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HomeMy WebLinkAboutENC2014-00167 A - • _ - Print Form CITY OF CAMPBELL . .9 ENCROACHMENT PERMIT Permit No ENS o�\� — 3O\(Q 1 'A (for working within the public X-Ref.File DEPT.OF PUBLIC WORKS 70 North First Street !'11 right-of-way) Application Date _ Campbell,CA 95008 SEP 1 c/1 , (( Application Expiration Date Ph. (408)866-2150 20/4 Issued APN Fx. (408)376-09504C (Norks Aa Permit Expiration Date t /(�'�5 APPLICATION-Application is hereby ifiEb'(+p blic Works Permit in accordance with Campbell Municipal Code,Section 11.04. (Application expires in six (6) months if the permit is not issued. Applica i&l iee is non-refundable.) A. Work Address or Tract No.: MH 69-344 located near corner of 5 Bascom Av and E Campbell Av Utility Trench Location: B. Nature of Work: excavate asphalt to raise MH 69-344;restore area to original or better condition 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: Art Castillo Telephone: 408-635-8812 Address: 870 N McCarthy Blvd,Milpitas,CA E-Mail Address: ac1634@att.com 24-HOUR EMERGENCY PHONE NUMBER: 650-868-3319 Is this work being done by the property owners at their own residence? n YES IT( 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 adviseclAat upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any and all damages arising ou th ond' ion of any private improvements in the public right-of-way.Accepted: -tA ' /3- (/ 1 (Applic t 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. 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 .3 RECEIPT NO. PERMIT APPLICATION FEE $ CZ PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ CONSTRUCTION CASH DEPOSIT $ n PLAN CHECK&INSPECTION FEE $ 2j P1 5 EMERGENCY PERMIT FEE $ q APPROVED FOR ISSUANCE I J IG/i- or City Engineer Date Permit Expires 12 Months After Date of Issuance 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 shal responsible for ensu' that all those providing services under the applicant are aware and understand all of the above conditions. 97(3/2 074{ Applicant Date: Contractor (Print Name) Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.02/14 • CENTER NO. F LANES 4......., ISSUE DATE 3 I I }p} W RIGHT / •�� 1 9/14 ROAD LANE END WORK LEFTILANE CLOSED ROAD WORK 4! AHEAD CLOSED I SIDEWALK I I W20-1 C20 C30 G20-2 MEDIAN 1 4 I 4 G20-2 SIGN I v u Y ©�nMn nn - - - - W US BANK L_ �LIVLJP [E�L� QVIE❑ 1998 MEDIAN ) 10�_A 0' _ _ A 100' ...--.--N100' u v z EDIAN z z (n 0 In 05 J 2 O 0 SIDEWALK M N "' ME�I N U U SIDEWALK 3 I SIDEWALK I�( 1� Q ow ow Q SPEED BUILDING I LIMIT 2150 a • • . 25 a TMEDIAN • • • OC) 0 as 4 Oil Mb 3 © 2 I SIDEWALK SIDEWALK Lu 4 Y -J 3 Qn Q LEGEND �(/ 1=1 TYPE III BARRICADE W/SIGN I--( TYPE II BARRICADE W/O SIGN • CHANNELIZING DEVICE T TRAFFIC CONE WITH CLIP ON SIGN T SIGN GENERAL TRAFFIC CONTROL NOTES • I O SIGNALIZED INTERSECTION DATE C�NST ARC COMP TRAFFIC SHALL CONFORM TO THE CALIFORNIA MANUAL ON UNIFORM TABLE A Ep ARROW PANEL(FLASHING ARROW)(WHERE REQUIRED) GED/C❑ N478 _ _ TRAFFIC CONTROL DEVICES(MUTCD)AND 2010 CALTRANS STANDARDS Y HIGH LEVEL WARNING DEVICE(FLAGTREE)(OPTIONAL) S N J S CA 1 2 NO LANE CLOSURES PERMITTED BEFORE 9:30A AND AFTER 3:30P MINIMUM RECOMMENDED DELINEATOR/CONE -a EXCHANGE &SIGN PLACEMENT In FLAGGER A. CASTILLO ENGINEER ACCESS TO DRIVEWAYS SHALL BE MAINTAINED AT ALL TIMES POSTED SPEED TAPER LENGTH L DELINEATOR SPACING SIGN SPACINGS TANS TOW AWAY NO STOPPING_TO_(SHOW HOURS) TELEPHONE (408) 635-8812 ADVANCE OF TAPER ONE LANE OF TRAFFIC IN EACH DIRECTION AND ALL HIGH VOLUME LIMIT TAPER TANGENT &BETWEEN SIGNS TANSAT TOW AWAY NO STOPPING ANY TIME VO K DJ W 550 TURNING LANES SHALL BE MAINTAINED AT ALL TIMES ON ALL STREETS (Km/11) (m) (m) (m) (m) i ENGR ARC AT A MINIMUM LANE WIDTH OF 10 FEET. ;, ,4 WORK ZONE(ACTIVITY AREA)LIMITS 25 MPH (40) 125 FT. (40) 25 FT. (8) 50 FT. (15) 100 FT. (45) DIRECTION OF TRAFFIC(NOT PAVEMENT MARKING) TYPE OF CONSTRUCTION ANY CONFLICTING SIGNS,STRIPING AND PAVEMENT MARKINGS SHALL BE 30 MPH (45) 180 FT. (55) 30 FT. (9) 60 FT. (18) 250 FT. (60) REMOVED OR COVERED BEFORE TRAFFIC CONTROL IS IN PLACE.ANY 35 MPH (50) 245 FT. (75) 35 FT. (11) 70 FT. (21) 250 FT. (75) O ROADWAY DESIGNATION(A THROUGH D) PROJECT PERMIT SIGN.STRIPING OR PAVEMENT MARKING REMOVED OR COVERED SHALL 40 MPH (60) 320 FT. (100) 40 FT. (12) 80 FT. (24) 250 FT. (105) BE REPLACED WHEN TRAFFIC CONTROL IS NO LONGER NECESSARY. •45 MPH (70) 540 FT. (165) 45 FT. (14) 90 FT. (27) 350 FT. (170) RD/EST NO 9254971 SCALE: NONE SAFE PEDESTRIAN ACCESS SHALL BE MAINTAINED AT ALL TIMES. •50 MPH (80) 600 FT. (185) 50 FT. (15) 100 FT. (30) 350 FT. (185) 3 •55*MPH (85) 1000 FT. (305) 50 FT (15) 100 FT. (30) 1000 FT. (305) DWG OF 3 P 504 -- it ( ¢ 4 1 , l0C l ISSUE DATE MEDIAN V � 1 9/1 4 s W C) MEDIAN 'Triplex- _._,_, US BANK OTHER UTILITIES THAT ARE NOT SHOWN MAY EXIST IN WORK AREA. 1998 LOCATION&DEPTH OF EXISTING SUBSTRRUCTURE NOT GUARANTEED. AT&T EXISTING MH 69-344 JS JJ MEDIAN RAISE EXISTING MANHOLE CALL JA TOLL FREE TO EXISTING SURFACE GRADE 48 HRS PRIOR TO DIGGING FOR ALL SUBSTRUCTURE LOCATIONS MEDIAN 800-227-2600 or 811 SIDEWALK ° MH uJ-344 17-1 MEDIAN Q ) I ,.... ,„ ,). ©1-F, _i_i„) DD3 :[Li FL, 1W 0 •C , .kp 4 .c , ck A _ SIDEWALK ct ws T 4 ___ I(//)� 1 U v , 20't" 2" 1"=20' 20' 40' I I J STREETLIGHT -LOG- LIP OF GUTTER DATE w FIRE HYDRANT - S - SEWER/STORM DRAIN CONST ARC COMP Q L/ - C/L - CENTER LINE N478 q O CITY MONUMENT E ELECTRICAL GED/C❑ LLl ® JOINT UTILITY POLE -TEL TELEPHONE EXCHANGE SNJSCA12 ® MANHOLES FENCELINE A. CASTILLO ENGINEER SIGN W WATER TELEPHONE (408) 635-8812 • BOLLARD BUSH V0KDJW550 ® STORM DRAIN ENGR ARC >< SAI CABINET a TREE TYPE OF CONSTRUCTION BOW BACK OF SIDEWALK PROJECT PERMIT CPC TYPE C-40 PLASTIC CONDUIT FOC FACE OF CURB SW SIDEWALK RO/EST NO 9254971 DWG 2 OF 3 P 504 -- 41 „s ISSUE DATE etc=—. -- a & 1 9/14 .� - - r _ . ... . . ' 9 i• - - ....... --t i t - ►`irk...- . o A,.-•••••>.7001lier7i, '''_ "--, ai\x�., LOOKING WEST AT DIG UP LOCATION LOOKING NORTH AT DIG UP LOCATION E CAMPBELL AVE. S. BASCOM AVE. S. BASCOM AVE./ E CAMPBELL AVE. CAMPBELL, CA ,. _ '! . .�40 It :amtaty,, /WowT�,,,•, .. �. CONSTRUCTION NOTES 1. PERMIT TO EXCAVATE ASPHALT Mr Pvne.0 ` TO RAISE EXISTING MANHOLE . lw�pc e•) I TO EXISTING SURFACE GRADE. r AFt_ Network ...•i-,;e >• Services •Y<1. A FW.un Su* I ��-�_'- 1 w>A>n _ 2. RESTORE AFFECTED ROAD WORK AREA THIS GARCIOB WASA OF AFETELINEERED AND DRAWN BY ECOMMUNII TELECOMMUNICATION SERVICES ID 1 INC.UNDER CONTRACT WITH AT&T,FOR QUESTIONS 8 [ n � TO ORIGINAL OR BETTER CONDITION. AND ASSISTANCE ON THIS JOB PLEASE CALL C ENGINEER AS NOTED IN THE TITLE BOX. . Ctww Osergr ® n . µL , 9 w.. a Mawr. CDNST ARC COMP a o GED/C❑ N478 C 1. COVER EXCHANGE SNJSCAI2 1,2 ENGINEER /A. CASTILLO _3 TM"' 2. LAYOUT PLAN DIG UP TELEPHONE (408) 635-8812 pThriurf m„s,,, Lech*:r et_ Jo 3. TRAFFIC PLAN ENGR ARC V0KDJW550 TYPE OF CONSTRUCTION LOCATION DETAIL T. M. 853-G6 PROJECT PERMIT SCALE NONE RD/EST NO 9254971 DWG 1 OF 3 P 504 --