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Home My WebLink AboutENC2014-00151 -:'-4,Pi ft - _4 CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No LJC. ')2t - G°I 5 DEPT.OF PUBLIC WORKS (for working within the public X-Ref.File 70 North First Street right-of-way) Application Date 9/1q./ 19- . Campbell,CA 95008 '2c-7( c`C Lc. Application Expiration Date Ph. (408)866-2150 ''))/Issued l /j1L_ APN Fx. (408)376-0958 Permit • FExpiration Date 2)i 2 I✓ APPLICATION-Application Is hereby made fora 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.) ndable.) A. Work'Address or Tract No.: - T CPM` ieFit-L /-', 1E--•-1, 1/4.)&-ar • I j� ,y _j Utility Trench Location: C to\F'(3Et,L 1W- 1.1IVC 1.5SI G E C i 't;/-1L ii-UF1JWE B. Nature of Work L 1k 'Flfe.E- GE-,gNIIGE t l tSTALLA+for 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 24hours before restarting any work. Name of Applicant: SAKI .cxE �A1 T CO, N tC..,9 (vl1-E-D0 pie i - Telephone:tf:*2 —756 j • Address: 12.25 S.ZAscfa'\ , --1-4 -- SAN SosE, Cicst 9512g E-Mail Address: yj >i e ifl LJv l ba{esj a1er, 4 9UR EMERGENCY PHONE NUMBER 2,x,9--790O Is this work being done by the property owners at their own residence? r YES NO The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell,its officers,agents,and employees free,safe and harmless from any claim or demand for damages resulting from the work covered by this permit.• The Applicant/Permittee hereby acknowledges,that they have read and understand both the front and back of this permit,and they will inform their contractors) 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 condition i� of any ivat improvements in the public right-of-way. J C//�( Accepted: NI lCOLti -DUN8f-kg I + 4 - ,J/�� g3�/'l (Applicant Permittee) (sign) Date - '\11\1.-Er V/6-ttiFT COt -STR'‘)6-1-i01Q4 -CO g/ic9/;: 4 (Contractor) (Print Name) Date SPECIAL PROVISIONS. • 1. Street shall not be open cut for underground installations.Minimum cuts ma be allowed far connections or exploration holes.Such cuts m, sy be Specifically aporovedbv 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. S. Prior to any work,the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way,which shall.be recorded. 5. Public Notification Requirements: • 7. SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT RECEIPT PERMIT APPLICATION FEE $ 3C S PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ CONSTRUCTION CASH DEPOSIT $ �S k PLAN CHECK&INSPECTION FEE $ l EMERGENCY PERMIT FEE $ • APPROVED FOR ISSUANCE - e12671 it 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 call-out,overtime inspection or when City ordered barricading is required.Any such costs in excess of the deposit will be billed to the Permit-tee. 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 ofthe 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 Perinittee must request In writing a final Inspection.end 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 Celtrans Manual of Traffic Controls for Construction and Maintenance WorkZones,dated 1990,available at Caltrarss.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 far 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 4110 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 frorn 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 mannerin which the same Is to be made for City-owned or maintained facilities, 2i Permitnee 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. 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