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HomeMy WebLinkAboutENC2013-00055 Print Form CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No N C 2cs 13 — c 5 5 DEPT.OF PUBLIC WORKS (for working within the public X-Ref.File 70 North First Street right-of-way) Application Date Mwxh 20,20L.3. Campbell,CA 95008 3�2 Application Expiration Date I j' --/3 Ph. (408)866-2150 Issued (/ 3 APN .1 r`LA 67 Chi Fx. (408)376-0958 , Permit Expiration Date -Y2-1 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.: Middle of street along Poplar Av.in front of 621 E.Campbell Ave.See attached map. Utility Trench Location: Approx.80 feet North of E.Campbell Av.Trench will be 12'long,3'wide,11'deep B. Nature of Work: Trench to fix a segment of damaged 8"VCP sewer mainline in the middle of the streea 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: Jorge Picado(West Valley Sanitation District). Telephone: (408)385-3009 Address: 100 East Sunnyoaks Avenue.Campbell,California 95008 E-Mail Address: jpicado@westvalleysan.org 24-HOUR EMERGENCY PHONE NUMBER: (408)828-1949 Is this work being done by the property owners at their own residence? p YES (X 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 fora any and all damages arising out of the condition of any private improvements in the public right-of-way. Accepted: Jorge Picado L W&i Saniian D/S& ). 74 peado _ Matt*.201 20/3. (Applicant P rmittee) (sign) / Date Pcidll.6 Underrvr1ol Con5�cUc7 1 Bill Morrow March,20 .2O/3. (Contractor) (Print Name) Date SPECIAL PROVISIONS: 1. Street shall not be open cut for underground installations. Minimum cuts!Tay be allowed for connections or exploration holes. Such cuts maybe specifically aoprovecilby the Inspector prior to cutting. It/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 4215 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 5_CHEDULE-FOR CURRENT FEES AMOUNT RECEIPT NO. PERMIT APPLICATION FEE $_ c-; PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS S CONSTRUCTION CASH DEPOSIT PLAN CHECK&INSPECTION FEE $ .> '7 • (s2 EMERGENCY PERMIT FEE $ APPROVED FOR ISSUANCE 3/ / ( For 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. 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. 5. Maintain safe pedestrian and vehicular crossings and free access to private driveways,bus stops,fire hydrants,and water valves. 6. 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. 7. 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. 8. 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. 9. Sawcut for all PCC or AC removals.All PCC removals shall be to the nearest scoremark and shall be doweled to existing improvements. 10. 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. 11. 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. 12. Compaction testing of subgrade,base rock,and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer. 13. 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. 14. 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. 15. 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. 16. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency. 17. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 18. 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. 19. 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. 20. 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. 21. 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. f r..9c Pctido (Wes/ Valle Sanl'{r,�ian 17isfrr'cfJ. March. '0,?©13 Applicant Date: >°ac/lic ()nderyiovnd Consffoc1-,o' Bill Macron?.. March 20,.0J13 . Contractor (Print Name) Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.09/10 ! t1: '— '` * l y` +,V p OSanath?r!! ≥jct 597 ' , .. ' 607 �'. • 617 X627 637 647 653 ' v; • " 35-i3 = __, , ..e y:o . ,.�., 4. ' '0 , LEGEND VC . ' :.f i a 4,_ 4-035-02T -lam CS LJ ' '.7- �l 4 M.rY LEL .VET%ryr Ity 2 `:s ,s Sewer Structures aorw t. • Manhole 1 - 4 . �,` Inside Drop MH 590 600 610%.,-,... 620 630 5r � (;) Outside Drop MH } 4640 r. s;" . @ '. �. t ``. ' , ® Vertical Riser 410 I. ',. j up : t. P$ Pump Station ` .. °° l�' , •' Tie Point 41 .4r. gra • ' Z Stub } Alll�' • -�" ( ' X811 , • X Abandoned MH ..J - ; - ti" Sewer Mains g is + •I l. F. f WVSD ';° 41.) rm.- ,*: ., ' #P '" San Jose .�>- rnig " Private y;x t` d�ti" _. P le Abandoned 4? : i '_ Laterals , ,arvm:aa. O he a'` " . • Repair is 6' long, 3'wide r -, y� NORTH and 11'deep aq+ �j 1 inch=75 feet , AIL U `tit' ''� - Annotation r . � �/ r Legend - 4 �_ " a __ a ' l��LZJ7 . • '; k 4-014-04 cap _�� 7. 675 (Dec t N 4-035-09 ; , I�`a`(Q�� E CAMP.BELL.AVE °'�'�J '# ��n __-- =4 035=11,-.-. tis$r� °.°a„ X0.7 West Valley Sanitation District F�, 1• — ` $ HDPE �‘%�� 135�i,„e�,$� Y. t� , 246 Iaam��5u. nl Fiscal Year 2012-2013 sewer repair project �:, ��1TE ?WPLt "` Work Order 16 i �' �� t,°N°wm�"^� T V7 °<, Mainline Repair at Poplar Ave 'r -' ,i,` IT ' f FOR INFORMATION ONLY- Campbell, CA 95008 ,.. / # ' 690 7 J NOT FOR CONSTRUCTION! tr. r VERIFY PRIOR TO In , •. L -#1.� .- - ' Ansi, 1 i t t i i 1 1 i 1 , 1 ! CONSTRUCTION. • SEE PAGE 104 /4 �. ) aT3J7 Li II I I I I I I I / •`� oN s ii A T /� J,y) /M/i Ifss' OfK .1•44 /Hi i...06 / 1.i = , l M / 4 Ors! 8 r r s • / ��;qty a... • W tia " iota ! tr7 7. —— r,,\P•. 4' 7• �4 s I lies o tc 1443 a i b TRACT 6/"., a 01 1 / • G /+N JY II A.N ' / _ /ass w rag) s N....0 /`. 000) MO c `• li• k IV s >f i /t�s c 3 1 '� 3 t 4 ) ...of 14.t ./ fElBD. I b b ,P �'. 1 t+ PCI.. 2 ; ergo I 2#64 I - Kq 'fi . _ .ws. I 47 w • •• + 60 *UV 4 r ; 1. i 2 3 I-1^2— Q V ' VI 44 P- u r. ) /sti •y t.0• X I 10 Q g )0 I 0.40 - /3 ca) y�f orta L 4.44�/ : 0+05 2+2) )+,4 0.,3 I�lig4 .i i 0.00 b tY fee) , ,; IF J• kO/�•y) �r�3sJ�3I1s7 ZaHt ONl 0•!e �si°j fN, redo ray) I A I i IJIO . IZm4wI n.r,ye) .'{. wrfi IN/ Ki t / o l6G IS 1457 _ 574 i+aa p I =13+fie \'ASI Sr id 2+70 „ - s. CAMP:EIL AVE.. • 8"H0PE • J/kq 4'1L/I .:OY ~Y /!a a' / /7 's t. aril fN .i :u) rim •r t 0 cw� rNt rr. ' / t u ar i.•iAI, ax / .� _ , -.k� �. • -'-rte 0,, :.• v7 HO7=L 4-/07-3 q... V. .� tr��/, / m,rr �f" +r \ m�J= 2„ . . - rye _ ♦ /? $/ )14:�',, 4 � 9 Ys CR 4 dT• BELL ♦�-JJ • te.1� o e / 4-/OB 2 \\ v 4 /1 /-, nu N. •i 434-/ / N. , \� GOOK PAGE SCALE CORRECTED TO ST t+ SEE PAGE. 34. . - 4 33 v.tOO I /0/.7/0S .Hr WEST VALLLEY SANITATION DISTRICT OF SANTA CLARA COUNTY FORMERLY CSD*4 I I US Structure 14-035.09 1 POPLAR AVE ETatiii Re DS Structure 14-035.02 1 POPLAR AVE 8.20 F Alt Pipe ID 13372 Inspected Date Q 110/2012003 I12 Pipe Seg Ref 1 Survey Direction pi E 'Downstream Distance/ I PACP Code i PACP Code Text ' Clockl r Clock2 1 Z T Continuous 1 Doc 1 Struct 1 C 0.0 AMH Manhole No 0 0.0 MWL Water Level 95 No 0 13.9 DSZ Deposits Settled Other No 0 84.8 BW Broken Void Visible 10 3 S1 No 5 88.0 BW Broken Void Visible 10 3 F1 No 5 90.5 CL Crack Longitudinal 2 No 2 92.6 TFA Tap Factory Active 9 No 0 101.0 MCU Camera Underwater S2 No 0 106.6 MCU Camera Underwater F2 No 0 107.9 MSA Abandoned Survey No 0 1 - AVE 4-35-9 -> 4-35-2 $ 8" f X Ag broken pipe S - Dirt Ex • osed Camera will ,,pass 'It�, 4 .o- P- . 1. 21. ' 84 ' 09" Severe fracture on both sides of the pipe.This is a continuous defect. TIT eaame0 paso• x3 4ajo - S adid ua:;oaq NI".y'"'�,` .a r u8 ' -SE-7 <- 6-SE-7 ' 3AV btfld0d 1l36dWkID ,.Z0 . 58 -:©©Z ©Z 0 t w: - rum eaare3 paso•x3 1.iTp - S - ' Ti U O lilkor .0t G «8 Z-SE-7 <- 6-SE-7 ' 3Ad btildCd 113EdWt D CAMPBELL POPLAR AVE , 8" • f=: 10 20 . 2003 30 ' 06" Severe cracks on 8"by 4" mainline Wye service connection on the left.