HomeMy WebLinkAboutENC2014-00060 MAR 17 2014 Pnnt Farm
CITY OF CAMPBELL ENCROAC RE D,Admimstrat,L., Permit No FAJ6 DCI — t3
DEPT.OF PUBLIC WORKS (for working V,iit1il i he public X-Ref.File
70 North First Street right-of-way) Application Date —`�_N.q
Campbell,CA 95008 Application Expiration Date^� ��1—l'\k
Ph. (408)866-2150 Issued 3/1 g /�4 APN (k1 oC0`55-ok'Zr
Fx. (408)376-0958 3/t 8/5
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 Addressor Tract No.: 115 S.3rd st,Campbell CA.
Utility Trench Location:
B. Nature of Work: Replacing a 1/2"CU service with new 1"PL
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.
•
408-702-8159hone:
Name of Applicant: Richard Bobrick i Telephone:
Address: 10900 N.Blaney,Cupertino CA
E-Mail Address: RZB8@PGE.com 24-HOUR EMERGENCY PHONE NUMBER: 1-800-743-5000
Is this work being done by the property owners at their own residence? nYES NO
r
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell,its officers,agents,and employees free,safe
and harmless from any claim or demand for damages resulting from the work covered by this permit.
The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit, and they will inform their
contractor(s) of the Information. Applicant is advised that upon Issuance of this permit, property owner, or property owner's successors, shall be
responsible for any and all da 1 �e rising out of the condition of any private improvements in the public right-of-way.
Accepted: 1�-�"` 3- 7..
(Applicant Permittee) (sign) Date
(Contractor) (Print Name) Date
SPECIAL PROVISIONS;
1. Street shall not be open cut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts may be
specifically approved by the Inspector prior to cutting.
_NZ_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 AMOUNT RECEIPT N
PERMIT APPLICATION FEE $ 3 7 7
PLAN CHECK DEPOSIT $
SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $
CONSTRUCTION CASH DEPOSIT
PLAN CHECK&INSPECTION FEE $ 3 7 7 lk
EMERGENCY PERMIT FEE $APPROVED FOR ISSUANCE -1` 3 I r t e//
19-
For City Engineer Date
Permit Expires 12 Months After Date of Issuance
GENERAL PERMIT CONDITIONS
I. A Construction Cash Deposit is required. Charges will be made against this deposit If there is an emergency cal I-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,ora departure from the plans and specifications,the City shall have the authority to require or approve
any modification or departure and to specify the manner in which the same is to be made for City-owned or maintained facilities.
22. Permitttee must provide advance notification to all parties that may be affected by the permit activities. Notification shall be reviewed by the City prior
to distribution and include dates of work and a contact name and phone number.
Applicant shall be responsible for ensuring that all those providing services under the applicant are aware and understand all of the above conditions.
•
Applicant Date:
764 3-i7-19
Contractor (Print Name) Date:
J:\FORMS\Templates\Encroachment Permits\Encroach merit Permit STATIC form2.pdf
Rev.02/14
AL FLAGGERS WILL CCI--1IUNICATE THROUGH HAND SIGNALS AND WALKIE TA' ''.IES WITH ONE ANOT' `ER
W20-1 'ES,: '3 N
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SIGNS BEING USED _' 4
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BE PREPAREA W20-4 l'
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ORK AREA
R30 24X24" BARRICADE
MOUNTED, PLACED ON a'
BOTH SIDES OF STREET --- ------2 20'APART 72HR PRIOR , 'a•'
TO START OF WORK '"
TOW-AWAY ?..,.,ZONE • _ .` ' `', ;..-.-1;,,1ob
1 PLACED AT EACH W20-1 �'.1 7
'ROOM WORK " , -41':,-0"..'..,,
'. GAS
25 !,,,,, F9
3 ,
MPH ,p W3-4 NOT TO SCALE
Ii,%'; MAX CONE SPACINGS
0 C9A SPEED MIN TAPER TAPER TANGENT
-► 25 125 25 50
3m� 30 180 30 60
SEE SPEC SHEET 2 FOR ADDITIONAL. , `,
TRAFFIC CONTROL STIPULATIONS _?�, 't-4
_ 35 245 35 70
W20-4
?'syy'�;":3:: •'� -' }' ,` W,f:,�1, ;;�:i.:, e�� '%m', Y.;'" ..: m :a.'4•v^;,.,.,: <H.; ...a„
11,4,. , �_ ass; ,_ , • ,� , *; ''' �,,.. � _. z. 320 40 80
FOR TCP QUESTIONS CALL: ; ,, 'z»,° ,v :, :. .
;fir ;a 45 540 45 90
ROBERT 209 ,' a j, ' �.
—2CC� 3r. 'I f ; ; � ;� •. ALL BUFFER ZONES SHALL BE A MIN OF 60'
r,. g .tl u ' •` '`"d a ALL SIGN SPACINGS SHALL BE A MIN OF 100'
>�:, .I t 4.D:;, :. -, §r_.;,7 .,u,A ,,.a:,_F' ;,.`:.€:'' <.�„� ,'• '' xan .ti. <ii.f°s;az:.,
PEDESTRIAN AND BICYCLE '! ,7;,":".. ,.‘
,. � Owner CITY OF CAMPBELL
ACCESS "
in
TO REMAIN OPEN AT ALL TIMES A. ` 1115 S. St Campbell ,C' Project Name alifornia
o ,' L ` ' i 51" W20-1 Mme Contractormber Traffic Control Contractor
WORK SHALL NOT EXCEED 12HRS N '& _ °: h"��� -`�+ PG&E ED SAFETY INC
Date
MIN 12' CLEARANCE FOR TRAFFIC Ni:,,, ,,,,,f:115,,,;,,,, PSPhone Sheet-1 3/14/2014
P M 31060955 M ! N SIGN S PAC I I�G 10 0' it `' A ASSIST
TIO ICYAL FLAGGED Td MAINTAIN CLOSURE
ASSIST BICYCLE,PEDESTRIAN AND DRIVE WAY Prepared
? TRAFFIC SHOULD NEED ARISE ED SAFETY SERVICES, INC
HOURS OF WORK SHALL BE DETERMINED BY THE CITY OF CAMPBELL
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EX. 1/2 Cu (3/4") EX. 1/2 CU (P/L) PROPERTY LINE i = >_(-)
c c c c c c c c c c o c EXISTING GAS FACILITIES i`, I-
7 6'OF 1 " P L C ❑ 4'X4'X3' HOLE �" N V) U W
M I . F W
ry FOC FACE 0 CUR 6 = p
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H M EXISTING GAS METER N vim n
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NEW GAS FACILITIES �""° Q
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� � CONSTRUCTION NOTES: c
1.PG&E TO DESIGN, TRENCH, BACKFILL AND REPLACE AN -
EXISTING 1/2" CU SERVICE WITH 1" PL.
2.PG&E TO PERFORM HOT TIE IN AND DEACTIVATION. N
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3.CALL GAS GSR FOR RELIGHT AFTER CONSTRUCTION IS ,, uj ,,;M
COMPLETE. m Z VI o 0
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AL' LAGGERS WILL GOr'""IIUNICATE THROUGH HAND SIGNALS AND WALKIE TA- -,IES WITH ONE ANON ER
W20-1 N
SIGNS BEING USED Ez
4
W20-4 I,%,
pt�� <,r 48X48" W3-4 4 3 W _ - E
48X48" C9A C9A a F.
S
48X48" W20-4 SIDEWALK CLOSEDOSED
W3-4d
CROSS HERE
RiZtAb
48X48" W20-1 z ..%,;
II
TAIL- 5.01k 9I 9evN I-
WORK AREA '‘,.
R30 24X24" BARRICADE
8
MOUNTED, PLACED ON
BOTH SIDES OF STREET
20'APART 72HR PRIOR \'TEMPORARY DELINEATION TAPE CROSSWALK
TOW-AWAY TO START OF WORK
TO BE PLACED TO ASSIST PEDESTRIANS
ZONE
AROUND WORK AREA
1 PLACED AT EACH W20-1ie
44(ft
28" 10Ib GAS
25 pE
MPH W3 4 NOT TO SCALE
SIDEWALK
;� �..
SIDEWALK CLOSED CLOSED
I I AHEAD♦ R MAX CONE SPACINGS
CROSS HERE I I 0 C9A - SPEED MIN TAPER TAPER TANGENT
-► 25 125 25 50
SEE SPEC SHEET 2 FOR ADDITIONAL 30 180 30 60
TRAFFIC CONTROL STIPULATIONS doss W204• I35 245 35 70
. 40 320 40 80
FOR TCP QUESTIONS CALL:
45 540 45 90
ROBERT @ 209-200-3351 ALL BUFFER ZONES SHALL BE A MIN OF 60'
ALLMIN OF 100
PEDESTRIAN AND BICYCLE ACCESS , Y Owner SIGN C SPACINGS CAMPBELLSHALL BEA
STOPCITY OF CAMP
TO REMAIN OPEN AT ALL TIMES Project Name Project Number
k 115 S.3rd St Ctractorampbell ,California
WORK SHALL NOT EXCEED 12HRS � W20-1 PGBE EAT'Y Clir Phone Sheet Number Date
MIN 12' CLEARANCE FOR TRAFFIC 209-333-0807 PS-2 3/14/2014'.
€ ADDITIONAL FLASHER TO MAINTAIN CLOSURE
PM 31060955 MIN SIGN SPACING 100' d ASSIST BICYCLE, PEDESTRIAN AND DRIVE WAY Prepared BY
TRAFFIC SHOULD NEED ARISE I ED SAFETY SERVICES, INC
HOURS OF WORK SHALL BE DETERMINED BY THE CITY OF CAMPBELL
CLOSURE STIPULATIONS AND SPECIFICATIONS THAT MUST BE FOLLOWED AT ALL TIMES
DRIVEWAY ACCESS SHALL REMAIN OPEN OR ACCESSIBLE AT ALL TIMES
�►II lane closures shall meet or exceed CA MUTCD 2012 specifications as well as conform to hours of work set forth by th
;ity. All areas of work when encroaching upon sidewalk access OR pedestrian safety shall have a CA MUTCD 2012 standard sidewalk
;losure detour detail in place to ensure pedestrian and public safety.
'edestrian access or detour will be maintained at all times in the event sidewalks must be closed, all paths of travel shall be similar to one
hat is closed.
'edestrian traffic shall at all times have a minimum 4 feet wide area of travel.
III open excavation areas shall be backfilled or trench plated prior to public usage.
X11 closures set forth in this TCP are the minimum allowed on project, field conditions may change requiring further traffic safety devices or
raffic control persons to ensure safety of traveling public, pedestrians as well as work forces.
111 changes to ensure safety will be made immediately to ensure a safe environment for all parties.
III traffic control devices, vehicles and personnel must be suited for the purpose intended as well as meet or exceed all CA MUTCD 2012
specifications as well as City specifications.
III devices shall be removed when no longer required.
III flaggers shall be certified and all intersections shall be flagged when required as shown on plans.
f work is done at night or encroaches on the hours of darkness all road work ahead signs shall have flashing a beacon, light towers will be
ised for flaggers and work areas and all other CA MUTCD 2012 requirements shall be met or exceeded as well.
JOT TO SCALE----SPACING OF SIGNS, TAPER AND TANGENTS WILL BE SPACED AS PER TABLE HAS SET FORTH AS GOVERNED BY
RAVEL SPEEDS.
III traffic devices shall meet or exceed CA MUTCD 2012. All signs shall be high intensity night time reflective, 48"x48" roll up signs.
III signs shall have a minimum of 2, 18" day time flags attached to sign stands during day time hours and if applicable flashing 12", 12v
beacons for night time work.
>ign stands shall be CA MUTCD 2012 compliant as well allowing for 18" to 7' height for signs as well as spring equipped for windy conditions.
'avement delineation not exactly as appears in field but traffic plan will still work as shown. All cones shall be 28" 10 lb and shall not be
)laced further than 40' apart.
UI hours of work shall be dictated by the Cities specified lane closure charts or as directed by the city inspector.
vehicle path of travel shall never be less than 12' in width. Closures and excavation not to exceed what forces expect to excavate per the dail:
;hift.
toadway shall not be opened until safe for public use. All open trenches must be plated or backfilled prior to public usage.
di areas of excavation must have a valid USA dig tag with corresponding dig ticket number, proof must be carried with the excavating forces
it all times.