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CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. Ol t-I-20 5
DEPT.OF PUBLIC WORKS (Non-engineered work within the public right-of-way) X-Ref File
70 North First Street ($10,000.00 maximum value of work) Application Date
Campbell,CA 95008 / Application Expiration
Ph.(408)866-2150 ISSUED: V 12 3< 5 Date
Fx.(408)376-0958 Permit Expiration Date: 41/2-2' //(c, APN 4))4 0(0 0 I�(
APPLICATION-Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code,Section 11.04.
(Application expires in 6 months if the permit is not issued.)
A. Work Address: J"1 ""�Vvl" 'Y/ spoo O
B. Nature of Work: c 4? (^Dn �kiWV
C. Attach three(3)copies of a drawing showing the location,extent and dimensions of the work. The drawing shall show the relation of
the proposed work to existing improvements. When approved by the City Engineer,said drawing become 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 securities.
NAME OF APPLICANT: �� j�/ /L T\ 21V141
Telephone: (.j ? 2A0--1121-43
Address: S2)J VI `(AW" If /L U( �,\ 8 u Q li'P26W
E-Mail Address: L70\49(2;14 IL , 11 w k2�
The Applicant hereby confirms that this work is being done by the p perty owner/applicant at their own residence.
The Applicant hereby agrees by affixing their signature to this permit to hold the City of Campbell,City of Campbell Redevelopment Agency,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 hereby ac wledges that they have read and understand both the front and back of this permit,and that they will inform their
contractor(s)of the infor tion. {�
ACCEPTED: LUYA" (t, 1,i141
(Applicant/Permittee) (Sign) Date
NOTES: All work shall conform with the attached approved plans and all applicable Campbell Standard Details and Conditions and applicable
insurance requirements.
The Contractor must have this permit and approved plans and must arrange to meet with the Public Works Inspector at the site at least two days
before starting work. Notice must be given to Public Works at least 24 hours before restarting any work.
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(Ticket No.)has been entered hereon. USA Phone: 1-800-227-2600. Ticket No.: .
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 design,installation or condition of private improvements in the public right-of-way.
SPECIAL PROVISIONS
1. Prior to any work,the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way,which shall be
recorded.
2.
3.
STANDARD AMOUNT RECEIPT NO.
SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) $
R-1 PERMIT FEE $ /
APPROVED FOR ISSUANCE: ` v% �r 23�
Date
for City Engineer
Permit Expires 6 Months after Date of Issuance.
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MEMORANDUM CITY OF CAMPBELL
TO: Bill Bruckart, Building Official DATE: 7/30/2014
FROM: Doris C Quai Hoi,Project Engineer(408) 866-2157
SUBJECT: BUILDING PERMIT APPLICATION
Site Address: 134 Hunt Way
For File No(s): BLD2014-661
Project Description: New Single Family Dwelling with attached garage
Applicant: Luka Dvornik
COMMENTS
The building permit and grading permit will not be issued until all Public Works Conditions of
Approval have been satisfied. Applicant will be required to pull an encroachment permit for
replacing damaged sections of the sidewalk. Visit the City website at: Home/Your
Government/Departments/Public Works/Engineering/Land Development/Documents on
obtaining an encroachment permit. Public Works Standard Details can also be found on this web
page.
These Conditions of Approval are a supplement to the Site Plans dated April 14, 2014 by Daryl
Fazekas. The plans are not approved for construction of public improvements.
PUBLIC WORKS DEPARTMENT CONDITIONS OF APPROVAL
1. Response Letter: Upon submittal of the revised Site Plans, the applicant shall
provide an itemized response letter verifying that all the Public Works Conditions
of Approval have been met or addressed.
2. Preliminary Title Report: Prior to issuance of any grading or building permits for
the site, the applicant shall provide a current (within the past 6 months) Preliminary
Title Report.
3. Proof of Ownership: Prior to issuance of any grading, drainage, or building permits
for the site, the applicant shall provide a current Preliminary Title Report, grant
deed, or other satisfactory proof of ownership.
4. Storm Drain Area Fee: Prior to issuance of any grading or building permits for the
site, the applicant shall pay the required Storm Drain Area fee, currently set at
$2,120.00 per net acre, which is $506.00.
5. Deferred Street Improvement Agreement: Prior to issuance of any grading or
building permits for the site, the owner shall execute a deferred street improvement
agreement for construction of City of Campbell's standard street improvements.
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134 Hunt Way
Unless otherwise approved by the City Engineer these improvements shall include,
but are not limited to, removal and replacement of street pavement structural
section to centerline, removal of existing rolled curb and sidewalk, installation of
City Standard vertical curb, gutter, sidewalk and park strip, ADA compliant
driveways, street trees, street lights, necessary drainage facilities and necessary
conforms to existing improvements. The current street improvements are not in
compliance with Campbell's public improvements standards per Detail 1,
Residential Separated Walk.
6. Street Improvement Plans/Encroachment Permit/Fees/Deposits: Prior to issuance
of any grading or building permits for the site, the applicant shall cause plans for
public street improvements to be prepared, pay various fees and deposits, post
security and provide insurance necessary to obtain an encroachment permit for
construction of the public street improvements, as required by the City Engineer.
Sheet Al shall include the following:
a. Show location of all existing utilities within the new and existing public
right of way including the sanitary sewer clean out and the water meter.
b. Relocation of all existing utilities including utility boxes, covers, poles, etc.
outside of sidewalk area. No utility boxes, covers, etc. will be allowed in the
sidewalk area.
c. Show the locations of all underground utilities (gas, water, electric, sewer)
connecting to the utility mains see Condition #6, 7, 8, 9 as it relates to this
sheet. Add a note if there are no upgrades to the laterals.
d. Condition#9 shall be shown on the plans for all pavement restoration.
e. Removal of existing sections of broken and cracked sidewalk and necessary
rolled curb. The extent of the work will be identified in the field with the
Public Works Inspector prior to construction of the public improvements.
7. Utilities: All on-site utilities shall be installed underground per Section 21.18.140
of the Campbell Municipal Code for any new or remodeled buildings or additions.
Applicant shall comply with all plan submittals, permitting, and fee requirements of
the serving utility companies.
8. Water Meter(s) and Sewer Cleanout(s): Existing and proposed water meter(s) and
sewer cleanout(s) shall be relocated or installed on private property behind the
public right-of-way line. (see Condition 6).
Sheet Al shows the water meter and sewer clean out in the public right of way.
Revise site plans to install behind property line (see Condition 6).
9. Utility Coordination Plan: Prior to issuance of building permits for the site, the
applicant shall submit a utility coordination plan and schedule for approval by the
City Engineer for installation and/or abandonment of all utilities. The plan shall
clearly show the location and size of all existing utilities and the associated main
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134 Hunt Way
lines; indicate which utilities and services are to remain; which utilities and services
are to be abandoned, and where new utilities and services will be installed. Joint
trenches for new utilities shall be used whenever possible.
Utility locations shall not cause damage to any existing street trees. Where there are
utility conflicts due to established tree roots or where a new tree will be installed,
alternate locations for utilities shall be explored. Include utility trench details where
necessary. (see Condition 6).
10. Pavement Restoration: Based on the utility coordination plan, the applicant shall
prepare a pavement restoration plan for approval by the City Engineer prior to any
utility installation or abandonment. Streets that have been reconstructed or overlaid
within the previous five years will require boring and jacking for all new utility
installations. Hunt Way has not been reconstructed or overlaid in the last 5 years.
The pavement restoration plan shall indicate how the street pavement shall be
restored following the installation or abandonment of all utilities necessary for the
project.
Sheet Al (Site Plan) dated April 14, 2014 by Daryl Fazekas does not identify any
new utility laterals connecting to its respective mains (water, sewer, gas, electric)
that will require work in the public right-of-way. All pavement work shall extend
to the most distant utility trench and pavement restoration shall encompass all
utility trenches creating one rectangle. (See Condition 6).
11. Utility Encroachment Permit: Separate permits for the installation of utilities to
serve the development will be required (including water, sewer, gas, electric, etc.).
Applicant shall apply for and pay all necessary fees for utility permits for sanitary
sewer, gas, water, electric and all other utility work.
12. Additional Street Improvements: Should it be discovered after the approval process
that new utility main lines, extra utility work or other work is required to service
the development, and should those facilities or other work affect any public
improvements, the City may add conditions to the development/project/permit, at
the discretion of the City Engineer, to restore pavement or other public
improvements to the satisfaction of the City.
13. Stormwater Pollution Prevention Measures: Prior to issuance of any grading or
building permits, the applicant shall comply with the National Pollution Discharge
Elimination System (NPDES) permit requirements, Santa Clara Valley Water
District requirements, and the Campbell Municipal Code regarding stormwater
pollution prevention. The primary objectives are to improve the quality and reduce
the quantity of stormwater runoff to the bay.
Resources to achieve these objectives include Stormwater Best Management
Practices Handbook for New Development and Redevelopment ("CA BMP
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134 Hunt Way
Handbook") by the California Stormwater Quality Association (CASQA), 2003;
Start at the Source: A Design Guidance Manual for Stormwater Quality Protection
("Start at the Source") by the Bay Area Stormwater Management Agencies
Association (BASMAA), 1999; and Using Site Design Techniques to Meet
Development Standards for Stormwater Quality: A Companion Document to Start
at the Source ("Using Site Design Techniques")by BASMAA, 2003.
14. Street Improvements Completed for Occupancy and Building Permit Final: Prior to
allowing occupancy and final building permit signoff for any all buildings, the
applicant shall have the required street improvements installed and accepted by the
City.
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