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HomeMy WebLinkAboutENC2014-00071 P/u: 3174e,fSi` I IL— ../ V .V e; f�`� .`�' ,✓, v-s I 2[1;4 Print Form e rpice--. �fn,y. 7ZLS. 2/5!6 fl CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No F RC 00 —000 1 DEPT.OF PUBLIC WORKS (for working w(thin•t1 efpubiic' X-Ref.File 70 North First Street rig f-wAy,) . ..: Application Date 3I'-\ IL( Campbell,CA 95008 Application Expiration Date ot I11 Ph. (408)866-2150 Issue d I �I e APN 40 30 d0 3 i Fx. (408)376-0958 Permit Expiration Date ( / 211 I 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.: 125 SOUTH SAN TOMAS AQUINO ROAD,CAMPBELL 'TT WED Jwall Utility Trench Location: SOUTH SAN TOMAS AQUINO ROAD&BUCKNALL ROAD M212014 .___._...__ .._..... - - ... ._.-.._......-- -. .-._._...._. B. Nature of WorAR OVERHEAD TO UNDERGROUND CONVERSION C. Attach four(4)cceltOISakiellgkerplan showing the location and extent of the work,and four(4)copies of the preliminary Engineer's Estimate ofWtft. 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: PACIFIC GAS&ELECTRIC(Tamara A. Thomas,Estimator) Telephone: 925.459.2148 Address: 1850 GATEWAY BLVD,CONCORD E-Mail Address: TXTS@ PGE.COM 24-HOUR EMERGENCY PHONE NUMBER: 1.800.743.5000 Is this work being done by the property owners at their own residence? " YES r` NO The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell,its officers,agents,and employees free,safe and harmless from any claim or demand for damages resulting from the work covered by this permit. The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit,and they will inform their contractor(s) of the information. Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any and all damages arising out of the condit' f any private'mpro ments in the public right-of-way. Accepted: %Q AAA Q. 7f/s...4,S / £_9 zor,/ (Applicant Perm' (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. 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 NO. PERMIT APPLICATION FEE $ 3 85 PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ CONSTRUCTION CASH DEPOSIT $ PLAN CHECK&INSPECTION FEE $ 3,6 5 L•( EMERGENCY PERMIT FEE $ APPROVED FOR ISSUANCE II/i /1 tt For City Engineer Date Permit Expires 12 Months After Date of Issuance Poles he.,n.v--P ft17ox 4. 4[&o)}(4 ya"14-s x 1170 eac1, = xG )i-(71swCc+,ouii 5oox S'2.1o%� 2�S� 1.6,./� _ # $"3 11 = GENERAL PERMIT CONDITIONS 1. A Construction Cash Deposit is required. Charges will be made against this deposit if there is an emergency call-out,overtime inspection or when City ordered barricading is required. Any such costs in excess of the deposit will be billed to the Permittee. 2. A one-year maintenance period and surety are required. Such period will begin on date of written acceptance by the City. 3. Refund or the cash deposit balance and refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work by the City. 4. Submit project schedule 10(ten)days prior to proposed start of work.Special provisions may be required for work within City facilities and downtown Campbell. 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 responsible for ensuring that all those providing services under the applicant are aware and understand all of the above conditions. -.+`t—zo�y Applicant Date: Contractor (Print Name) Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.02/14 v N W20-1 aea SHARE SIGNS BEING USED THE ROAD I F W20-5RT �Nov n� °° 048X48" W4-2RT W _O._ E Of,. `► I RIAHEA" 48X48" W20-5RT W4-2RT CLO3ED S CLOSED 48X48" C30 TAPER 245' z "*. I 48X96 TOWABLE ARROWBOARD RO •*II Ill Oil 9•III A EAAoD 48X48" W20-1 I PLACED AT EACH W20-1 • • •. ••• ROAD WORK SPECIAL ` SHARE 1...2.•n 25 4 THE ADDITIONAL TRAFFIC CONTROL BUFFER 120" 'j ROAD PERSON TO MAINTAIN CLOSURE ASSIST BICYCLE,PEDESTRIAN AND DRIVE O O�O MPH LANE WAY TRAFFIC SHOULD NEED ARISE ,1 I CLOSE R -J r I I i, O r----:".. 1. q • • WORK ARE Y > °Y< V u Q ;Q R30 24X24" BARRICADE YyV MOUNTED, PLACED ON \l BUCKNALL ROAD BOTH SIDES OF STREET ELEC 20'APART 72HR PRIOR S Aiiik TOW-AWAY TO START OF WORK a�� °�° ZONE NOT TO SCALE c � OSE LANE M MAX CONE SPACINGS LOC 803-809, 81 \ ' SPEED MIN TAPER TAPER TANGENT W 25 125 25 50 < 30 180 30 60 SEE SPEC SHEET 2 FOR ADDITIONAL r n.w u+ 35 245 35 70 TRAFFIC CONTROL STIPULATIONS \ .� 40 320 40 80 FOR TCP QUESTIONS CALL: 45 540 45 90 ROBERT @ 209-200-3351 1 ., v 1 ALL BUFFER ZONES SHALL BE A MIN OF 120' ALL SIGN SPACINGS SHALL BE A MIN OF 245' PEDESTRIAN AND BICYCLE ACCESS 28" 10Ib ;.i Owner CITY OF CAMPBELL TO REMAIN OPEN AT ALL TIMES Project Name Project Number San Thomas Aquino Rd @ Bucknall Rd Campbell, California WORK SHALL NOT EXCEED 12 H RS II Prime Contractor Traffic Control Contractor ° ED SAFETY INC ROAD PG&E MIN 12' CLEARANCE FOR TRAFFIC HEAD W20-1 Phone 209-333-0807 SPS-2 NumberDate 2/14/2014 PM 30984842 MIN SIGN SPACING 245' Prepared ByED SAFETY SERVICES, INC HOURS OF WORK SHALL BE DETERMINED BY THE CITY OF CAMPBELL i SIGNS BEING USED 4 I N i SHOULDER 48X48" C30A-CA I � CLOSED , I W - E I SAHOEAOR 48X48" W21 -5 , I 14 I S AHEAD 48X48" W20-1 SPECIAL Brie r' I SHARE 11 " ADDTIONAL TRAFFIC CONTROL THE PERSON'TO MAINTAIN CLOSURE ASSIST " ROAD BICYCLE,PEDESTRIAN AND DRIVE I WAY TRAFFIC SHOULD NEED ARISE oaI 1 PLACED AT EACH W20-1 I ' ROAD WORK 48x60 4 25 , 4.1iI I_ MPH I ° I I W20-1 nva I I_ >taom �a ovoa I I I t CD Z I I I i Q' --J 4 �3Q 8e � Q°W pY�O R30 24X24" BARRICADE MOUNTED, PLACED ON < � " ter BUCKALL ROAD BOTH SIDES OF STREET k 20'APART 72HR PRIOR - - - . - ' - ELEC TOW-AWAY TO START OF WORK �A$ I h - WORK AREA ZONE ° ' ' NOT TO SCALE 0I I MAX CONE SPACINGS CV �I SPEED MIN TAPER TAPER TANGENT LOC 807 25 125 25 50 BUFFER 120' _ 30 180 30 60 SEE SPEC SHEET 2 FOR ADDITIONAL I _ -J TRAFFIC CONTROL STIPULATIONS SHARE THE -0 35 245 35 70 " , TAPER 80' ROAD 40 320 40 80 FOR TCP QUESTIONS CALL. 45 540 45 90 ROBERT @ 209-200-3351 CC °`DER C30A-CA ALL BUFFER ZONES SHALL BE A MIN OF 120' CLOSED ALL SIGN SPACINGS SHALL BE A MIN OF 245' PEDESTRIAN AND BICYCLE ACCESS 28" 10lb Owner CITY OF CAMPBELL TO REMAIN OPEN AT ALL TIMES :do°os D W21-5 Project Name Project Number AHEADSan Thomas Aquino Rd@BucknaIIRd Campbell, California WORK SHALL NOT EXCEED 12 H RS Prime Contractor Traffic Control Contractor PG&E ED SAFETY INC ROAD MIN 12' CLEARANCE FOR TRAFFIC HEAD W20-1 Phone 209-333-0807 SPS-3 NumberDate 2/14/2014 PM 30984842 MIN SIGN SPACING 245' SHOULDER TAPER = TAPER/3 Prepared BY ED SAFETY SERVICES, INC HOURS OF WORK SHALL BE DETERMINED BY THE CITY OF CAMPBELL i N I SIGNS BEING USED I I leD 48X48" W1 -4 W - - E 4 H737, 48X48" W20-1 4 S I I I SPECIAL KEEP •�® RIGHT ADDITIONAL TRAFFIC CONTROL PERSON TO MAINTAIN CLOSURE ASSIST I BICYCLE,PEDESTRIAN AND DRIVE I 36X48 WAY TRAFFIC SHOULD NEED ARISE 1 PLACED AT EACH 1/1,20-1 I ROAD WORK I STREET WIDE ENOUGH STOPPING TRAFFIC IS 4 NOT REQUIRED BUT TRAFFIC CONTROL PERSON 414 I WILL ASSIST HOMEOWNERS IN AND OUT OF THEIR 2 5 tr DRIVEWAYS AS NEEDED. W20-1 ovo ° i a MPH W20-1 odoa d I W N- N.) I I WOR AREA , 4 i 661$°02-8 R30 24X24" BARRICADE ` ,, =mo ^" ` BUCKNALL ROAD MOUNTED, PLACED ON V 1% �,,,,, ,;,y,;,,...,u u .:: / • ELEC BOTH SIDES OF STREET \ /' - 20'APART 72HR PRIOR TO START OF WORK ��� �� �\ TOW-AWAY oxo Av / „ g NOT TO SCALE r- KEEP KEEP 28 1 0)b MAX CONE SPACINGS NRIGHT', , RIGHT SPEED MIN TAPER TAPER TANGENT LOC 812-813 "'► hORK W20-1 25 125 25 50 nHFs o SEE SPEC SHEET 2 FOR ADDITIONAL z °A0 oRK Q 30 180 30 60 W20-1 TRAFFIC CONTROL STIPULATIONS �� 35 245 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 90' ALL SIGN SPACINGS SHALL BE A MIN OF 180' PEDESTRIAN AND BICYCLE ACCESS CITY OF CAMPBELL TO REMAIN OPEN AT ALL TIMES Project Name San Th Project Number San Thomas Aquino Rd @ Bucknall Rd Campbell, California WORK SHALL NOT EXCEED 12HRS P�Contractor &E ETraffic Control Contractor D SAFETY INC MIN 12' CLEARANCE FOR TRAFFIC „ ; ` 209-333-0807 Sheet Number Date 2/14/2014 PM 30984842 MIN SIGN SPACING 180' SHOULDER TAPER = TAPER/3 Prepared By 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 III lane closures shall meet or exceed CA MUTCD 2012 specifications as well as conform to hours of work set forth by till ;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. \II open excavation areas shall be backfilled or trench plated prior to public usage. \II 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. \II changes to ensure safety will be made immediately to ensure a safe environment for all parties. \II 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. \II devices shall be removed when no longer required. \II 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. \II traffic devices shall meet or exceed CA MUTCD 2012. All signs shall be high intensity night time reflective, 48"x48" roll up signs. \II 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 ►eacons for night time work. sign 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 placed further than 40' apart. \II hours of work shall be dictated by the Cities specified lane closure charts or as directed by the city inspector. %hicle path of travel shall never be less than 12' in width. Closures and excavation not to exceed what forces expect to excavate per the daily ,hift. toadway shall not be opened until safe for public use. All open trenches must be plated or backfilled prior to public usage. \II 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. Y 4 N W20-1 aeoa I 4 SIGNS BEING USED I I , 1 ' I W20-5RT 03S0 I 048X48" W4-2 RT \V aavi ia�a � SHARE W -0- E I I THE CIV ' I ROAD O O 1 RIGHT o 48X48" W20-5RT W4-2RT S 4 Hi LANE �3a _ _ _ — — CLOSED 48X48" C30 - _ J _- _I' _. - ._ - - ROAD EA0 48X4871 W20-1 1 oxo TAPER 245' " I ' SPECIAL 48X96 TOWA�EARRO;BOARD SHARE II,� r • o • • • THE • • • • ADDITIONAL TRAFFIC CONTROL j • I ' • • • • • • ROAD PERSON TO MAINTAIN CLOSURE ASSIST BICYCLE,PEDESTRIAN AND DRIVE I o% WAY TRAFFIC SHOULD NEED ARISE :I BUFFER 120' 4 +1� I 1 PLACED AT EACH W20-1 LANE • ROAD WORK 25 LOSE . R30 24X24" BARRICADE 8 MOUNTED, PLACED ON • j BOTH SIDES OF STREET , 20'APART 72HR PRIOR MPH i ELEC r TOW-AWAY` TO START OF WORK ^`�`� ' ZONE ,,,,,,,,,.......yo ,�,; WORK ARE , 4 NOT TO SCALE 800-8027814-818 ,� I 7 MAX CONE SPACINGS LOC #. h SPEED MIN TAPER TAPER TANGENT ' ' ' 25 125 25 50 <-.> SEE SPEC SHEET 2 FOR ADDITIONAL "�I I 30 180 30 60 TRAFFIC CONTROL STIPULATIONS 28 101 b .+ 35 245 35 70 ! 40 320 40 80 FOR TCP QUESTIONS CALL: ' ' 1 ' '„ 45 540 45 90 ROBERT @ 209-200-3351 I I HEAD W20-1 ALL BUFFER ZONES SHALL BE A MIN OF 120' ALL SIGN SPACINGS SHALL BE A MIN OF 245' PEDESTRIAN AND BICYCLE ACCESS Owner CITY OF CAMPBELL TO REMAIN OPEN AT ALL TIMES Project Name Protect Number San Thomas Aquino Rd @ Campbell Ave Campbell, California WORK SHALL NOT EXCEED 12HRS Prime PG&E Contractor ETraffic Control Contra DSAFET NC MIN 12' CLEARANCE FOR TRAFFIC Phone 209-333-0807 Sheet Numbe Date r 2/14/2014 PM 30984842 MIN SIGN SPACING 245' Prepared By ED SAFETY SERVICES, INC HOURS OF WORK SHALL BE DETERMINED BY THE CITY OF CAMPBELL