorney's fee to be fixed by the court. DEGAN DEVELOPMENT CORPORATION, Now, therefore, we, A CALIFORNIA CORPORATION as Principal, AND INDEMNITY COMPANY OF CALIFORNIA as Surety,are obligated to the City of Campbell,and all contractors,subcontractors,laborers, material men and other persons employed in the performance - of the aforesaid agreement in the sum of- Four Hundred Twenty Seven Thousand Dollars ($427,000.00), lawful money of the United States, for the payment of which sums will and truly to be made,we the said Principal and Surety bind ourselves, successors and assigns, jointly and severally,by these provisions. The condition of this obligation is that if Principal,its successors or assigns,or.its subcontractor,.or subcontractors,shall fail to pay for any labor, materials, or other supplies, used in the performance of the work permitted to be done, or for amounts due under the unemployment insurance act with respect to this work or labor,then the Surety on this bond will pay for them,in an amount not exceeding the sum specified in this bond,and in case suit is brought upon this bond will also pay a reasonable attomey's fee,to be fixed by the court. Venue �fy action arising out of this obligation shall lie in the County of Santa Clara,State of California. It is expressly stipulated and agreed that this bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under Title 15(commencing with Section 3082)of Part 4 of Division 3 of the Civil Code,so as to give a right of action to them or their assigns in any suit brought upon this bond. Should the condition of this bond be fully performed,then this obligation shall become null and void,otherwise it shall be and remain in full force and effect. No prepayment or delay in payment and no changes,extensions,addition or alteration of any provision of said Encroachment Permit or in any plans and specifications referred to herein,and no forbearance on the part of the City shall operate to release the Surety from liability on this bond,and consent to make such alterations without further notice to or consent by the Surety is hereby given,and the Surety hereby waives the provisions of Section 2819 of the Civil Code of the State of California. In witness,the parties have executed this agreement as of January 8 2015 (Principal) DEG OPMENT CO R N, FOR IA CO N By Title �2Q i'g v� (Surety) INDEMNITY CO PANY OF CALIFO NIA By �G ��I �d ✓/�' Susan E. Barrett,Attorney-in-Fact Address of Surety: (Attach Acknowledgments 2999 Oak Road, Suite 420,Walnut Creek, CA94597 Both Principal's and Surety's Attorney in Fact) Surety's Bond Number 724444S (Accompany this bond with attomey-in-fact's authority from Surety to execute the bond,certified to include the date of the bond.) J:TORMS\TemplatesEncroachment PermitslBond for Labor&Materials.doc(Rev.03/08) tlt POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725,IRVINE,CA 92623 (949)263-3300 KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each hereby make,constitute and appoint: ***Nip Pham,Susan E. Barrett,jointly or severally*** as their true and lawful Attorney(s)-in-Fact,to make,execute,deliver and acknowledge,for and on behalf of said corporations,as sureties,bonds,undertakings and contracts of surety- ship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every act necessary,requisite or proper to be done in connection therewith as each of said corporations could do,but reserving to each of said corporations full power of substitution and revocation,and all of the acts of said Attomey(s)-in-Fact,pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,effective as of January 1st,2008. RESOLVED,that a combination of any two of the Chairman of the Board,the President,Executive Vice-President,Senior Vice-President or any Vice President of the corporations be,and that each of them hereby is,authorized to execute this Power of Attorney,qualifying the attomey(s)named in the Power of Attorney to execute,on behalf of the corporations,bonds,undertakings and contracts of suretyship;and that the Secretary or any Assistant Secretary of either of the corporations be,and each of them hereby is,authorized to attest the execution of any such Power of Attorney; RESOLVED,FURTHER,that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond,undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective officers and attested by their respective Secretary or Assistant Secretary this May 23,2013. B SAND �N' MpAN Y Y ,'�c ...:......... % GO PO �c Daniel Young,Senior Vice-President yJo�4oRq�!'.. ., �� UOP RqT 9 2�nr OCT. _ �v 10 Z ' OCT.5 n By =o' 193G 1967 reggN.0 ice-President r�d7., �2'0 ,,�o•.. qw 1/r=oe State of California ���., * ,,,.." + r County of Orange On May 23 2013 before me, Gina L Garner.Notary Public Date Here Insert Name and Title of the Officer personally appeared Daniel Young and Gregg N.Okura Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)islare subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hislher/their authorized r capacity(ies),and that by his/her/their signature(s)on the instrument the person(s),or the entity upon behalf of GINA L.GARNER . P which the person(s)acted,executed the instrument. COMM.It 2021213 g Y� _ NOTARY PUBLIC CALIFORNIA I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is �q `�-.a ORANGE COUNTY b true and correct. My Comm.wores May 18,20171 RU WITNESS my hand and official seal. Place Notary Seal Above Signature Gina L.Gamer,Notary Public CERTIFICATE The undersigned,as Secretary or Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney are in force as of the date of this Certificate. This Certi�fic�ate/is executed in the City of Irvine,California,thiB th day of January, 2015. Mark J.Lansdon,Assistant Secretary ID-1380(Rev.05/13) ACKNOWLEDGMENT State of Califomia. County of Santa -Clara `On- /' �� !,before me, N. Pham, Notary Public (insert name and title of the officer) personally appeared Susan Ea Barrett who proved to me on the basis of satisfactory evidence to be the person(s)whose hame(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the sam a in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.- I certify under PENALTY OF PERJURY under-the laws of the State of California that the foregoing paragraph is true and correct. N.PHAM - commission#2073391 WITNESSjhanhd official seal. Z Notary Public-,California D Santa Clara County My Comm.Expires Jul 30,20 BB Signature (Seal) J v r CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. State of California ) County of On )..t_, 201 S before me, Date Here Insert Name and Title of the Officer personally appeared r .CA,NV\CA,\�-, ,AAc)Vt`-6 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JOANN-THONIASO WITNESS my - and official seal. .,..�.,� N Commission# 1930682 a=�� Notary Public-California z f` Z ' Santa Clara County Signature My Comm.Expires Mar 28,2015 S��vaature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑.Partner — ❑ Limited ❑General ❑Partner — ❑Limited ❑General ❑ Individual ❑Attorney in Fact ❑Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association •www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 A BOND FOR FAITHFUL PERFORMANCE ENCROACHMENT PEPIMT NO. 2014-00053 DEGAN DEVELOPMENT CORPORATION, We,the undersigned A CALIFORNIA CORPORATION (hereinafter"Principal")and INDEMNITY COMPANY OF CALIFORNIA a corporation organized under the laws of the State of California and authorized to transact business in the State of California, as Surety, are obligated to the City of Campbell, (hereinafter"City")a municipal corporation under the laws of the State of California, in the sum of Four Hundred Twenty Seven Thousand Dollars (S 427,000.00 )for the payment of which sum we obligate ourselves and our successors and assigns,jointly and severally by the following provisions: The condition of this obligation is: Because the obligated Principal has,on March 10 2014 entered into written Encroachment Permit with the City for the Project, a copy of which Encroachment Permit is attached and made a part of this bond, for construction of Project Complete Improvements Specified on Street Improvement Agreement for APN: 403-10-125 and 403-10-114 Now,therefore,if the Principal shall faithfully perform the work in accordance with the plans,specifications and permit documents during the original term,and any extensions of the permit which may be granted by the City,with or without notice to the surety,and if it shall satisfy all claims and demands incurred under the permit,and shall fully indemnify and save harmless the City from all costs and damages which it may suffer by reason of failure to do so,and shall reimburse and repay the City all outlay and expense which the City may incur in curing any default,then this.obligation shall be void;otherwise to remain in full force and effect, with surety obligated to secure the full and faithful performance of all of Principal's obligations under the attached Encroachment Permit. If any legal action be filed upon this bond,it shall be filed within one year after final payment has been made under the Encroachment Permit excluding the warranty period, if any, provided for in the Encroachment Permit, and venue shall lie in the County of Santa Clara, State of California,and that surety,for value received stipulates and agrees that no change, extension of time,alteration or addition to the terms of the Encroachment Permit or to the work to be performed under it or the specifications accompanying it shall in any way affect its obligation on this bond, and it does by this means waive notice of any change, extension of time,alteration or addition to the terms of the Encroachment Permit or to the work or to the specifications,and thereby waives the provisions of Section 2819 of the Civil Code of the State of California. . In witness,the parties have executed this agreement as of January 8 2015 (Principal) DEGAN MENT CO ON, A A IA CORP I By Title- 0,. (Surety) INDEMNITY COMPANY OF CALIFORNIA . BYC //� Susan E. Barrett,Attorney-in-Fact Address of Surety: 2999 Oak Road, Suite 420,Walnut Creek, CA94597 (Attach Acknowledgements) Surety s Bond Number 724444S (Accompany this bond with Attorney-in-fact's (Both Principal's and authority from Surety to execute the bond, Surety's Attorney in Fact) certified to include the date of the bond.) J:\FOR,MS\Templates\Encroaclrment PermitsrBond for Faithful Performance.doc(Rev.03/08) POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725,IRVINE,CA 92623 (949)263-3300 KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each hereby make,constitute and appoint: ***Nip Pham,Susan E. Barrett,jointly or severally*** as their true and lawful Adomey(s)-in-Fact,to make,execute,deliver and acknowledge,for and on behalf of said corporations,as sureties,bonds,undertakings and contracts of surety- ship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every act necessary,requisite or proper to be done in connection therewith as each of said corporations could do,but reserving to each of said corporations full power of substitution and revocation,and all of the acts of said Attomey(s)-in-Fact,pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,effective as of January 1st,2008. RESOLVED,that a combination of any two of the Chairman of the Board,the President,Executive Vice-President,Senior Vice-President or any Vice President of the corporations be,and that each of them hereby is,authorized to execute this Power of Attorney,qualifying the attomey(s)named in the Power of Attorney to execute,on behalf of the corporations,bonds,undertakings and contracts of suretyship;and that the Secretary or any Assistant Secretary of either of the corporations be,and each of them hereby is,authorized to attest the execution of any such Power of Attorney; RESOLVED,FURTHER,that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond,undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective officers and attested by their respective Secretary or Assistant Secretary this May 23,2013. o CJ G'2 ' By: O .•,� AND j 4ANY Daniel Young,Senior Vice-President �y�Q`�oRpoR.,;:�,,,w �GOp p OR 0 OCT. c 2G y. f :w: 10 Z OCT.5 T B Gregg N.O ice-President of 1936 ;? 1967 0��wp•'*�bD' �gffFOFL��Pa� State of California County of Orange On May 23,2013 before me, Gina L.Gamer,Notary Public Date Here Insert Name and Title of the Officer personally appeared Daniel Youno and Gr a N.Okura Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)Ware subscribed to the within instrument and acknowledged to me that he/she/they executed the same in histherltheir authorized capacity(ies),and that by hisrher/their signature(s)on the instrument the person(s),or the entity upon behalf of GINA L.GAR NIER which the person(s)acted,executed the instrument. Q COMM.#2021213 NOTARY PUBLIC CALIFORW_ I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is- UNT 3 ORANOE COY 2 true and correct. �1 My comm.expires May 18,20171 WITNESS my hand and official seat. Place Notary Seal Above Signature Gina L.Gamer,Notary Public CERTIFICATE The undersigned,as Secretary orAssistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine,California,this 8 t h day of J a n u a r y 2.015. By: Mark J.Lansdon,Assistant Secretary ID-1380(Rev.05113) ACKNOWLEDGMENT State of Cal ifomia County of .Santa Clara � On J �_before me, .N. 'Pham, Notar.y Public _ (insert name and title of the officer) . personally appeared Susan E. Barrett who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the sam a in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. N.PHAM Commission#2073391 WITNESS.my hand n official seal. z :-„ Notary Public-California z Z Santa Clara County My Comm.Expires Jul 30,2018 Signature (Seal) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County ofa�� n On w�a� ' vl� ui S before me, �t�. ��n d_�� `� �Jt��c�� I' .Uh! I� Date Here:Insert Name and Title of the Officer personally appeared ��i \1. \AAC)`Wz C- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument. I certify.under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my and nd official seal. JOANN THOMASON Commission# 1930682 Si nature Notary Public-California i g - z Santa Clara County ? Signa re of Notary Public M Comm.Expires Mar 28,2015 Place'Notary Seal Above OPTIONAL Though'this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signers) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑Limited ❑General ❑ Partner — ❑ Limited ❑General - ❑ Individual El Attorney in Fact ❑Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑_Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association •www.NationalNotary.org - 1-800-US NOTARY_(1-800=876-6827) Item#5907 4G�C INSCO INSURANCE SERVICES, INC. insC�'�O Underwriting Manager for: �pco Developers Surety and Indemnity Company Indemnity Company of California 17780 Fitch,Suite 200•Irvine,California 92614•(949)263-3300 www.InscoDico.com BOND NO. 724446S $ 1,350.00 premium is for a term of 1 year(s).,; MONUMENTATION BOND FOR SUBDIVISIONS KNOW ALL MEN BY THESE PRESENTS,THAT WHEREAS, DEGAN DEVELOPMENT CORPORATION,A CALIFORNIA CORPORATION hereinafter called SUBDIVIDER,is the developer of that certain subdivision known as 1411 and 9421 Westmont Avenue ;and WHEREAS,all monuments have not yet been set in the positions noted in the proposed Final Subdivision Map for said subdivision, NOW,THEREFORE,we the subdivider as Principal,and the INDEMNITY COMPANY OF CALIFORNIA,2999 Oak Road, Suite-420,Walnut Creek,CA 94597 (Legal Title and Address of Surety) as Surety,are held and firmly bound unto the CITY OF CAMPBELL ` in the sum of Forty Five Thousand Dollars ,($45 000.00 ), lawful money of the United States,for the payment of which sum well.and truly to be made,we bind ourselves, our heirs,executors, administrators, successors, or assigns, or any or all or either of them,shall fail to pay any engineer or surveyor for the setting monuments in the positions noted in the proposed Final Subdivision Map for said subdivision in accordance with the provisions of Government Code Sec.66495 et.seq.,then said Surety will pay the same in an amount not exceeding the amount hereinabove set forth. IT IS HEREBY EXPRESSLY STIPULATED AND AGREED that this Bond shall insure to the benefit of any and all persons,companies,and corporations entitled to file claims against it,pursuant to Government Code Sec.66497. Should the condition of this Bond be fully performed,then this obligation shall become null and void,otherwise it shall be and remain in full force and effect. And the said Surety,for value received,hereby stipulates and agrees that no change,extension of time,alteration or addition to the terms of the Agreement or Contract,or to the work to be performed thereunder, shall in any way affect its obligations on the Bond,and it does hereby waive notice of any such change,extension of time,alteration or addition to the terms of the Agreement or Contract. IN WITNESS WHEREOF this Instrument has been duly executed by the Principal and Surety above named on January 13 ,20.15 Principal Surety DEGAN DEVELOPMENT CORPORATION, INDEMNITY COMPANY OF CALIFORNIA A CA CO_RPO O By: By: Susan E. Barrett Attorney-In-Fact ID-1416(CA)(7/01) POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725,IRVINE,CA92623 (949)26373300 KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each hereby make,constitute and appoint: ***Nip Pharn,Susan E. Barrett,jointly or severally*** as their true and lawful Attomey(s)-in-Fact,to make,execute,deliver and acknowledge,for and on behalf of said corporations,as sureties,bonds,undertakings and contracts of surety- ship giving and granting unto said Attorneys)-in-Fact full power and authority to do and to perform every act necessary,requisite or proper to be done in connection therewith as each of said corporations could do,but reserving to each of said corporations full power of substitution and revocation,and all of the acts of said Attomey(s)-in-Fact,pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,effective as of January 1st,2008. RESOLVED,that a combination of any two of the Chairman of the Board,the President,Executive Vice-President,Senior Vice-President or any Vice President of the corporations be,and that each of them hereby is,authorized to execute this Power of Attorney,qualifying the attomey(s)named in the Power of Attorney to execute,on behalf of the corporations,bonds,undertakings and contracts of suretyship;and that the Secretary or any Assistant Secretary of either of the corporations be,and each of them hereby is,authorized to attest the execution of any such Power of Attorney; RESOLVED,FURTHER,that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond,undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMN ITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective officers and attested by their respective Secretary or Assistant Secretary this May 23,2013. By: \ L2i Daniel Young,Senior Vice-President `�yJQ4o�...6 F�ti;I GG APO gqT�9 ' 10 �; OCT.5 To �lr ea= By. regg N.0 rce President = "; 1936 :e= tiv O 1967 3. Oy 2 �?�iO•..�OWA.•*�l+a•'` i C/FORS\ State of California bum,uu� County of Orange On May 23,2013 before me, Gina L.Gamer Notary Public Date Here Insert Name and Title of the Officer personally appeared Daniel Young and Gregg N.Okura Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/are subscribed to the within instrument and acknowledged to me that helshe/they executed the same in hismerltheir authorized capacity(ies),and that by hisfherltheir signature(s)on the instrument the person(s),or the entity upon behalf of GINA L.GARNER which the person(s)acted,executed the instrument. o COMM.#2021213 NOTARY PUBLIC CALIFOFM I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is 3 ORANGE COUNTY true and correct. My Comm.e*h s May 18,2017 WITNESS my hand and official seal. Place Notary Seal Above Signature Gina L.Gamer,Notary Public CERTIFICATE The undersigned,as Secretary or Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine,California,this 13 t hof January . 2 01 5 By: Mark J.Lansdon,Assistant Secretary ID-1380(Rev05/13) ACKNOWLEDGMENT State of Cal ifomia County of. Santa Clara On � _before me, N. 'Pham, Notary Public (insert name and title of the officer) personally appeared Susan E. Barrett who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the sam a in - his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. N. PHAM Commission#2073391 WITNESS my hard a d official seal. z -d Notary Public-California D ,, Z*7Santa Clara County My Comm.Expires Jul 30,2018 Signature ti (Seal) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Zt>S'oe On" ���.►� Alt u l S before me, �D��vt� Lv vva c �� . O YcA Date Here Insert Name and Title of the Officer . personally appeared CkNV\Ck . V\/\-u\A Name(s)of Signer(s) who proved .to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JOANN THOMASON WITNESS my ha and official seal. Commission# 193nnR2 z z :.ffi Notary Public-California > Signature �% a Santa Clara County Sign ure of Notary Public My Comm.Expires Mar 28,201 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) -Other Than Named Above: Capacity(ies) Claimed by Signer(s) . Signer's Name: Signer's Name: ❑Corporate Officer - Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑Partner = ❑ Limited ❑General ❑Individual ❑Attorney in Fact ❑Individual ❑Attorney in.Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: " 02014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 i.s. Postal service"" CERTIFIED o RECEIPT DomesticZI a 7R�efptQiardcopy) La n � ockbox,add lee as appropriate) Return $ ❑Return Receipt(electronic) $ Postmark 3 ❑Certified Mall Restricted Delivery $ Here 3 []Adult Signature Requlred $ ❑Adult Signature Restricted Delivery$ 3 Postage $ Total P°5f Mack Mohsen $ LSentTo Degan Homes, Inc. 2959 Winchester Blvd.Campbell, CA 9500 GILII IOU Ir1011 OVIVIVV JJIWVI"Vi LIIV Iv11v V1r IN ILA. UCIICI I L,: 1 receipt(this portion of the Certified Mall label). for an electronic return receipt,see a retail 1 unique identifier for your mailplece, associate for assistance.To receive a duplicate :lectronic verification of delivery or attempted return receipt for no additional fee,present this ielivery. USPS®-postmarked Certified Mail receipt to the 1 record of delivery Qncluding the recipient's retail associate. >Ignature)that is retained by the Postal SeNicel Rastdcted delivery service,which provides for a specifed period. delivery to the addressee specified by name,or to the addressee's authorized agent iportant Reminders: '� -Adult signature service,which requires the fou may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail°,First-Class Package Service°, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which Certified Mail service is not available for requires the signee to be at least 21 years of ag international mail, and provides delivery to the addressee specified Insurance coverage is notavailable for purchase by name,or to the addressee's authorized ageni with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically Included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailplece,you may request Certified Mail item at a Post Office-for the following services: postmarking.If you don't need a postmark an this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portiol of delivery(including the recipient's signature). of this label,affix It to the mailplece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. ��ENDER: COMPLEM THIS SEC710AI OAIPI,FTE THIS SECTION ON DELIVERY Complete items 1,2,and 3.. A. Signatur I-Print your name and address on the reverse ❑Agent so that we can return the card to you. ❑Addressei I Attach this card to the back of the mailpiece, B. Received by(. n Name) C.- a of even or on the front if space permits. / .,Article.Addressed to: _ D. Is delivery•address different from item 1? Ysj IMack.'Mohsen If YES,enter delivery address below: ❑'No Degan Homes, Inc. 13'5' 'Winchester Blvd. iCampbell, CA 9500 Il I'll I III III I Il II I III I I I I III I I IIIIII I I 3. Service Type Registered Mail Express ❑Adult Signature [7 Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restrict 9590 9402 2544 6306 4233 53 Certified Maitified l Restricted Delivery ❑Return eceipt for r` ❑Collect on Delivery Merchandise �Collect on Delivery Restricted De 'CI Signature ConflnnatlonT :z. acle_Number(Transferfrom service/abe/) __ livery g —Iisurd Mail ❑.Signature Confirmation 7❑]i ❑91 0 0 0 1 5 7 7. .218 0 psurd Mail Restricted Delivery' RestrictedDelivery I l 1 I l t I t 1 t I 1 t 3ver$500) �e r.......45211 i..l..on��oeni�G�n nn.nnn•onC4 n.,.,,o�t1..aornm Rcncin+ USPS TRACKING## First-Class Mail Postage,&'Fees.Paid USPS Permit No.G-10 9590 9402 2544 6306 4233 53 F /L United States °Sender:.Please print your name,addre d ZIP 1161 this bo Postal Service orkS 0 e7 PUBLIC WORKS h First StE LL 70 North Campbell, CA 95008 ANC Zoit. — ocvS3