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HomeMy WebLinkAboutENC2013-00096 Print Form CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No EiNc- 20 13 OC C d DEPT.OF PUBLIC WORKS (for working within the public X-Ref.File 70 North First Street right-of-way) Application Date S/Z-o/ i 3 Campbell,CA 95008 -- J Application Expiration Date Ph. (408)866-2150 Issued �� APN :) 115 ‘‘C V1 Fx. (408)376-0958 • Permit Expiration Date )'Zt I-I 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.: 155 E CAMPBELL AV Utility Trench Location: ALONG E CAMPBELL AVE NR N THIRD ST AND ORCHARD CITY DR B. Nature of Work: FOR DIG UP TO REPAIR/CLEAR BLOCKED CONDUIT FOR JOB 8994440 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: HERMAN DOMING FOR AT&T Telephone: 925-867-4239 Address: 2600 CAMINO RAMON RM 2E900B SAN RAMON CA 94583-5000 E-Mail Address: hd1796@att.com 24-HOUR EMERGENCY PHONE NUMBER: 925-867-4239 Is this work being done by the property owners at their own residence? YES fX 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 damages arising out of the condition of any private l improvements in the public right-of-way. Accepted: //2---7-72491/1.9� .9e)/Y///�..Y �1� z 13r 7 / (Applicant Permittee) (sign) Da e /rvCc 'i t74 7771- J 7Z,}f Scl, y //,E-2 13/2,7 /, /..z z)_ (Contractor) (Print Name) Date SPECIAL PROVISIONS: 1. Street shall not be open cut for underground installations. Minimum cuts play 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 PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT RECEIPT NO, PERMIT APPLICATION FEE PLAN CHECK DEPOSIT S SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ - CONSTRUCTION CASH DEPOSIT $ PLAN CHECK&INSPECTION FEE - EMERGENCY PERMIT FEE S APPROVED FOR ISSUANCE For City Erttgineer Date Permit Expires 12 Months After Date of Issuance GENERAL PERMIT CONDITIONS . 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 emeregencles 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. 41 i 7- `'"7� 3 Applicant Date: Contractor (Print Name) Date: 1:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev.09/10 . J ISSUE DATE at&t 1 5/13 .. +..„ • Y _ .ate 7 LOOKING WEST AT DIG UP #2 LOCATION LOOKING EAST AT DIG UP #1 LOCATION E CAMPBELL AVE. E CAMPBELL AVE. $_ .- , Tom_ T € awes . . ' , �' - © CONSTRUCTION NOTES h �� - { ^ .. �- -:-P.-7,:::„...,,,,„ 1. PERMIT TO EXCAVATE ASPHALT s.ZI. e -,,, �_- - u ",.. •�... I rrIZP TO REPAIR DAMAGED CONDUIT. : —n -�O e.11 xt r a P a s AFLSe Network '~ _ , 2. RESTORE AFFECTED ROAD WORK AREA e e MS JOB EWNEEREDARo0MMM8Y OAVN 4. = � 3 � TO ORIGINAL OR BETTER CONDITION. AaART �ICT�„ EE a••e NC.UWER COMM=MiMATIT.FORGUFeT�V9 E I �—^ 1 5"1,-.2. -,- _ ,, 3 • AN°Ergwm wTEoWTrETmeamcNCE ON MO JCS �` { I NF .�y— LMIMAYI }= t -- INDEX CONST ARC CDMP _ -1 � _ b=,- ri j , GEa/co N478 - �� /-� EXCHANGE SNJSCA12 �o 1 ► f • 1. COVER ENGINEER HERMAN DOMINGO _� � �: 2. LAYOUT PLAN DIG UP 1 & 2 TELEPHONE (925) 867-4239 rt- _ ERenoRAre— ERiRaeAve /� --r �' Vii; ENGR ARC VOKDJSE20 . ."-.7...- -- .',C 3. TRAFFIC PLAN-Di 4. TRAFFIC PLAN-2 TYPE OF CONSTRUCTION LOCATION DETAIL PROJECT PERMIT RO/EST NO 8994440 DWG 1 or 4 P 504 -- ISSUE DATE SIDEWALK dt&t 1 5/13 STACK'S 139 SIDEWALK • W W W SS SS O S - gl P [1-11-1-i l Cl) SD SD 0 SD / \ MEDIAN 3 DIG UP #2 120 TO MH 76-6 SB 89-19 SIDEWALK -�� / T 1 DIG UP #1: REMOVE AND `s/OF�q 1 , O O � REPLACE 4'x4' OF ASPHALT 4/� LH REPAIR DAMAGED CONDUIT I DIG UP #2: REMOVE AND / D � n REPLACE 4'x4' OF ASPHALT J 'n I BUILDING L. REPAIR DAMAGED CONDUIT ((//� 150 n �.-./ STREETLIGHT -LOG- LIP OF GUTTER __ r�^��I DATE l V FIRE HYDRANT -9 - SEWERISTORM!ANN I IJ L CONST ARC COMP CRY MONUMENT - E - CENTERLINE CAWEI®� I ® -E- ELECTRICAL //��!!�� GED/CO N478 ® JOINT UTIUIYPOLE =TEL- TELEPHONE OTHER UTILITIES THAT ARE NOT O ((V]I EXCHANGE SNJSCAI2 MANHOLE 'v-O--D- FENCELINE SHOWN MAY EXIST IN WORK AREh VV VV PA. LOCATION&DEPTHOFE)ISTING O ENGINEER HERMAN DOMINGO -C- SIGN -w- WATER SUBSTRUCTURE NOT GUARANTEED. it 0BOLLARD h�q' TELEPHONE (925) 867-4239 ® STORM DRAIN >,./ BUSH O1 U/J I ENGR ARC VOKDJSE20 ���f�(�y�3r���"] CALL un,A,TOLL FREE ll V ® BN CABINET "t.tl l" TREE TYPE OF CONSTRUCTION BOW BACK OF SIDEWALK i �,J 48 MRS PRIOR TO DIGGING CPC TYPE ORE PLASTIC CONDUIT FOR ALL SUBSTRUCTURE 10' r 2• PROJECT PERMIT FOC FACE OF CURB LOCATIONS SW SIDEWAX RD/EST ND 8994440 800-227-2600 or 811 1""1a 1a DVG 2 OF 4 P 504 SPUD ISSUE DATE LEGEND IIa" CENTER NO. •F LANES at&t 25 , 5/13 TYPE.OARNCAE w/sox W20 SIGN OR END s-c TYPE I eA.aube v/o e.I RIGHT • g1NP1C A °WIN 8 ROAD \ / I I ROAD WORK T TRAFFIC COE WM CUP ON SW ) T ewN WORK ® LANE LANE sorwux CLOSED ® swwAlmnOTIRSECSNN e \,, AHEAD \, CLOSED CLOSED �_ SAD Amor PANEL CRASHINGNaaW)(N•�REQUIRED) / ��� G20-2 CROSS HERE ;' NwN IEVAL UMW GENIE(FLAMM)(OPTIONAU C20(CEN)SIGN T R9-11 FLAGGER TANS YN05OPPND—ro-(amnNagn VI W20-1 C20 W1-4 C30 TANSAT TOW AWAY NO STOPPING ANY TIME R ® NT.O zc a:(ACUITY MEGUNTO R... DIRECTION CP TRAFFIC(NOT PATEI0HT NARKING) o OROADWAY OESICNADEW(A TMACO N 0) WI-4 SIGN T. • a STACK'S • • too' my too' BUILDING ...—.—N----1 'I' 139 • •t• 155 o d. •It z z o ,� SIDEWALK \ / i B L'?" 'I PARKING ;no��// SIDFWAI K II SIDEWALK _ a <= a SPUD MTE ,--•"----------'--- CP • • • • • — • Ir • • o • a = • (117173E111, &W . . •IE© E. , • •• \ PARKING b MEDIAN - M D I) SIDEWALK p SIDEWALK ea un N. I BUILDING N. ' E 150 GENERAL TRAFFIC CONTROL NOTES N QN � TRAFFIC PLAN-1 Ali . TRAFFIC STALL CONFORM TO TIE CALIFORNIA MEWL EN UNIFORM N CDNST ARC SOAP TRAFFIC CartRa LEVEES WO)AND 2N1 CALTRANC meet \ O _TABLE A_ GuNCD N478 10 LANE CLONES PEWCTIEO REFINE DSOA AND AFTER OW. \MANYAa q MINIMUM RECOMMENDED DEUNEATOR/CONE EXCHANGE SNJSCAI2DRIVEWAYSSHALLLL X [D AT ALL TOES \ O & SIGN PLACEMENT ACCESS TO D HERMAN DOMINGO 01E LANE 6 TRAFFIC M EACH•4pCTO91 MID NJ.HIGH VRW11C POSTED um, UPOt NEED L D¢NI701 000060 9W PAM S ENGINEER TURNING LIES SNAIL EE MAINTAINED AT ALL IDES ON ALL STREET' \ WIT Tun weal rIp WMN m TELEPHONE (925) 867-4239 AT A NNDRR1 LAZE WIDTH IF 10 FEET. \ Oft OA) OE_ 06 Did ENGR ARC VOKDJSE20 NO WED OR SONS,STRIPING T AND PAWEIRCE IS DI L SHALL Y 25 MPH(40) 12$FT.(40) 25 FT. (5) 50 FT. US) 100 FT.(45) REINED IC COVERED ESTRRE TRAFFIC V R:0.ISM SAGE. ANY \ 70 MPH(45) 100 FT.(as) ao FT. (0) so R. Oa) 280 FT,No) TYPE OF CONSTRUCTION sow.STRIPING Q PAVEMENT HAM M ROWED DI COVERED SHALL 33 MPH(50) 243 FT.()5) 20 FL (11) TO U. (21) 250 FT.(M) 2E REPLACED EIL TRAFFIC CONTROL is 141 LWGER NECESSARY. \ 40 MPH(1D) 320 FT.11001 40 FT. (IS) SO FT. (24) 250 FT.(103) PROJECT PERMIT N •Oa MPH(70) 540 FT.GUI 4e FT.(14) oN FT. (27) 350 FT.070) SCALE: NONE WE PEOESTRGW 6EVL ACCESS S RE MAINTAINED AT ALL TOES \ •50 MPH No) 100 FL(Tae) SO FL(IS) 100 FL (50) 310 FL(1ES) RD/EST NO 8994440 •5341044(ae)1003 FT.Nos) to FT.(Is) 1W FT. (TA)1000 FT.(]DS) DVG 3 OF 4 P 504 -- LEGEND - ISSUE DATE CENTER NO. •F LANES A Tyre El IIAMQAOE VON ate OR �'� \ : TIVENIINIFICAX aDloaceaEro as 1 5 13 \RIGHT END �OAD / �\ ROAD WORK `°"`�'"°'°"'p WORK /% ,®SELANE LANE AHEAD (WC)... •Nw,Em EL""D01 CLOSED ,•�„.AIE1(FusE o AKr w CwaE ) Hal I1ML NAbE10 OEMs W20-1 d TANS TOW MINMININSTOPPe10—TO_(•NW HOURS) C20 W —r C30 TANSAT TOY AWAY RO SICPPN0 AMT TEE ®KOK DONE(AGENT(AREA)URTS a — 0PEOTIOK a MUM NOT PAYMENT INEKNO) A MONDAY OENNATION(A D M AN CO STACK'S 139 . Q BUILDING 155 PARKING \... ....}///a a .4=F + C151 0' r Ir NO PARKING p 1 / \ I PARKING h s SIDEWALK • • _ • • MEDIAN N I a • OQ il s • R • BUILDING I. N TRAFFIC PLAN-2 GENERAL TRAFFIC CONTROL NOTES 1 TO TN[ DATE TRAFFIC aLN6.CIIET)01 DWIio OWN-Tw 11OFOTM TKN 05 CIMROL DEVICES OE/TCID AI.2016 EAL1AAllt STONERS.STONERS. i \ CDNST ARC COIP TRAFFIC —TABLE A_ a G N478 WI LAME CLOWNS PERMITTED + AF Na Tu MINIMUM RECOMMENDED DELINEATOR/CONE " EXCHANGE SNJSCA12 ACCESS TO DRIVEWAYS MOLL IC IADITADIE0 AT ALL IDES. & SIGN PLACEMENT A)P ENGINEER HERMAN DOMINGO Pof110 v® TANN 1N1NN L )o1EAmK OWNS NMI MONO S RP TUMOR LIN EINE ES DULL cM 50 IMRE 604TAONal Ep YATEM r TIMES 04 L S ALL NIGH STTRErs O+DI D+KCD UIE ANNEd RP, TELEPHONE (925) 867-4239 AT A MEDIUM LNE NOM OF 10 FEET. Tom_ W !W (52'Tam MOM ENGR ARC VOKDJSE20 25 NAN(a) 125 FT.(a) 25 FT. (E) 50 FT. CIE) 100 R.(45) NIT DIIELRT)Ai SINS,STEWING N•PAVOEMT INKIOAN awl E SO ION(y) 150 FT.(se) 30 PT. (6) eo FT. (10) 250 FT.(00) TYPE OF CONSTRUCTION REMOVED oa COWMEN IMRE TRAFFIC SRii,STRIPING WAKING WAKI REMOVED IS DI PLACE. A COMIC) LL N MPN(50) 2s FL(m) 33 FT. (Ip 70 FT. (21) 250 FT.(75) PROJECT PERMIT E K IRALE0 VIVI TRAFFIC CE NTRO-05 Ia LOGO!INCESSANT. 40 Mnl(e0) 320 FT.(100) 40 FT. (12) 00 FT. (24) 250 R.(ISO) •u WM(70) 540 ET.(167) b FT. Dq )o FT. (27) 350 FT.(175) SCALE: NONE ROAEST NO$994440 WE FEISTEIN ACCESS 906.0.EE MOONED AT ALL TOES. •SO 11011(E0) 600 PT.(fee) 00 R. (15) 100 FT. (30) 350 FT.(165) •5SWn1(65)taco 07(305) 30 FT. (II) 100 FT. (30)1000 R.(305) DWG 4 OF 4 p SpA ——