HomeMy WebLinkAbout773 Loyalton Dr. PLEASE KEEP THIS SHEET ON TOP
Project Fact Sheet
1. Project Address: 1-1 ENC boo a0
2. APN:
3. Owner Name(s): �,n�P `�y�r�c'e
4. Owner Address: —1-1 3 c,;1
5. Owner Phone: L--\ `6
-
6. File No. (Planning) a()\ 3 - -5(e.
b
7. Project Planner: O
8. Cross Reference File(s)
9. Condition of Approval:
Circle one: City Council Planning Commission Comm Dev. Director
Resolution No.
10. Architect:
11. Architect Address:
12. Architect Phone:
13. Engineer Name:
14. Engineer Address:
15. Engineer Phone:
16. Surveyor Name:
17. Surveyor Address:
18. Surveyor Phone:
19. Monumentation Security Amount:
C:\Documents and Settings\joannat\Desktop\My Forms\Templates\Project fact sheet.doc �,
.PTO BE RECORDED WITHOUT FEE MAR 10 2014
SECTION 6103 GOVERNMENT CODE AT THE REQUEST OF CITY OF CAMPBELL CITY Tv CLERK'SpQ iE NT : 22507733 Pages' 6
Recording Requested By: ) 1111 111 1 Fees. . . . No Fees
City of Campbell ) Taxes. . .
Copies.
AMT PAID
REGINA ALCOMENDRAS RDE # 026
After Recording Return To: ) SANTA CLARA COUNTY RECORDER 1/29/2014
Recorded at the request of 2:40 PM
City Clerk ) City
City of Campbell )
70 North First Street )
Campbell, CA 95008-1423 )
APN:403-43-007 (Space Above for Recorder's Use Only)
Address: 773 Loyalton Dr.Campbell,CA 95008
AGREEMENT FOR PRIVATE IMPROVEMENTS
IN THE PUBLIC RIGHT-OF-WAY
In consideration for granting permission to construct improvements in the public right-of-way,
Kelly Bybee (property owner) enters into this Agreement with the City of Campbell. The
improvements contemplated under this permit are for the benefit of the real property commonly known
as 773 Loyalton Drive. The City of Campbell grants such permission to install a concrete walkway in
the parkstrip under Encroachment Permit No. ENC2014-00020. All conditions of Encroachment
Permit ENC2014-00020 remain in full force and effect.
The property owner shall be solely responsible for maintaining the improvements in a good and
safe condition at all times; and the property owner shall indemnify, defend, and hold harmless the City
of Campbell, its officers, officials, agents, volunteers, employees and attorneys from any and all claims,
actions, losses, liabilities and costs (including reasonably incurred attorney's fees) arising out of or
connected with, or alleged to arise out of or be connected with the installation, design or condition of the
improvements, except for any claims, actions, losses, liabilities and costs proximately caused by the sole
negligence or willful misconduct of the City of Campbell, its officers, officials, agents, volunteers,
employees or attorneys. This provision is intended to be the dispositive of all rights of indemnity and
contribution between the parties, and property owner waives and releases any and all rights to indemnity
or contribution from the City of Campbell, in law or equity, arising out of, or connected with any and all
claims, actions, losses, liabilities and costs (including reasonably incurred attorney's fees) for which
property owner is obligated under this paragraph to provide indemnity or defense to the City of
Campbell, its officers, officials, volunteers, employees or attorneys.
The City, in its sole discretion, may revoke the rights granted under Encroachment Permit No.
ENC2014-00020 and remove the improvements installed under Encroachment Permit No. ENC2014-
00020 at any time, without liability to the property owner, or require that the improvements be removed,
and property owner shall have no right to compensation from City in any form.
THE FOREGOING INSTRUMENT IS A TRUE
AND CORRECT COPY OF THE ORIGINAL
ON ALE IN THIS OFFICE.
ATTEST: ANNE BYBEE,CITY CLERK
CRY OF PBELL,CA
BY 01QA Page 1 of 3
DATED 0. 0 .
In the event that Owner fails to reimburse the City for the costs of removing the improvement
("default") as required by this Agreement,the City shall have and may execute the absolute right, at the
City's option and without demand or notice to Owner, to claim and impose a lien, attached as Exhibit A
and incorporated herein by this reference ("Lien"), on said real property (also referred to herein as
"Collateral"). City's failure to exercise this option will not constitute a waiver of the right to exercise it
in the event of any subsequent default.
(a) Amount of Lien: The Lien shall be for the entire amounts then owing under this
Agreement.
(b) Recordation: City is authorized to record the Lien in the appropriate Recorder's
Office(s).
(c) City shall have full authority to perform all acts and things that City may consider
necessary or advisable to impose, maintain and enforce the Lien.
(d) Debtors' Warranty: OWNERS WARRANT that they are the owners of the Collateral and
Owners have the right to make this Lien Agreement.
(e) Debtors' Covenants: Owners agree:
(i) To pay City all amounts payable pursuant to this Agreement on or before the due
date when due and payable, and to perform all terms of this Agreement;
(ii) To defend the Collateral against claims and de ands of all persons and entities;
(iii) To keep the Collateral in good condition; to perform other acts that may be
necessary to preserve the Collateral and protect the Collateral against
unreasonable loss and all hazards, and;
(iv) To immediately notify the City in writing when Owners become aware of any
event that substantially affects the value of the Collateral, or the rights and
remedies of City in relation to the Collateral.
(f) Prohibitions: Without the prior written consent of the City, Owners will not permit any
liens or security interests (other than the City's Lien)to attach to the Collateral;permit the
Collateral to be levied on under legal process; dispose of the Collateral; or permit
anything to be done that may impair the value of the Collateral or of the Lien, which is
the subject of this Agreement.
(g) Notices: Any notice, demand or request required hereunder, or by law, shall be given in
writing (at the addresses set forth below)by any of the following means: (a) personal
service; (b) facsimile; (c) overnight courier or delivery service; or(d)registered or
certified, first class U.S. mail, return receipt requested.
Page 2 of 3
•
Property owner agrees to maintain homeowners or general liability insurance with a limit of at
least$100,000 for damages arising from the installation, design or condition of the improvements.
This provision shall run with the land and be binding on the property owner's successors.
Executed this 3 day of A , 20 \L\
/6161i2& t
Property Owner
Property Owner
(Attach Notary Acknowledgment
For All Parties)
CITY OF CAMPBELL, a municipal
Corporation
Michelle Quinney
City Engineer, City of Campbell
ATTEST:
,C C
Anne B e, City Clerk
by: Wendy Wood, Deputy City Clerk
Page 3 of 3
•
Exhibit A
Recording Requested By: )
City of Campbell )
)
When Recorded Mail To: )
)
City Clerk )
City of Campbell )
70 N. First Street )
Campbell, CA 95008 )
)
)
Space above this line for Recorder's use only
CLAIM OF LIEN
I, , City Engineer for the City of Campbell, a California Municipal
Corporation("City"), do hereby certify:
A. On or about , 20_, ("Debtors")
executed an Agreement for Private Improvement in the Public Right of Way with the City of Campbell
("Agreement").
B. The Agreement was recorded in the Santa Clara County Recorder's Office on or about
,20 Document Number
C. The Agreement allowed the Debtor's to provide, construct, and/or install certain private
improvements in front of their property at , Campbell, California, at their
own costs and expense. Pursuant to the terms of the Agreement, the Debtors expressly agreed that if
they failed to comply with the Agreement, the City was authorized to remove said improvements and
recover the full cost and expense thereof from the Debtors or their successors.
D. The Debtors did not remove the improvements after being notified to do so. Therefore,
the City removed said improvements.
E. In , 20 , the City informed the Debtors about the improvements
that would be removed pursuant to the Agreement.
F. The City subsequently completed the work. On or about , 20_, the
City sent the Debtors an invoice for said work in the amount of$
G. Pursuant to the terms of the Agreement, the Debtors expressly agreed that the City is
authorized to, at the City's option and without demand or notice to the Debtors, immediately claim and
impose a lien on the real property commonly known as , Campbell, California,
APN Number , for the entire amounts then owing under, or incurred
pursuant to,the Agreement, including without limitation,the entire unpaid principal amount.
Page 1 of 2
•
WHEREFORE, the City of Campbell, A California municipal corporation, pursuant to the
Agreement, hereby claims a lien upon the work of improvement and the land upon which it is situated,
namely, the real property commonly known as , Campbell,
California, APN Number , in the amount of $
and said amount shall constitute a lien against said property until paid in full.
IN WITNESS WHEREOF the City of Campbell, California, a California Municipal Corporation,
has duly authorized the undersigned to execute this instrument in its name.
Dated: By:
for the CITY OF CAMPBELL, a California municipal corporation
(Notary Acknowledgement Required for Signatures)
Page 2 of 2
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of So v\--`No. 0,\co(&_
On «,N,uc a 3 ao IL\before me,.�,k,.r. ;�o.�.t �A so, ivo �•l y P�'���
(Here insert nIme and title of tlf a officer)
personally appeared (e`\1 Pjy�H._e
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
4��_„ Commission# 1930682
WI S my hand and official seal. a
� Notary Public -California
'Tf� Santa Clara County
M Comm.Ex Tres Mar 28,2015
(Notary Seal)
Signature of Notary Public
ADDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
czycN,4 a1E t . ;�-Ltl;�v document is to be recorded outside of California.In such instances,any alternative
(Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
7.7 J G rw-\. .OY• Cc,X01`1 California (i.e. certifying the authorized capacity of the signer). Please check the
(Title or description of attached document continued \ document carefully for proper notarial wording and attach this form if required.
( • State and County information must be the State and County where the document
Number of Pages Document Date 'V 114 signer(s)personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s)personally appeared which
must also be the same date the acknowledgment is completed.
(Additional information) • The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title(notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
he/she/the}-is/ace)or circling the correct forms.Failure to correctly indicate this
❑ Individual(s) information may lead to rejection of document recording.
E Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges,re-seal if a
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Partner(s) • Signature of the notary public must match the signature on file with the office of
the county clerk.
❑ Attorney-in-Fact • Additional information is not required but could help to ensure this
❑ Trustee(s) acknowledgment is not misused or attached to a different document.
❑ Other Indicate title or type of attached document,number of pages and date.
• Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasscs.com
Doris Quai Hoi 60
From: Vince Huppe
Sent: Wednesday, January 29, 2014 7:05 AM
To: Michelle Quinney; Doris Quai Hoi
Cc: Syed Wahidi
Subject: RE: 773 Loyalton Drive Tree Removal Application
Michelle, yes, both trees were purchased, planted, maintained by the resident and both can be removed.
Doris, Joy has the copy of the tree removal application as of yesterday afternoon. Yes on the tree removal ap. there is documentation. Feel
free to email or call if there are any questions.
Vince
From: Michelle Quinney
Sent: Tuesday, January 28, 2014 5:18 PM
To: Doris Quai Hoi; Vince Huppe
Cc: Syed Wahidi
Subject: RE: 773 Loyalton Drive Tree Removal Application
Is this the approval to remove both trees?
From: Doris Quai Hoi
Sent: Tue 1/28/2014 4:02 PM
To: Vince Huppe
Cc: Michelle Quinney; Syed Wahidi
Subject: RE: 773 Loyalton Drive Tree Removal Application
Thanks Vince.
Is this also documented on the tree removal permit?
Not sure if you gave Michelle a copy of the approved permit for street tree
removal but if you haven 't, could you
pdf me a copy (Michelle is out sick) . We need this before we can release the
building permit.
Could you also post the 10 day notification too please. Thanks.
Doris
From: Vince Huppe
Sent: Tuesday,January 28, 2014 3:58 PM
To: Doris Quai Hoi
Cc: Michelle Quinney
Subject: 773 Loyalton Drive Tree Removal Application
Hi Doris, Hi Michelle, regarding the tree application for 773 Loyalton I will give it to Joy today. Regarding the type of trees to plant, since the
block is a"hodge podge"of different trees, mostly small to median in size and since there are other Crape myrtles on the block, planting of
two Crape myrtles is recommended.
If you have any questions, you got my number...
Vince
1/30/2014
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of•cA,yn
MEMORANDUM •` City of Campbell
Public Works Department
f (;
ORCH ARC
To: Anne Bybee, City Clerk Date: January24,2014
From: JoAnna Thomason, Office Assistant
Subject: Document for Recording
Hi Anne,
Please attest and send the following document for recording:
Street Improvement Agreement for Private Improvements in the Public ROW for
773 Loyalton Dr. Campbell, CA 95008
Public Works will need a copy of the final recorded document for our file.
No conformed copy is necessary.
may recognize the owner O
T anky ,
Jo
Attachment
J:VoAnnaT\Recording Requests\Attest&Sign.DOC(Rev.03/08)
TO BE RECORDED WITHOUT FEE
SECTION 6103 GOVERNMENT CODE
AT THE REQUEST OF CITY OF CAMPBELL
Recording Requested By: )
City of Campbell )
)
)
After Recording Return To: )
City Clerk )
City of Campbell )
70 North First Street )
Campbell, CA 95008-1423 )
APN:403-43-007 (Space Above for Recorder's Use Only)
Address:773 Loyalton Dr.Campbell,CA 95008
AGREEMENT FOR PRIVATE IMPROVEMENTS
IN THE PUBLIC RIGHT-OF-WAY
In consideration for granting permission to construct improvements in the public right-of-way,
Kelly Bybee (property owner) enters into this Agreement with the City of Campbell. The
improvements contemplated under this permit are for the benefit of the real property commonly known
as 773 Lovalton Drive. The City of Campbell grants such permission to install a concrete walkway in
the parkstrip under Encroachment Permit No. ENC2014-00020. All conditions of Encroachment
Permit ENC2014-00020 remain in full force and effect.
The property owner shall be solely responsible for maintaining the improvements in a good and
safe condition at all times; and the property owner shall indemnify, defend, and hold harmless the City
of Campbell, its officers, officials, agents, volunteers, employees and attorneys from any and all claims,
actions, losses, liabilities and costs (including reasonably incurred attorney's fees) arising out of or
connected with, or alleged to arise out of or be connected with the installation, design or condition of the
improvements, except for any claims, actions, losses, liabilities and costs proximately caused by the sole
negligence or willful misconduct of the City of Campbell, its officers, officials, agents, volunteers,
employees or attorneys. This provision is intended to be the dispositive of all rights of indemnity and
contribution between the parties, and property owner waives and releases any and all rights to indemnity
or contribution from the City of Campbell, in law or equity, arising out of, or connected with any and all
claims, actions, losses, liabilities and costs (including reasonably incurred attorney's fees) for which
property owner is obligated under this paragraph to provide indemnity or defense to the City of
Campbell, its officers, officials, volunteers, employees or attorneys.
The City, in its sole discretion, may revoke the rights granted under Encroachment Permit No.
ENC2014-00020 and remove the improvements installed under Encroachment Permit No. ENC2014-
00020 at any time, without liability to the property owner, or require that the improvements be removed,
and property owner shall have no right to compensation from City in any form.
Page 1 of 3
In the event that Owner fails to reimburse the City for the costs of removing the improvement
("default") as required by this Agreement,the City shall have and may execute the absolute right, at the
City's option and without demand or notice to Owner, to claim and impose a lien, attached as Exhibit A
and incorporated herein by this reference ("Lien"), on said real property(also referred to herein as
"Collateral"). City's failure to exercise this option will not constitute a waiver of the right to exercise it
in the event of any subsequent default.
(a) Amount of Lien: The Lien shall be for the entire amounts then owing under this
Agreement.
(b) Recordation: City is authorized to record the Lien in the appropriate Recorder's
Office(s).
(c) City shall have full authority to perform all acts and things that City may consider
necessary or advisable to impose, maintain and enforce the Lien.
(d) Debtors' Warranty: OWNERS WARRANT that they are the owners of the Collateral and
Owners have the right to make this Lien Agreement.
(e) Debtors' Covenants: Owners agree:
(i) To pay City all amounts payable pursuant to this Agreement on or before the due
date when due and payable, and to perform all terms of this Agreement;
(ii) To defend the Collateral against claims and de ands of all persons and entities;
(iii) To keep the Collateral in good condition; to perform other acts that may be
necessary to preserve the Collateral and protect the Collateral against
unreasonable loss and all hazards, and;
(iv) To immediately notify the City in writing when Owners become aware of any
event that substantially affects the value of the Collateral, or the rights and
remedies of City in relation to the Collateral.
(f) Prohibitions: Without the prior written consent of the City, Owners will not permit any
liens or security interests (other than the City's Lien) to attach to the Collateral;permit the
Collateral to be levied on under legal process; dispose of the Collateral; or permit
anything to be done that may impair the value of the Collateral or of the Lien, which is
the subject of this Agreement.
(g) Notices: Any notice, demand or request required hereunder, or by law, shall be given in
writing(at the addresses set forth below) by any of the following means: (a) personal
service; (b) facsimile; (c) overnight courier or delivery service; or(d)registered or
certified, first class U.S. mail, return receipt requested.
Page 2 of 3
Property owner agrees to maintain homeowners or general liability insurance with a limit of at
least$100,000 for damages arising from the installation, design or condition of the improvements.
This provision shall run with the land and be binding on the property owner's successors.
Executed this day of J &A.j , 20 \
/ IM.e646
Property Owner
Property Owner
(Attach Notary Acknowledgment
For All Parties)
CITY OF CAMPBELL, a municipal
Corporation
Michelle Quinney
City Engineer, City of Campbell
ATTEST:
Anne Bybee, City Clerk
Page 3 of 3
Exhibit A
•
Recording Requested By: )
)
City of Campbell )
When Recorded Mail To: )
City Clerk )
City of Campbell )
70 N. First Street )
Campbell, CA 95008 )
)
Space above this line for Recorder's use only
CLAIM OF LIEN
I, , City Engineer for the City of Campbell, a California Municipal
Corporation("City"), do hereby certify:
A. On or about , 20_, ("Debtors")
executed an Agreement for Private Improvement in the Public Right of Way with the City of Campbell
("Agreement").
B. The Agreement was recorded in the Santa Clara County Recorder's Office on or about
, 20_Document Number
C. The Agreement allowed the Debtor's to provide, construct, and/or install certain private
improvements in front of their property at , Campbell, California, at their
own costs and expense. Pursuant to the terms of the Agreement, the Debtors expressly agreed that if
they failed to comply with the Agreement, the City was authorized to remove said improvements and
recover the full cost and expense thereof from the Debtors or their successors.
D. The Debtors did not remove the improvements after being notified to do so. Therefore,
the City removed said improvements.
E. In , 20 , the City informed the Debtors about the improvements
that would be removed pursuant to the Agreement.
F. The City subsequently completed the work. On or about , 20_, the
City sent the Debtors an invoice for said work in the amount of$
G. Pursuant to the terms of the Agreement, the Debtors expressly agreed that the City is
authorized to, at the City's option and without demand or notice to the Debtors, immediately claim and
impose a lien on the real property commonly known as , Campbell, California,
APN Number , for the entire amounts then owing under, or incurred
pursuant to,the Agreement, including without limitation,the entire unpaid principal amount.
Page 1 of 2
WHEREFORE, the City of Campbell, A California municipal corporation, pursuant to the
Agreement, hereby claims a lien upon the work of improvement and the land upon which it is situated,
namely, the real property commonly known as , Campbell,
California, APN Number , in the amount of $
and said amount shall constitute a lien against said property until paid in full.
IN WITNESS WHEREOF the City of Campbell, California, a California Municipal Corporation,
has duly authorized the undersigned to execute this instrument in its name.
Dated: By:
for the CITY OF CAMPBELL, a California municipal corporation
(Notary Acknowledgement Required for Signatures)
Page 2 of 2
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of SO4[v vC� C\c
On cS.l`Nue t- 13 , ao ly before me, ���.v.v\ l`;\nv\/�fl`( \ t�IO�C.•c U CA C__,
`\ (Here insert name and title of tke officer)
personally appeared (&\'-i 1 b2-,E'
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.
NM
CommissionJOANTHO# 1930ASON682
WI S my hand and official seal. a �`��� Notary Public-California i
z ''jj Santa Clara County
M Comm.Ex fres Mar 28,2015
(Notary Seal)
Signature of Notary Plic
ADDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
,t,ee rw,ev�J �h{ psi t 4 o.� .. twk tl,I,p_vseVL document is to be recorded outside of California.In such instances,any alternative
acknowledgment verbiage as may be printed on such a document so long as the
(Title or description of attached document)
verbiage does not require the notary to do something that is illegal for a notary in
—1.-1 - L�1Glcr)Nr\ f1Y CC=
`` California(i.e. cert�ing the authorized capacity of the signer). Please check the
of attached document`V continued document carefully for proper notarial wording and attach this form if required.
(Title or description
• State and County information must be the State and County where the document
Number of Pages Document Date '�511(4 signer(s)personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s)personally appeared which
must also be the same date the acknowledgment is completed.
(Additional information) • The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title(notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
he/she/they,is/ere)or circling the correct forms.Failure to correctly indicate this
❑ Individual(s) information may lead to rejection of document recording.
❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges,re-seal if a
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Partner(s) • Signature of the notary public must match the signature on file with the office of
the county clerk.
❑ Attorney-in-Fact :• Additional information is not required but could help to ensure this
❑ Trustee(s) acknowledgment is not misused or attached to a different document.
❑ Other Indicate title or type of attached document,number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com
ENCROACI1M] PERMIT ISSUANCE CHECK LIST(INT ►L USE ONLY)
City of Campbell Encroachment Permit No.ENC ≥ \t-1 — 0
Department of Public Works Tract No.
Address: '"\"1 z Lc)\\61 •
ITEMS REQUIRED FOR PERMIT APPLICATION:
1. Encroachment Permit Application complete,with applicant signature and date(front and back)
2. Permit Application Fee paid$ -Receipt Number&Date
3. Plan Check Deposit Paid(2%of Engineer's Estimate,$500 min)$ Receipt Number
4. Grading Plan Review Fee paid $ -Receipt Number&Date
5. City Engineer's Estimate Completed and Submitted
6. Four(4)Sets of Street Improvement Plans
7. Four(4)Sets of Grading and Drainage Plans
8. Check Lists(Grading and Drainage, Street Improvement)
ITEMS REQUIRED PRIOR TO PUBLIC WORK CLEARANCE FOR BUILDING PERMITS
9. Plan Check&Inspection Fee:Engineer's Estimate(EE)=$ ;if EE is<$250,000,then fee is 14%of EE.
If EE≥$250,000,fee is Actual Cost+20%. $35,000 minimum deposit.
Amount$ Receipt No.&Date
10. Security for Faithful Performance and Labor and Materials, 100%each of Engineer's Estimate,supplied or paid.
Amount$ Form Receipt No.&Date
11. Security for Monumentation Amount$ Receipt No.&Date
12. Construction Emergency Cash Deposit: 4%of Engineer's Estimate.($500 minimum,$10,000 maximum)
Amount$ Receipt No. &Date
13. Storm Drainage Area Fee Amount$ Receipt No.&Date
14. Street Improvement Agreement signed and notarized(proof of ownership submitted)
15. Right of Way Documents Completed and Fees Paid.
16. All other Public Works requirements listed in the Conditions of Approval of the development.
17. Other Fees, Payments,Deposits Amount$ Receipt No.&Date
18. SWPPP+NOI 19. C3 Certification 20. Covenant Agreement
1. Geotech Letter 22. Storm Water Management Plan
ITEMS REQUIRED PRIOR TO ISSUANCE OF ENCROACHMENT PERMIT:
23. Contractor's signature added to the permit application (front and back)
24. Contractor's City of Campbell Business License#
25. Worker's Compensation Insurance Information Sheet received from Contractor.
26. Certificate of Insurance with Additional Insured's Endorsement received from Applicant or Contractor.
27. One mylar set and six(6)or less sets of off-site plans signed by engineer,stamped APPROVED FOR CONSTRUCTION.
Contractor, _Inspector _PW Superintendent(Service Center)
EP File LD File _Signals&Lighting Supervisor(Service Center)
28. Permit signed by City Engineer.
29. INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE,PERMIT MAY BE ISSUED.
Issuer:Initial and date aid file with permit
J:\FORMS\Templates\Land Development\Street Improvements\Encroachment Permit Issuance Checklist.doc(Rev.07/11)
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PUBLIC WORKS SUBMITTAL REQUIREMENTS
City of Campbell
Department of Public Works
www.cityofcampbell.com 4 Public Works --> Land Development
A. ITEMS REQUIRED FOR PARCEL OR TRACT MAP SUBMITTAL:
1. Utility clearance letters from public utilities or copies of letter requests(see page 5 of item 7 below for sample)
2. Two(2)copies of the Preliminary Title Report(current within the last 6 months)
3. Two(2)copies of the Grant Deed(s)for the subject property(ies)
4. Two(2)copies of all referenced maps and documents used to prepare the Parcel or Tract Map(deeds,maps,etc.)
5. Map Plan Check Fee paid
6. Four(4)Sets of Parcel or Tract Map
7. Check List for Parcel Maps and Tract Maps
8. Two(2)copies of Closure/Area Calculations
9. Soils Report
10. Submittal appointment time scheduled with Public Works Project Engineer
B. ITEMS REQUIRED FOR STREET IMPROVEMENT PLAN SUBMITTAL:
1. Preliminary Title Report(current within the last 6 months;proof of ownership may be substituted with City's approval.)
3. Encroachment Permit Application complete
3. Applicant signature and date on Encroachment Permit(front and back)
4. Permit Application Fee paid
5. City Engineer's Estimate Completed and Submitted
6. Plan Check Deposit Paid(2%of Engineer's Estimate, $500 min)Receipt Number
7. Four(4)Sets of Street Improvement Plans with City Standard Title sheet and standard border on all sheets.
8. Check List for Street Improvement Plans
9. Submittal appointment time scheduled with Public Works Project Engineer
C. ITEMS REQUIRED FOR GRADING&DRAINAGE PLAN SUBMITTAL:
I. Four (4) Sets of Grading & Drainage plans (24" x 36" size sheets) submitted to the Public Works Department with City
Standard Title sheet and standard border on all sheets.
2. Grading Plan Review Fee paid
3. Check List for On-Site Grading&Drainage
4. Soils Report
5. Submittal appointment time scheduled with Public Works Project Engineer
J:\FORMS\Templates\Land Development\Public Works Submittal Requirements rev. 05/09
MEMORANDUM CITY OF CAMPBELL
TO: Daniel Fama, Project Planner DATE: 1/22/2014
fix
FROM: Doris C. Quai Hoi, Project Engineer(408) 866-2157.
Syed Wahidi,Public Works Inspector(408)-866-2165
SUBJECT: BUILDING PERMIT APPLICATION
Site Address: 773 Loyalton Drive
For File No(s): PLN2013-00360
Project Description: Admin Site and Arch Review Permit to reconstruct and enlarge an
attached garage for a single family residence (from 382sgft to 539sqft)
Applicant: Kelly and Anne Bybee
PUBLIC WORKS DEPARTMENT CONDITIONS OF APPROVAL
COMMENTS: The proposed project is not over 50% in building square footage therefore
does not trigger any Public Works standard Street Improvements; however the plans do
show that the applicant is proposing to relocate the existing garage and driveways which
therefore is causing work to be done in the public right-of-way.
1. Applicant is required to obtain an Encroachment Permit for all work within the public
right-of-way prior to the issuance of any grading or building permits for the site.
2. Applicant shall cause plans for all improvements in the public right-of-way to be
prepared, pay various fees and deposits, post security and provide insurance necessary to
obtain an encroachment permit for construction of the public improvements.
3. Applicant shall execute an Agreement for Private Improvements in the public right-of-
way for any non-standard improvements in the public right-of-way.
4. Current plans show the removal and replacement of two trees within the public right-of-
way. Applicant shall apply for a Tree Removal Permit for the tree removal and
replacement.
J:\LandDev\Conditions\Ping\Loyalton Drive 773.DOC Page 1 of 1
OF CAM
DEVELOPMENT REVIEW COMMITTEE
fg ROUTING SHEET
DEVELOPMENT APPLICATION
Rf H ARV
Distribution: January 14, 2014
Presentation: January 14, 2014
Completeness/Conditions Comments: January 21, 2014
ROUTE TO:
X Building Division Police Department
X Fire Department Redevelopment Coordinator
X Land Development Division Traffic Engineer
Project Description: Administrative Site and Architectural Review Permit to reconstruct and
enlarge an attached garage for a single-family residence (from 382 sq. ft. to 539 sq. ft.).
File No.: PLN2013-360
APN: 403-43-007
Applicant: Kelly and Anne Bybee
Property Owner: Kelly and Anne Bybee
Project Address: 773 Loyalton Dr. 14/y
Zoning District: hA
R-1-6 (Single Family Residential) A"vile ' 4 ftr`)
General Plan Designation: Low Density Residentialp
PROJECT PLANNER: Daniel Fama
DEPARTMENTAL RECOMMENDATION: If it can be determined that this project
will require minimal or no comments by your department/agency, please return this
comment sheet with your initials to the Project Planner as soon as possible.
Status Initial
Conditions
p1.1G LR D. ifs)
No Conditions
Additional information/revisions (see attached)
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On Lo alton Dr facing south.
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On Loyalton Dr facing south.
nd Development Information si
Prepared by: JF APN: 403-43-007 Date: 1/21/14
Address: 773 Loyalton Dr Lot size: 6,433 (SF)
If this project is part of a larger development(new subdivision,new townhomes)or commercial development,
skip A through D.
A. Existing building area(SF): 2,010 B. Proposed addition area(SF): 157
C. Total area w/addition(A+B): 2,167 D. Percent increase(B/A): 8%
(if less than 50%, stop research)
Tract or Parcel Map(circle one): Tr.3163 Date recorded: 1962
(Tract#or book&page)
Any found records of Storm Drain Area fee previously paid? Yes❑ (provide info below) No
(Fee initiated for residential subdivisions - 8/15/55; all developments -* 5/16/60)
Date paid
(file#&address or LID#)
Storm Drain Area fee: 0.14 X $2,120.00 = $296.80
(area in acres) (fee/acre)
Any found records of building permits in last five years?Yes ® (provide info below)No ❑
Was permit issued? Yes ® (provide info below)No ❑
Nature of Work: Installed PL Cleanout.No backflow required by WVSD Permit Number: BLD2013-01235
Within STANP? Yes ® No ❑ (check one)
STANP Requirements: Curb® Gutter® Sidewalk ® Rolled curb
None ❑ NA❑
Existing improvements present? Curb® Gutter ® Sidewalk ® (check all that apply)
Sidewalk dimension(BOW to FOW): 4.5 ft Park strip dimension(FOW to BOC): 4.5 ft
Driveway dimension(s): 16 ft D/W ADA compliant? Yes® No ❑
Street light info: JP❑ older pole ® galvanized pole ❑
Water meter and sewer cleanout info: Water meter located in park strip.
Sewer Cleanout located within property.
Street ROW half width(CL to PL): 30 ft
Date that street had been resurfaced: July 1999
Electrical panel relocation? Yes ® No ❑ NA ❑
New eletric subpanel.
Provide details and attach pictures(8.5x11), assessors map(11x17)and aerial map(8.5 x 11):
J:\LandDev\Land Develop Information Sheets\Loyalton Dr. 773.doc
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On Loyalton Dr facing south.
OFFICE O F COUNTY ASSESSOR SANTA C L A RA---( C O U N T Y , CALIFORNIA
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/673 /663 /653 /643 /633 /623 /6/3 /603 Cadastral map for assessment purposes only.
Compiled under R. & T. Code, Sec. 327.
AD R 1 E N TRACT N. 3222 44 D RIVE s ° Effective Roll Year 2013-2014
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DEC2 3 2013 l to \ l
rREVIEW Pubiic vr`v1A6 hu�nir�lstrati CITY OF CAMPBELL
PLAN RCL1T on
.ew Submittal ❑Resubmittal: (2nd'3rd'4th,cLh Review) Revision to Existing Permit
RECEIVED/( �3 • / .2--) -' APN 4 (7)3 ,_zig X607
APPL]CATION/PERMIT4 3 -137// JOB ADDRESS-7 7 ,3 /,d( i/
JOB DESCRIPTION 4C-0/.7110V7 /
Elo,
COMMERCIAL ESIDENTIAL
Plans P.ECIEVED
Structural Caics. _WVSD
Soils Report ,, _School Fee.Form I
_Truss Calcs. —Health Department Approval
T-24 Calcs. Response Letter
Initials `i
L
Building
an Checked By Date:
Structural Plan Checker: Date: .
❑APPROVED ❑NOT APPROVED
Planning Zone:
lan Checked By: — —. • Date:
OAP PROVED DNOT APPROVED •
Wublic Works
plan Checked By: - Date: 1-7- ,Zr1 , 3
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,vim APPROVED ❑NOT1APPROVEDc/
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DFire
Plan Checked By: Date: - .
0 APPROVED El NOT APPROVED
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Application for Building Permit .
Ti r ..rte T- =how ` ;, Intake P on(offiFkiie9nly)
Ap_plicant'Ftll in all;applica$fe-area�_prease`print-clearly-�k-Ap�eation�����a�
"°�₹ �••A�chifectlDesigner,w_ ?genf.
Applicant is Conractoc — — — — —— — — — — — — — — — -- -—- ------
P15ect=Identification
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Job Address � - l�
State '_, ;-
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�eo�ec-t'fype (check appr9pnate;iemj „�, �A����,��._ ��.'.�PLUMB�` .:;.:ELE
Commercial Residential _
scope of Work �. -: •� 4m�il�� � ... � ..•�:- °-"
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Valuation:$ g, n - Const.Type: Occupancy:
-- reSi t`�
Is Bldg.Sprinklered? Yes No Existing Use:
ed
Proposed Use
re S )dem-i-)fe-- #of Stories: / #of Units:
Comm.Sq.Ftg. Office: Retail:
Warehouse: Other:
Res.Sq.Ftg. Total Sq.Ftg. Dwelling: Gar: #of cars Patio: Porch: Deck:
(Production Homes Only) Master Plan#: Lic.#
Plan#: Suffix:
.u..y�n• "-k n.6'F*,PdF,- SL Yst F,MJC ---
OchiRS NameAddress,�Pf one
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ContractorigName Ad'cite—gb Rifor etaM ntracto:t?s Ltc`# '`^
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License �.� - � ..��� ..
----------------•-----_---------------- X Engineer (please check one)
Architect Designer
Name Phone:
Address Bus. Phone:
Cit State Zip Code
Email Y
Desired;contact:persort ".7.=,0v n• -0 wner3.W Contractor _ AYcfiitectX.Designer .r- '''Agent
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I -� t
ApphcantS nature - PrrntedName e
Revised September 2012