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Home My WebLink AboutENC2013-00082 • Print Form CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No at 3^OQOg2 DEPT.OF PUBLIC WORKS (for working within the public X-Ref.File 70 North First Street right-of-way) Application Date y/3 O1/3 Campbell,CA 95008 Issued E( (J( 3 Application Expiration Date /6/30//3 Ph. (408)866-2150 --- APN Fx. (408)376-0958 T 1' Permit Expiration Date 11* 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.: east bound on Budd Ave,driveway to apartment complex,east of California Street. Utility Trench Location: n/a B. Nature of Work: placement of 2 poles to support sagging Telco cables. Ar4 T g#7666 i 7s- 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: AT&T California/Dan Borja Telephone: 408-635-8822 Address: 870 N McCarthy Blvd,Milpitas,CA 95035 E-Mail Address: db2871@att.com 24-HOUR EMERGENCY PHONE NUMBER: 408-635-8822 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 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 damag,,s_ rising out o ition of any private improvements in the public right-of-way. Accepted: "\...-"---- --;)C>1:1CA 1"—k--1) 4/3 C� lI .3 (Applicant Permittee) (sign) tp5 e NVIAs (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 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 PUDIC WORKS FEE SCH_E12UE Q_B CURRENT FEES AMOUNT 7, RECEIPT PERMIT APPLICATION FEE $ J 7o l�C PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ CONSTRUCTION CASH DEPOSIT $ PLAN CHECK&INSPECTION FEE $ EMERGENCY PERMIT FEE $ __ _ APPROVED FOR ISSUANCE "jam s/i1( 3 For City Engineer Date Permit Expires 12 Months After Date of Issuance 2 pci(e'c () rcL0I6oe&t ) iGG 2 326 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. /,- C-1.n"" TA-T /1/2, (Vj 3 Applicant Date: ica t Nl6 Contractor (Print Name) Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.03113 ISSUE DATE cl A0 atBEt n ' 2 a o "a 1 4/13 II II I I I I I 13- s vii 6'-- 3 W a` a (�� g LEGEND 0.42 ROAD SIGN- v La L IZI VRAD CABINET dOIS -3 SUB BOX Ols ---- g �--;( STREETLroHr 0 0 ..D TRAFFIC LIGHT N (STANDALONE) 229 TRAFFIC LIGHT COo BUDD AVE _, (OVERHEAD) I I I ® MONUMENT I 1 6 FIRE HYDRANT MO BOY/— O CONCRETE SW —w1e SOAK ® xIM POLE Q CONCRETE SW A ow CONCRETE SW ® MANHOLE T d 1 —B•I�F ® STORM DRAIN o C3MDD L NI I-I POTHOLE • S I- FENCELNE GO)CL- w I' ,,,,-"�aCH,. -'" J -OHO CL a TREE 'J,• HEDGE I u cn _.._.. _ - ROW RIGHT OF WAY 5_ __- + } FOC FACE OF CURB O 'b BOC BACK OF CURB It IV ,_ o : LOG UP OF GUTTER b - FOW FRONT OF WALK 04BLOWS- -020FOC _BOW SACK OF WALK 0.10 FOC- I -0.1BlOG 1PARKWAY— - D\°---'"-- -,, � ' ow / OW ' PARKWAY EOD EDGE OF DRNEWAY -0-25 FOW SW SIDEWALK 0.25 FOW- CONCRETE SW ' CONCRETE SW P/L PROPERTY LINE CONCRETE SW PS PARI(STi6P � — —OJO�W DW DRIVEWAY CONCRETE SW _--WW WALKWAY CL CENTERLINE UTILITIES PRCP06ED POLE LOCATION f1 —W— WATER I I I I 11 II I I DIG AREA 4'x4'DIRT I I I I I I I I I -T-- TELEPHONE § $ 250 3 RESTORE TO ORIGIN.OR BETTER c L5 �- ELECTRIC 1 S g 4 BUDD AVE t Q o DON�,ION 2 i $ ₹ —SS— SANITARY SEWER m g t a 218 —SD— STORM DRAIN a I A e i s PROPOSED ME DAMN/2 E BUDD AVE —G— GAS 'T DIG AREA x4'DIRTI.�0 fESfdtE 700 CROW OR BETIFJt N + 9�A rtiii- It I USE EXTREME CAUTION I 1 .--,r,CAI, ? G I'2' 6.• LOCATION AND DEPTH OF EXI - ♦b0. li y �lyi_ ;�i GENERAL CONSTRUCTION NOTES: SUBSURFACE ANDS E;U$'f Af2Ea k..(".y a,�' NOT GUARANTE U�Sb CE •EXTRA CAUTION SHOULD BE TAKEN WHEN STRUCTURES N't.S4 OW MAY EXIST. 5+ -&y- i • GEOICO N4-7B DIGGING AND PLACING THE FACILITIES FOR t• s l S 4 EXCH. SNJSCAI2 __ AT&T CALIFORNIA,AS OTHER UTILITIES MAY 1. i Ions BE IN CLOSE PROXIMITY OF THE WORK ea.'3.i fec 1 t 'SE p• !1! ENGR. DAN BORJA TEL. 408 635$822 LOCATION. CAUTION I!! P. 9 A`-?.P �4;,'•` st hove str;lc"° t ) AT&T ASSUMES NO RESPONSIBILITY FOR THE ACCURACY OF THE •TUNNEL CURBS AND GUTTERS ° )�, ``^�' ' f.t L7 ENGR ARC VOKDJW7D0 •ALL BENDS WILL BE A RADIUS OF 0 UNLESS SUBSTRUCTURE INFORMATION HEREIN PROVIDED.THE USER ASSUMES 4 ON tIR- OTHERWISENOTED. RESPONSIBILITY FOR VERIFYING SUBSTRUCTURE LOCATIONS BEFORE CALL US,51aaiw-`-�.pf�} ^oTr � tit" EXCAVATING AND ASSUMES ALL LIABILITY FOR DAMAGE TO TELEPHONE q$HOURS PRIdk tDlGTBtI II4 FOR ALL ,4•- N''� TYPE OF CONST. •RESTORE AREA TO LIKE OR BETTER CONDITION FACILITIES AS A RESULT OF SUCH EXCAVATION.CALL UNDERGROUND SCALE 1'-20' POLE PERMIT •NOTIFY CITY OF CAMPBELL 72 HOURS SUBSTRUCTURE LOCATIONS SERVICE ALERT ON:(800)227-2600 TWO DAYS BEFORE DIGGING IN e 1)2• 'I- Y BEFORE STARTING WORK OPERATIONS, PROXIMITY TO TELEPHONE PLANT. 1-800-227-2600 or 811 .f 1 - I ROIEST.NO. 76661 755 ADHERE TO ALL PERMIT REQUIREMENTS. C 10 2C 40' DWG. 2 OF 3 P504 } ISSUE DATE g s' , .. n , at al 1 4/13 it sc i ....'C....,... Q 4` 00 ..-W W Gn.,,, u s 0O "" a W W Rpae Mo;a Fah CoN M' Nk dY A.. Ø..D.. E Ceewme Are i # ,o 0 4_ ,,,......^". a F$o0u } , Whe Er n . d 0 0 - F ,e R.,..e $ 1 env s t e PROPOSED WORK LOCATION .4 w� 1.1 ...f ,I ' �' - CAL1FO 5T AFL Network Services �' _ -- A Fujikura Business �` .A'..,%. ` W.ERo ERrnn ssowsn JEFFREY no OF. - PROPOSED RXE LOCA1ON t1: - %BUDD AVE M NEW rROUS UNDER CONTRACT TO ATAE0.EON QUESTIONS Mdo DIG AREA or DIRT � JOSPLE.SEC.E AS NOTED..ME SOX nGEO/CO N4-78 �� y �1��l1/1��1r'1 1/ :'f�r EXCH. SNJSCA12 .J ' ' AREA EA 4X4' s `"y, P01F '� ��."4'.,. ENGR. DAN BORJA TEL. (408)6358822 BUDD AVE •:.. . zY e / '4 ENGR ARC VOKDJW7D0 TYPE OF CONST. POLE PERMIT VIEW OF PROPOSED POLE LOCATION#1 VIEW OF PROPOSED BORE PIT#2 LOOKING SOUTH ALONG BUDD AVE LOOKING WEST ALONG BUDD AVE RO/EST.No. 7666175 DWG. 1 OF 3 P504 Page 1 of 1 Syed Wahidi From: BORJA, DAN [db2871@att.com] Sent: Tuesday, April 30, 2013 2:46 PM To: Syed Wahidi Subject: AT&T Job#7666175 Permit Application Attachments: AT&T Job#7666175 Permit Application.PDF; AT&T Job#7666175 Permit Drawings.pdf Hi Syed, Attached is the permit application for placement of 2 poles (Telco only) on Budd Ave. Our cables are sagging way below minimum height due to the excessive length of the span. AT&T will be doing the work, and no outside contractors will be involved. Also,the holes will be manually dug due to close proximity to the fire hydrant and street light. Thank you very much for your assistance! Dan Borja AT&T California 870 N McCarthy Blvd Milpitas, CA 95035 408-635-8822 *** eSafe 8 scanned this email for malicious content *** *** IMPORTANT: Do not open attachments from unrecognized senders *** 5/1/2013