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Home My WebLink AboutENC2013-00126 Yb ' 0.........,.w.�...,.... rcurlir,Not' L' � C;��'�Z ) DEPT.OF PUBLIC: (for working within the public X-Ref.File 7D North FirsrSt. • r c\ right-of-way) Campbell,CA 950083 0 L-U 11511 •Application Date 07/09/13 (408)866-2150 J issued 7 2, Application Expiration Date `(CA(t y Fax(408)3'76-0958 Expiration Date 7/I S/( I APN a'iC 1- 1..: `y 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 met.;* E/si of 62 Decorah Ln,265'S of Patio Dr . . • - Utility trench location 4 x 4 in asphalt _ B.Nature of work Service repair(2420) - - C.Attach four(4)copies of an engineered plan showing the location and extent of the work,and tour(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 andmust 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 San Jose Water Company •� ..q Telephone 408-279-7867 • Address 110 W.Taylor St, San Jose, CA p r r15)� r�} • 7I SU ^24-HOLIP,•EMERGENCY TELEPHONE NO. E-Mail Address' Is this work being done by the property owners at their own residence?. Yes X No • The Applicant/Persnittee 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.pemrit,property owner,or property owner's successors,shall be responsible - • for any and all damages arising out of the condition of any private improvements in the public right-of-way. • ' ' . •Accepted Karen Juliano .. ° � 7 J • (Applicant Pennittee)•(sign) • Karen Juliano -7 Gp113 • • Contractor (Print Name) Date. ' SPECIAL PROVISIONS • _l. Street shall not be open cut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts may ,a, be specifical y approved by the In pector prior to cutting. 2. Pavement may be cut for underground installations and must be restored in accordance with the Utility Restoration Standard Details Method "A"Backfill,unless otherwise approved by Inspector. ____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 noe valid for excavations until Underground Service Alert(USA)has been notified and . the inquiry identification number has been entered hereon. USA Phone 1400-227-2600. 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. . SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES • AMOUN- RECEIPT NO. PERMIT APPLICATION FEE $ 3% 7 Q PLAN CHECK DEPOSIT - $ - . SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS • $ CONSTRUCTION CASH DEPOSIT $ PLAN CHECK&INSPECTION FEE . $ 371 • At'rxuv hi)1-Utt1SIiUANC . •• 7/(Sit 3 1 roe City Engi J Date Permit Expires 12 Months After Date of issuance .1:\forms\pwperm Revised 12.27.04 vua1uav>1.L 1 L'1\1,111 L.V1YU111tJIVJ 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 Pennittee. 2. A one-year maintenance period and surety are required. Such period will begin on date of written acceptance by the City. • 3. Refund of•the casts 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. Acceptaocti by the City will be made in writing to the Fermitsec. 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. The 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 11 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 Perntinee. 9. •Sawcut for all PCC or AC removals. Al-FCC removals shall be to nearest scorcmark 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 barricadluS may result in the City's providing signing and barricades and charging the cost fincluding all labor and materials)against the cash deposit. 12. Compaction testing of subgrade,base rock,and asphalt concrete by Pennittce 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 utside the hours of 8:00 aan.to 4:00 p.m, - • 14. No storage of materials or equipment will be allowed near due edge of pavemcnt,the traveled way,or within the sbouideriine which would create . a hazardous condition to the public, • • • . - - • IS. 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 Fermium 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 theieon. 18. Call.back(call out)due to emergencies 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 Clam 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. Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above conditions. Dgi bly signed by Karen am Karen Juliano DN cndG mhga hilw.o�an WaterComp. smeuten Date.Mi]A6.041421116-07`10' ' /� 71 r�� Applicant 4O 'I Karen Juliano 1 ate Contractor (Print Name) l7 gf l S • . • Date ]:\forms\pwperrn - Revised 12.27.04 •