ENC1999-00213~ OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working within the
public right-of-way)
Permit 'expires in 12 months~E~
X-Ref. file
Application expires in ~ months
APPLICATION - Application Ls hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application expires in 6 mon~.s
if tl~ permit ts n~t i~u~l. Application F~ ts
A. wort ~ or ~ # E/B Campbell N/S Klm Louis 296015 N/B Bascom N/S Fewtrell 346003
- E/B Campbell F/S Winchester 326003 N/B Bascom F/S Campbell 346109
u~ity ~ ~oc~o. E/B Hamilton MD Bascom 346102
a. N.n=~ ,~.o~t Bus/Ad Shelter Installation/Electrical
C. Ankh four (4) copies of an engineer~ plato showing the location and extant of the work. and four (4) c~pies of the preliminary Engineer's F.~tima~ of work. The
ptans shall show the r~lation of the proposed work to existing surfne~ and un--nd improvements. Whe~ approved by the City Engin~r, ~ plan bec. om~ a pa~ of
this permit.
D. All work .Oall mr, form to the City of C~pbell Stand~rd Specifications and Details for Public Works Construc~on; the Oene~l Pet~it Conditiom list~l on the rever~e
side; and thc Special Provisions for thts permit, ltst~l below. F~ilur~ m abide by these conditions ~md provisions may r~ult in jo~ shut-down and/or foffeimr~ of F~ithful
Performan~ Sure~e~ ~nd cash deposits. (See General Peri.it Conditions 1 and 2.)
£. THE CONTRACTOR MUST RAVE TH~S PER.MIT AND APPROVED PLANS AT THE SITE AND MUST NOTXFY TH~ PUBLIC WORK~ DEPARTMENT AT
LEA.iT TWO DAYS BEFORE ~I'ARTING WORK. NOTICE MUST BI: GIVEN TO PUBLIC WORX~ AT LEA.%~ 24 ~d~.S~B_F.F(~RE RE.h'T~G ANY WORK.
Nan~ of Applier.. Valley Transportation Authority ~ ~"~Tel~phone ~,~ / ~'.9~'~ ~ (o
3331 N. First Street, San Jose CA 95134-1906
~ :4 ~ou~ ~amo~cv rE=~HO~ NO.
h thh work being dom by the property owner at their own residenc~? . Yes No
The Applkam/Permin~e her~y agr~ by afl. lng their sign~r~ m ~is permit m hold the City of C..~n~beU, its office~, agents and employees free, safe ~nd has.ess from
any claim or demand for ~an~ges resulting from thc work wvemd by this pem~it.
The Applicant/Perm~-~ hereby acknowi~ges thai they have read and understand both the front and back of this pemgL and they will inform their ~onu=acmr(s) of the
information.
(Applican~P~,-~-,,it~e) (sign) Dat~
__2.
~PECLAL PROVISIONS
__1. Street shall not ~ open cut for underground instatl~itms. Minimum ~
~rov~ by ~e I~mr p~or m ~inm
~v~m ~y ~ ~t for u~r~ ~ ~ ~t ~ ~m~ ~ ~r~ w~ ~U~ T~ ~m~ S~ ~, M~ 'A~,
~s ~ ~pr~ by lmp~r.
W~k to ~ s~ by a ~ ~ S~or or C~il ~~ ~o
~ S~ 421~ of ~ O~t ~ ~ ~ ~ ~ v~id for ~
~n ~ ~ ~ ~ ~n.. U~ ~ ~UT-~. U~ ~C~ NO
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT
PERM. IT APPLICATION FEE
PLAN CHECK DEPOSIT '
SECURITY FOR F~ PERFO~~OR & MATERIAI~
CON~I'RUCTION C~H DE~S~ ,
P~ ~&~PE=ON~ ~/~ d L . ~
TYPE * AMOUNT REC~PT NO.
oO
$
~iorms ~pwperrn~ r~v.0196
GEN]~RAL PERMIT CONDITIONS
I. A CONg'I'RUCTION CASH DEPOSIT is required. Charges will be made against this deposit if there is an emergency call-out, overtime inspection
or when City o~ered barricading is required. Any such costs in excess of the deposit will be billed to the Permi~e.
2. A ON'E-YEAR MAINTENANCE PERIOD AND SURETY a~ required. Such period will begin on date of written acceptance by the City.
3. REFUND of the cash deposit balance and refund or cancellation of the Faithful Performance Surety will be inidated by thc writton acceptance of the
work by the City.
,~. The Permi~e MUST R,EQUF_,ST IN WR.ri'ING a final inspection and acceptance of the work upon completion. Acceptance by the City will be made
in writing to the Permim:e.
$. MA.INTAIN safe pedestrian and vehicular crossings and f~e access to private driveways, bus stops, fi~ hydrants and water valves.
6. A CONSTRUCTION TRAFFIC CONTROL PLAN and a CONSTRUCTION SCHEDULE is required for all lane closures, detours m~d street clotures.
This plan must be R,~=V~'WED and APPROVED prior to any lane closures.
7. The CONSTRUCTION TRAFFIC CONTROL PLAN shall confotva with the Caltran~ Manual of Traffic Controls for Consu'uction and Maintenance
Work Zones. dated 1990, available at Calwans. Tr~ffi¢ control equipment s~ail ~ncludc Type II f~nshin~ arrow signs ~f required.
8. REPLACE IN KIND any damaged or r~moved cxi.~ improven~ents, including planting.
9. Sawcut for all PCC or AC removals. All PCC removals shall be to near~st scoremark and shall be doweled to existing improvements.
I0. OVERTIME INSPECTION PREMIUM will be charged against the c~h deposit for inspection required outside thc hours of 8:00 a.m. to 4:00 p.m.
at the currant overtime rate, minimum one hour charge.
I 1. SATURDAY INSPECTIONS must be arranged in advance. Saturday inspection &-ne is charged at thc current overtime rate with a three hour
minimum. Advance payment for the est~nated time is required.
12. Adequate signing and lighted BARRICADING is required on the job site. Failure to provide such signing and barricading may result in the City's
renting such signing and barricades and charging thc cost (including ail labor and materials) ag~,tst the cash deposit.
13. Compaction testml; of subgrade, bas," rock, a~l asphalt concrete by Permitt~c is REQUIRED unless otherwise stated by the City Engineer.
14. The Contractor or Permiuee will have a SUPERV~I$ORY REPRESENTATIVE available for contact on the project at all times during construction.
Contr~tor or P,,rmit~e shall provide a phone number at wluch they can be contacted outside the bour~ of 8:00 a.m. to 4:00 p.m.
I5. No gTORAGE of materials or equipment will be allowed ncaa the edge of pavement, the u-aveled way, or within the shouldertine which would create
n ha,zan~us condition to the public.
16. This permit shall not be construed as authorization for excavation ~ 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 RF. LE^SE the Permiuee from any liabilities contained in other agreements or contracts with the City and any other public
agency.
I8. This permit is NOT TRANSFERRABLE. Work must be performed by the Pcrmiuee or his designated agent or conu'actor a~ specified thereon.
19. CALL BACK (call out) due to emergencies regarding this permit, shall be at the cur~nt overtime rate with a three (3) hour mlnin'al~ cha.rge per
20. Pursuant to Chapter 14.02 of thc Campbell Municipal Code, applicant shall not cause to be discharged any material into the municipal storm drain
system other than storm water. Applicant sh~l adhere to the BEST MANAGEMENT PRACTICES established by the S, anta Clam Valley Nonpoint Source
Pollution Control Program.
Applicant shah be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the Ibove conditions.
Applicant Date
j:\forms\pwperm2 6/96
CITY OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 ,~,orth First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working within the
public right-of-way)
Issued ~'~-Ole{ .ff~
Permit expires in 12 months
Permit No.
X-Ref. file
Application Date
Application expires in 6 months
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. Application Fee is non-refundable.)
,, work ed, , or ,
C. Attach four (4) copies of an engineered plans showing the location ~ extent of the work, and four (4) copies of the preliminary Engineer's Estimate of work. Thc
plans shall show the relation of the proposed work to existing surface and under~ro~nd 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 Specifr. atinm ~nd De~aiis for Public Works Construction; the ~ Permit Conditions listed on the reverse
side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions nnd provisions may result in job shut-down and/or forfeiture of Faithful
Performance Sureties and cash depnsit~. (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 REb~ARTING ANY WORK.
Name of Applicant ~
Is this work being done by the property owner at their own residence? yes No
The Applicant/Permittec 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 ApplicanffPcrmittee 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.
(Ap'~icam/penrduee) (sign) Dare ~
SPECIAL PROVISIONS
Street shall not be open cut for underground installations, Minimum cuts may be allowed for co __p~__ZL,'~s. or exploration holes, ~ucb ct~s mav be sm~eif'~dly
approved by the Inspector prior to cuuin?,
Pavcmem may be cut for underground installatiom and must be restored in accordance with the Utility Trench Restoration Sumdard De~ls, Mffhnd 'A' Backfill,
unless otherwise approved by Inspector.
Work to be staked by a licensed ~ Surveyor or Civil Engineer and two (2) copi~ of the cut sheets sm m the PubF~ Works 1~ t~.-'fore ~ work.
Per Section 4215 of the Government Code ~ permit is not valid for excavations until Underground Servic~ Alert (USA} has been notified and the inqui~
identifw, ation number ha~ been entered hereon. USA Phone 1-800-227-2600. USA TICKET NO.
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT
PERMIT APPLICATION FEE
PLAN CHECK DEPOSIT
SECURrI~ FOR FAITHFUL PERFORMANCE/LABOR & MATERIALS
CONSTRUCTION CASH DEPOSIT
PLAN CHECK & INSPECTION FEE ~
APPROVED FOR ISSUANCE
TY~ * ~,Mot~rr l~CEt~r No~
$
for City Engineer
Dato
\form~\pwpcrm2/rev.6/96
~ . ~ GENERAL PERMIT CONDITION!
I. 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 O~_,~'R ~N~CE PE~OD A~D SUR~ ~ ~Ui~. 'Such period wi~ begin on d~te of w~it~n ~.~pt~.~ by the City.
3. REFUND of 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. Accoptance by the City will be made
5. MAINTAIN safe pedestrian and vehicular cm~sings ~md fre~ access to private dri~ew~y~, bus stops, fire hydrams and water valves.
6. A CONSTRUCTION TRAFFIC CONTROL PLAN ~md a'cONSTRUC~IoN SCHEDULE is ~luit~' fbr all lane clbsures,'detours and street closures.
This plan must be REVIEWED and APPROVED prior to any lane closures.
7. The CONSTRUCTION TRAFFIC CONTROL PLAN shah conform with the Calmms Manual of Traffic Conuols for Construction and Maintenance
Work Zones, dated 1990, available at Caltrans. Traffic control equipment shall include Type H flashin~ arrow signs if required.
8. REPLACE IN KIND any damaged or removed existing improvements, including planting.
9. Sawcut for all PCC or AC removals. All PCC removals shall be to nearest scoremark and shall be doweled to exis~ng improvements.
I0. OVERTIME INSPECTION PREMIUM will be charged against the cash deposit for inspection required outside the hours of 8:00 a.m. to 4:00 p.m.
at the cnn'eat overtime rate, minimum one hour charge.
I 1. SATURDAY INSPECTIONS must be arranged in advance. Saturday in.~oection time is charged at th~ curl~int over'ne rate .with a three hour
minimum. Advance payment for the estimated time is required.
12. Adequate signing and lighted BARRICADING is required on the job site. Failure to provide such signing and barricading may result in the City's
renting such 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 PermRtee 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 ~nes during construction.
Contractor or Perrmttee 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. N° STORAGE of materials or equipment will be allowed near the edge of pavement, the travel.ed way, or within the shoulderline which would create
~ 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 Permit'tee from any liabilities contained in other agreements or contracts with the City and any other public
agency.
18. This permit is NOT TRANSFERRABLE. Work must be performed by the Permittoe or his designated agent or contractor as specified thereon.
19. CALL BACK (call out) due to emergencies regarding this permit, shall be at the curt'eat overtime rate with a three (3) hour minimum charge per
OKCBH'CBCe.
20. Pursuant to Chapter 14.02 of the Campbell Municipal Code, applicant shall not cause to be discharged any matet~fl into the municipal storm drain
system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the S. anta Clara Valley Nonpoint Source
Pollution Control Program.
Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above conditions.
Applic~t
Date
j:\forms\pwperm2 6/96
PUBLIC WORKS DEPAR~ RECEIPT
Effective August 1, 1999
ITo: ci,ycIer, PU""C"O ,F,,ENO. qff'
] PIc~c collar & r~cipt for the tbllow~ng moni~: ·
~435.535.4921 [ Pml~t R~enue {s~ify prol~t}
: ENCROAC~IENT PERMIT
4722T Applicauon Fee
! Non-Uulit¥ Encroachment Permit
Minor Encroachment Permit < $5000
First Permit (No Fee} Subsequent Permit/Yr
IJti[ily Encroachment Permit
\rtcrial/Collector Street i $34 t.25)
I Res~denual Su'ecuOther Areas ($236.25)
"203] Plan Check Deposa - 2% of ENGR. EST. . $500 m~n1
2203[ Fa,htul Pertormance Security IFPS) Il00% of ENGR. EST./
22031 Libor and Materials Security (100% of ENGR. EST.)
22031 Monumcmauon Security ~ 100% of ENGR.EST.)
22031 Cash Deposit (4% of ENGR.EST.)($500 min/$10.O00 max)
22031 L.aoor and Material Security (100% of ENGR. EST.)
i Plan Check & Inspection Fee INon-Utility)
4.7221 Engr Est. < 5250.000 (12% of ENGR. EST.}
2203! En~r. Est.>5250,000 (Deposn 8% of ENGR. EST.,S30.000 mtn.}"
4722] Uulltv < $100.000
i ~ Mimmum Charge Per Location ,.~
CondmtsIPipelines up to 500 Feet ~SI 75/ft)
Above 500 Linear Feet ~$1. IS/rD
ManholeeiVaul~s/Etc. ($I lO.251ea)
Pole ScuRemoval ($ l0 25/eal
Street Dee Planting/Removal ~$ ! 10.25~tree)
2203) Utility > $100,0~0 Actual Cost
4.722i Street Free Planting/Removal Permit (SI 10.257
~.7601 Proiect Plans & Spec~ficauoas Prolect No.
4.760[ Standard Spec~ficauons & Detads ,'Sl/Pg $12.50/Bk1
\erlat Plot 24" ~ 36" i542)
'xcrlal Print 8 1,2" ~ i1' ($t5)
Maps and Plans 24' x 36' (S5)
47221 Penalues: Failure to restore public improvemen~ ($1~/Calend~ Day?
1~21 Penalues: Failure to co~ect u~fe co~iuons {$1~)/Calendar Day)
1722 ~t Line AdNstment (S577.50)
47221 Notary Fee (per signature) ($10}
17221 Vacation of Public Streets & Easements ($577.50)
47221 Parcel Map (4 Lots or Less} ($1.125 + $25/Lo0
4,72_2t Final Tract Map (5 or More Lots} !$I~450 + S25/Lot)
4.7221 Ccruficam of Compliance /$525)
~.T221 Ccrnticate of Correction t$315}
4.7221 Assessment Segregar on or Reapportionment
: First Split
Each Additional Lot
(5577.50)
($ 78 50)
-I.721: 5;lotto Drainage Area Fee Per Acre ' R-i, $2.000)
; (Multi-R~. $2.250)
(All Other. $2.500)
~9201
TRAFFIC
2arkand Dedmat~on Fee (75%/25% Due Upon Cert. of Occupancy~
4.728{ Inlersecnon Turn Counts ITwo-Hour Count}
4728~ Intersecnon Yurn Counts {a.m. or p.m. peaks)
¢7281 Tralfic Flow Map I Daffy Traffic Volumes}
4.7281 CampVetl Traffic Model (Full Scope Assessment}
472.8] ('ampnelt Traffic Mo(lei (Reduced Scope Assessmentt
4271 [ rruck Perm,s
t563)
($131.257
~$28.35)
(S2,362.50)
($777)
! S36.75/trip}
4.728t NO Parking Signs !Si/each or $25t100)
OTHER
NAME OF XPPLiC.",NT ~
TOTAL
h:~,forms~ccfrm4 xls rev. 7/13/99 (rap)
CITY OF C~WPBEL., CA
'.;7
DESCRiPTiON
~'2~HL ~_~-
$120:00
fw~f~ D6T~
CHEC~ ~0:!8!~2
T~U ~C~:,~ ·
.a,IC WORKS DEPART'MF_.JTF I~Cg. IFT '
Effective July 1. 1996
Plea~ collect .e. teceip~ faa' the fol~daI monies:
Acc'T. i'TE~ ' ,,, ' ·
435,5354921 ! i ' '' ' '' ' '~' "~: ':"" ' ' ' '~" ::i . ~" ".'.:.~: .~ .... ::::::::::::::::::::::::::::::::::
£NCROACHM£NT FERMIT
4722 Application Fee
Noa-Ulgiw ~t Permit ($22~)
R-I FTr~ Pe~it (No Fee), Subse~a~ent Petmiu~'r
UtiliW En~ent P~mlt
P,,~G~-:-: SlmeVOdmt Areas (~22~)
2203 Hah ~k ~sit - 2% of~G~ ~. (~(~
~03 Fateful P~..~ ~h~ f~) (l~o~G~.)
2203 ~r a~ M.~h ~ (I~G~ ~.)
2203 Mon~c~on ~;~, ( I a~* o[ ~G~.)
4~ ~.~ < ~0,~ (I~A of ~G~ ~.)
· * ~03 ~~>S~0,~ (~sit 8% oE~GK ~0,~ mm.)*e ·
C~d~ ~ m ~ F~ (S1.~1
4~ S~t T~ Plan~o~l ~it ($105)
4~ (M~i C~ ~ I 1.~4.010)
~lti~: Fail~ ~ c~ ~o ~ (Sl~a., Day)
~ND DEV~LOPM~
4~ Lot LAc Adjus~t
4~ P~el Map (4 ~u or ~) ($1.~ + ~
4~2 ~1 T~t Map (5 or M~ ~) ($1 ~ $0 + ~t)
4~ C~m of ~mpl~ ($5~)
~ Split (~50)
~h A~ ~ ($170)
(All ~,
49211 P~nd ~d~a~n F~
4%5 ~ Potage
~FFIC
4~1 [n~on Turn Co~ (a.m. ~ p.m. ~) ~$125)
4~ C~p~ll T~c M~t (Full ~ A~t)
4271 T~ P~iu
4~ No ~ 3igns ($1/~b or S~/1~)
0~ER
NAME 0F APPLI~
· *A~I C~ H~ 2~. ~'~ ~-In~ ~ ~it)
,/~
FOR
CITY CLERK
ONLY
I° Fro' Ptan C'l~d~ aad Cas~ Del~s~u. send :.~low copy m F"maace, DaSe/' Inillals I
h:~frm4(~c)mp(mv 10a97)
'UBL/C WORK~ DEPARTMENF RKL-'E/FF
Ett~cbvc July I, 1996
?l=a.~ collect ~' receipl for cb~ follDw~S mon~:
435.~35 4921 [
KNCROAC~ PE~
N~-UdIi~ ~t ~it (S225)
2203 Fai~ful
2203[ ~r afld Ma~als ~u6~ (I~G~ ~.)
2203
2203 C~h ~sit
Plan ~k ~ [~fion Fm ~-Ufili~)
~1= ~oval ($1o5/~)
4722~ ~nalti~: Fail~ m co~ ~c ~difons
4~2 As~ssment
O~ER
FOR
CITY CLEI~
JR[CEIVED BY "'
/' / ;2,/t, ;z ~
ONLY
'For Plan Cl~.c k. and Casa. D~pos~l, ,~-~ .~clFo ~' ~ m' F'mance.
Date/' Initials
h:~c frm4tcxcbnMr,~v
JUN 1~ 1~ 10: 1~ FR SANGER ~ ALTGELT 810 734 ~771 TO 1~1083~10 P.01/01
S~ger ~ Altgelt ONLY AND CON~ ~O R~H~ U~ ~E CER~CAT~
HOLDER. THIS CER~RCA~ DOES NOT AMEND, ~ND OR
P.O. ~ox 12365 AL~R THE. CO~GE AFF~DED BY ~E PO~IES BELOW.
San ~to~io, TX 78212 COMPANIES AFFORDING COVERAGE
(210)73~-6677 Fax(210)?34-6771
A ~IT;D PACIFIC
~R~ ' -' ..... - ,.
~OMP~Y
CLE~ C~EL HOLDINGS, INC. ~ ~ELI~C~ NATION~
ELLER ~DZA CO~PO~TION
200 CONCO~ P~ZA, SUITE 780 c
S~ ~ONIO TX 78216 ....
CO~P~
i, D
THIS I$ TO CE~I~ THAT THE POLICIES ~ INSU~CE UGTED BELOW HAVE BEEN ISSUED TO THE IN~UR;D NAMEO ~OVE FOR ~E POLICY PER~OD
~NDiCA~D. NO~ITHSTANDING ANY R~IR~E~, T~RM O~ CONOI~ OF ~Y C~T~CT OR O~ DOCUMENT WITH ~PEcT TO WHICH THIS
CERTIRCAT~ ~AY B~ I~UED OR MAY P~T~N. ~E INSU~CE ~FORDED BY ~E POUGIES D~RI~D H~EiN IS SU~T T0 ALL THE TER~S.
........ ~?0NS AND CONDmONS OF SUCH POLiCiES, UU~S s~0WN,,,~Ay HA~ BEEN REDUC~ BY P~D
L~ ~ OF ~R~CE ~CY N~ ~Y ~ ~Y ~A~N
A Gm~c"~ ~UCYNO. VU~ 04/10/99 .-, ,,n~/lO/~O
X COM~RCI~ ~ L~LI~
~L O~ ~T~ ,, ._ ,,
~D~Y ~
SC~LED ~T~ (per ~r~)
X [ N~O~D ~T~ (Pe~ a~ent) s
~R~ D~AGE
~NAGE ~B~ AuTO ONLY.
~Y ~TO
O~ ~ ~TO
~ O~ER ~ ~ F~ AGG~GA~ ~,
T~ [~T~ .
P~E~CUT~ I~L .......
003792009 --
CERTIFICATE HOLDER IS N~D AS ~DITION~ INS~ED AS T~IR I~R~ST
~Y
F~ TO BE~ETTE ~ 510-834-9410
[:"~'*'~' ....... ,:~'~' '¥' *~' :'~'": '"~; ~:~:~ ~ ~::~":~:~::~:~:~:'~ ~;~;~.~.x.~.~ ......... ~' ' "~ ....... ' ..... o · "
** TOTAL P~GE.O! **
3UN-18-1999 15:36 Uz~ PERMIT 408 321 ?569 P.02
Sange~ & Al tgelt only A.o c~ .o ~ ~ THE
P.O. Box 123~5 a~ ~,~~ iv ~~
S~ ~onio, ~ 78212 ~p~ ~~ ~~
(210) T]4-GGTT F~(210) g34- 6771
A ~ITD PACIFIC
/
~ ~IA ~~TI~ ~ /
200 ~~ P~, ~ 780 c . ..~
A ~~ ~~~ 'o4/to/~~ o~/~o/oo ~~ ,~,~.
., ~o~,~~) ~
A ,~~ ~ ~. ~ ~ 04/10/~9 0~10/00
,~ ~~ ~ ....
~ ~I J~ _ , ~ ~. ~
~ ~~~~__ 003~92009 ....
F~ TO B~E~ ~ 510-834-9410
~'~ ............... ~=~'~ ........ ,?~L~?-_ 'L -. ..... ~ ~ ~:~ -~- Z~ .... ~-- '~L_....~ ~: V'-~ .J'~'~ .~ ~ .....
TOTAL PRGE.OI **
TOTAL P. 02
I:N3UCY NUMBER: vq 85/~680[ COMMERCIAL GENERAL UABILrTY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE ..
Name of Person or Orgaaization:
VALLEY TRANSPORTATION AUTHORITY
(If no entry appears above, information required to complete this endorsement will be shown in the Declara-
lions as applicable to this endorsement.)
WHO IS AN INSURED {Section II) is amended to include as an insured the person or organization shown
in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you.
CIT~ OF CAi~BET.L PJiDEVELOI~ENT AGENCY, ITS OFFICE]IS OFF[CTAT.S, FRPLOYKES AND '
VOL[~FfEEI~ POll LOSSES ARTSING F[O~ I~OP/[ PEHFORN~h BY THE CONTRACTOR FOR THE CIT~.
PRIMARY ~ORDINC:
SIYIEJ-ECT TO AT~.T. O~ ~ ~a~rD PRO~TISIONS OF THE POLICY, SUCH INSURANCE'AS PROVI:
BY THIS ENDORSEHENT SHALL BE DEEHED PR.IHARY, BUT ONLY lfiTH RESPECT TO I~ORK
PERFORN~ BY OR FOR'THE ~ INSURED IN CONNECTION I~Ttl THE ABOVE DESCRIBED
CG20 10 11 85
Receipt
OR RE T ~, DOLLARS
J r ACCOUNT ,Z{."~I ~ ' C) cash
J _ PAYMENT ~ - ~ check [~5~ --
/ ~ACANCS DUE ~ ~ money BY
~---- ~ %/ order -- ~lm2
PAYMENT
BALANCE DUE
~/'~~~~ ~ ~/~l~e'y~Trc~nts;c~r;ation Authority
July 30, 1999
City of Campbell
Mr. Peter Eakland
Department of Public Works
70 North First Street
Campbell, California 95008
J i.! !~ 3 ~ I999
PUBLic WORKS
Subject: Bus/Ad Shelter Installation/Electrical Encroachment Permit Request.
Dear Mr. Eakland:
Enclosed is a completed City of Campbell Encroachment Permit application, a copy of
Eller Media's Insurance Certificate showing City of Campbell as additional insured (hard
copy to follow), and three sets of plans and specifications as requested for the following
site:
Location
S/B Bascom N/S Campisi
Bus Stop #
346108
The permit fee of $445.00 has been requested from Eller Media.
Should you need further information, please contact me at 321-5824.
Sincerely, ~~_ ~:Ll-'f~ 5V~
Deborah V. Dionne
Permit and Utility Services Unit
Rail Design and Construction
Cc:
Spike Cryderman, Eller Media
Les Miller, Deputy Director
William A. Kindricks, Business Relations Manager
George Tacke, Senior Management Analyst~
Steve Newgren, Construction Inspector ( ~-~ ! - ~,~"~/~ ~
Robert Keller, Construction Inspector
File ~/~/~
3331 North First Street · San Jose, CA 95134-1906 · Administration 408.321.5555 · Customer Service 408.321.2300
7-38-1999 11:16AM FROH CAMPBELL PUBLIC WKS 408 3760C__1~8
CITY OF CAMPB~L.L
DEPT. OF PUBLIC WORKS
70 Nonb Fir~ St
Camp~Jl, CA 9.~X)8
(408) ~-21S0
Fax (408) 376-0958
ENCROACHMFdCT ~
(for worlr~ within ~1~
public right, of.w~y)
Pcnnk expires in 12 monks
A~pUc~oo
· %~aUo' n cxpi~r.s in 6 momtu
I!
Thc Pennin~ MUST REQUF_.ST 1N WICrI~G a final ~naad accegum~ of ~ work upon complenon. Ac,<4qama~ by the City will be ma~e
m ~vti~n~ ~o Ibc ~e.
:~. MAINTAIN safe pedesaian aM vetucultr crOSSings and fzee access m pfi~ ~ys, ~ ~, ~ by~ ~ ~r vdv~,
6. A CON~U~ON ~C CONSOL ~ ~ a CON~U~N ~~ is ~ for ~
~. ~ CON~U~ON ~C COBOL P~ ~ ~ wi~ ~ ~ ~ of T~ Co~ls for C~
~i~. Adv~e pay~nt for ~ e~ ~ b ~.
12. Ad~ ~gn~g a~ ~ ~C~O i$ ~ ~ ~ j~ a~. Fa~u~ w ~v~ ~ s~
13. Cv~c~n tes~ ~ ~c, ~ ~ ~ ~t ~ by ~ ~ ~Q~ ~S ~
14. ~ Co--mr or ~e w~l ~vc z ~~RY ~P~A~E &v~ f~ co~ on ~ pm~ at ~ ~S ~ ~n.
a ~ ~n ~ ~e public,
16. This permit ~a~l ne< be construed as amhori~anon for c~ava~on and sradin& on private pmix:rt7 ADJA~ to I~c work or any miser work for
~ · SCl)amc permit my be zequm~, nor does it tdieve th~ Pennitme of any ob~anon m ol~aia any ~er pen~t n:cl~irM by
17. Tim p~tmit does NOT R~=EASE the Perglljt~e ffo~ an~ liabi~$ C.o~r'~n~t in ~ a~r~.men~ ot ~ wid~ ~ City ~d any other pub~:
agency.
18. 'rais p~mdt L$ NOT TEANSF£R.RA~LE. Work mast
19. C~ BACK (~ out) due ~ ~~ ~
20. Pursuant Io Cbapier i4.02 of I~e Cam:pi>gU Mumci~al Code. Iq:~iica~ ~ DOt *.aus~ m lag ~ any ~ i~ I1~ I~ SWm ~ '
~11gm other ~,~p storm wa~et. Applicant shlJI adhere m the BF.,S'T MAJ~&GEMENT FRACTICF. S ~"~s~lished by ~ ~ ~ Valley Nonpoint ,~:~l:e
Pollution Conuoi Program.
A~pticam sisal] be responsible for ensuring ~at a~! d~ose pfovsding se~vlces under dsc applics~ ate aware ~f and undertone all of ~ dsove condi~ons,
Applicant
j:~nns~pwpcrm2 6/96
r'.tl~%' al.~Ll, l~ t,V ~I-UU~
1~-~9~ 15]:11 FR S;~HG~F ALTGELT ~10 ?34 $771 TO 51~834~410 p 01/01
15
CLEAR CHARNEL HOLDINGS, INC.
ELLER ~F. DIA CORPOP. ATION
200 CONCORD PLAZA, ~UITE 780
SAN ANTONIO TX 78216
O0M~ANY
BGC~-Y IKJ~ S
04/Z0/99 04/20/00
003792009
CERTIFICATE HOLDEK I~ NAMED A~ ADDITIONAL
M~YAPPEAR.
FAX TO BER~-~ETTE ~RD S10-834-9410
CITY OF CAMP~B~L
?0 NORTH FIRST gTRE~
CAMP~ELh CA 9410T
INSURED AS THEIR INTEREST
~: TOTRL paGE.01 ~:~
~~f~l~eTy~Trc~nLs;c~r;ation Authority
June 18,1999
RECEIVED
JUN 2 2 999
PUBLIc WORK8
ADMINISTRATION
City of Campbell
Mr. Peter Eakland
Department of Public Works
70 North First Street
Campbell, California 95008
Subject: Bus/Ad Shelter Installation/Electrical Encroachment Permit Request.
Dear Mr. Eakland:
Enclosed is a check for $425.00 from Eller Media for additional permit fees for the five
locations listed below:
Location
E/B Campbell N/S Kim Louis
E/B Campbell F/S Winchester
E/B Hamilton MD Bascom
N/B Bascom N/S Fewtrell
N/B Bascom F/S Campbell
Bus Stop #
296015
326003
346102
346003
3461O9
Should you need further information please contact me at 321-5824.
Sincerely,
Deborah V. Dionne
Permit and Utility Services Unit
Valley Transportation Authority
CC:
Spike Cryderman, Eller Media
Les Miller, Construction Manager
William A. Kindricks, Business Relations Manager
George Tacke, Senior Management Analyst
Steve Newgren, Construction Inspector
File
3331 North First Street · San Jose, CA 95134-1906 · Administration 408.321.5555 · Customer Service 408.321.2300
ELLER M. EDIA COMPANY A / P DISBURSEMENTS
169O4O
06/14/99 COC PERMI(5) BUS SHELTER PERMIT-
425.00
.00
425.00
CH: 169040 06/15/99 CITY OF CAMPBELL
425.00
~~/Aal~e~y~Trc~nLs;c~r;ation Authority
June 16, 1999
City of Campbell
Mr. Peter Eakland
Department of Public Works
70 North First Street
Campbell, California 95008
Subject: Bus/Ad Shelter Installation/Electrical Encroachment Permit Request.
Dear Mr. Ealdand:
Enclosed is a completed City of Campbell Encroachment Permit application, a copy of
Eller Media's Insurance Certificate showing City of Campbell as additional insured (hard
copy to follow), and three sets of plans and specifications as requested for the following
five locations:
Location
E/B Campbell N/S Kim Louis
E/B Campbell F/S Winchester
E/B Hamilton MD Bascom
N/B Bascom N/S Fewtrell
N/B Bascom F/S Campbell
Bus Stop #
296015
326003
346102
346003
346109
The additional permit fee of $425.00 has been requested from Eller Media.
Should you need further information please contact me at 321-5824.
Sincerely,
Deborah V. Dionne
Permit and Utility Services Unit
Valley Transportation Authority
CC:
Spike Cryderman, Eller Media
Les Miller, Construction Manager
William A. Kindricks, Business Relations Manager
George Tacke, Senior Management Analyst
Steve Newgren, Construction Inspector
File
3331 North First Street · San Jose, CA 95134-1906 · Administration 408.321.5555 · Customer Service 408.321.2300
BUS STOP SHELTER HOTES
t. Installation shill confonr, to'July 1992 CSJ specs and plans.
2. Shelter wiring will meet lt.E.C, requirements.
3.'C. onductors 'ut11 match exststtng 'circuit conductors.
4.. Shelters ut11 be fused at tie in point and tn shelter uith FHM 3 fuses.
5. Grounding of shelter done in leg of shelter ~tth t8 bare and 3/8 bolt.
6. Limit one shelter t° individual lighting circuit.
7. Shelter load shown on sheet E-7.
8. See ~ndivtdual plans for sl~ectftc information on each s~te.
!
s~tt, ch Wfuse-----['] Il:
L. Sh
SHELTER
EXISTING
SERVICE CONNECTION-
LIGHTING PULLBOX
~ To S/L pull box
or Service point
120 VOLT SHELTER PULL BOX
Detail 4
only on
S/L service
0',1'3
County Bus Shelter
Sheet
"240 VOLT SHELTER PULL BOX "
11'3 1/2 F'RECAST CONCP~L-TE
BOX N~IN-,~'~'TIH UO MARKED
"County Shelter"
WAIF. R,eRCX~ 2 POLE fUSED
CONNECTOR RAIED 30,%
WTI'H 1Va:) 31A~ FUSES
SIDEYVALK OR IOP
OF CURB GRADE - ".
WAIERPROOF
36' TAIL ~,'m!
"TAPED EI4D
.... . t3Et..L Et,,'D
(TYr,.I
SEAL. A~,Ot l( IU
- · -- C"O~t~Ut ! %%111,4
tAPER
/.
· I'.PVC to S/L box
o2 ~ 8 ~/ ground
or~tch exsJst~ng
conductor s~ze
IqG,qF.~: E-43S E ~ E-37. ~
L *'- L[NGTH
CONNECTOg
METAL SPLIC~ pROVOIOE WATERTIG~ti i,u
SPLICE WITH SHRINK TUBING ~qD INSULKTED SPRING CONNECTOR
CONDUCTORS)
SECTION.
,ROYED
DATE
coHDUCTOR SPUCItqG
SPRING CONNECTORS
2/*//~'7. DEPART/~I'~ OF PUBUC WORKS
Sheet. 3
WAI'E
-
2 POLE 30,~ 600V_
POLE 30A~ 60QV_
,~n-,--.4
FUSE DETAIL
1L
.,M~PROVED
DATE
,Aim,
FUSED SPLICE
CONNECTORS
DEPARTMENT'O---'-~ PUBUC 'V~tOBY,~
E-53 ~
-- p.O.&r- ~C. BOX
- U.O. ~G{-{1' $£RV~CE
; ~ .- . . ....-..'.'. -.'. - '-. '.~..-
Shelter Lighting Oiagram
Eiler ~edla Inc.
see tndtvidOa, location maps for
conduit, wire size and voltage or
service point.
SQUARE 0 IFSZZtR
SERIES F-l
SWITCH with 3 amp fuses
/~ pole ~40 volt)
pole t20 volt)
~Shelter ~oustng
.S KVA SQUARE D
500 SVIB
TRAHSFOR~ER (~en required)
BALLAST BLUE
LAMP
LAMP
WHITE
BALLAST
LAMP
LAMP
P[C (WHEH REQU[R[O)
Gro~fl4 red in pull box|
¢
t
sheet 6 .
facsimile
TRANSMITTAL
To:
Of:
Fax:
Pages:
Deborah Dionne, VTA
Valley Transportation Authority
321-7569
2, including this cover sheet.
Attached is signed copy of encroachment permit. If you have not done so, please send
encroachment permit materials to the City as requested by our inspector, Randy Westfall.
From the desk of...
Peter Eakland, Traffic Engineer
City of Campbell
70 North First Street
Campbell, CA 95008
408-866-2154
Fax: 408-376-0958
YUN-18-1999 15:34 UTA PERMIT
j,,thori,y
488 321 ?569 P.02
June 16, 1999
City of Campbell
Mr. Peter Eakland
Department of Public Works
70 North First Street
Campbell, California 95008
Subject: Bus/Ad Shelter h~llation/~ectrical Encroachment Permit Request.
Dear Mr. Eakland:
Enclosed is a completed City of Campbell Encroachment Permit application, a copy of
Eller Media's Insurance Certificate showing City of Campbell as additional insured (hard
copy to follow), and three sets of plans and specifications as requested for the following
five locat/ons:
Location
E/B Cmnpbell N/S Klm Lores
Fdl3 Cmnpbell F/S Winchester
E/B Hamilton MD Bascom
N/B Bascom N/S Fewtrell
N/B Bascom F/S Campbell
Bus Stop
296015
326003
346102
346OO3
346109
The addii/onal permit fee of $425.00 has been requested from Eljer Media.
Should you need further tn~ormation please contact me at 321-5824.
Sincerely,
Deborah V. Diorme
Permit and U~lity Services Unit
V/flley Transpo~on Authority
CC:
Spike Cryderman, Eller Media
Les Miller, Construction Manager
William A. Kindricks, Business RelaXions Manager
George Tacke, Senior Management Analyst
Steve Newgren, Construction Inspector
File
3331 Ko,th ii~sl St~eel · San ]use, CA ')5134.]'/0& - Administrution 401.371.5555 - Customer Service 408.321.2300
JUN-18-1999 15:53 UTA PERMIT 408 521 ?569 P.OI
PERMIT & UTILITY SERVICES UNIT
DATE:
TIME:
FACSIMILE COVER SHEET
NAME: P~
COMPANY NAME:
FAX#:
FROM:
VALLEY TRANSPORTATION AUTHORITY
CON~I'RUCTION OPERATIONS
PE. RMrr & UTILITY SF..RVlCES UNIT
3331 N. 1ST 6TREET
SAN JO~F., CALIFORNIA 95134-1906
FAX NUMBER: (406) 321-7569 ·
TITLE:
TOTAL NUMBER O AGES (I UDING THIS COVER SHEE'I'):......,.~~'
COMMENTS:
IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL (408) 321-5856
3331 No~lh F'rst Street San Jose, CA 95134-1906
June 8, 1999
CITY OF CAMPBELL
Public Works Department
Deborah V. Dionne
Permit and Utility Services Unit
Valley Transportation Authority
3331 North First Street
San Jose, CA 95134-1906
Re: Bus/Ad Shelter Installation
Dear Ms. Dionne:
We are in receipt of your June 1 letter transmitting information regarding five additional bus shelter
locations for which you require a permit. Before we can proceed, VTA needs to complete the enclosed
City of Campbell Encroachment Permit application. Please note that an additional $425.00 is required
to cover the fees for this permit.
We have attached a copy of our current fee schedule for your information. Treating VTA as a utility
allows for decreased fees, however, the correct amount for the Plan Check and Inspection Fee is based
on $120.00 per location. The $1,200.00 quoted by our Traffic Engineer last year was based on ten
locations and then was not revised when two more locations were added. Also enclosed is a copy of
Permit #98-195, which was issued for last year's bus shelter locations, as well as a copy of last year's
Certificate of Insurance which will need to be updated for this new permit. To help speed the process
along, as soon as an acceptable Certificate of Insurance is in place, work can be scheduled for this
project, even if the additional $425.00 check is still in process.
Please complete the enclosed permit application and note that a signature is required on both sides.
Return at least three sets of all plans and specifications. I have retained a copy for reference until the
official permit is issued.
If you have any questions, please contact me at (408) 866-2165.
Sincerely,
Randy Westfall
Public Works Inspector
cc:
Peter Eakland, Traffic Engineer
Permit 99-213
h :\permits\ 99213 vta(mp)
70 North First Street · Campbell, California 95008.1423 · TEL 408.866.2150 · Fax 408.376.0958 · mD 408.866.2790
'Adopted 6/17/97 .'
Re,olu~-~on 9236 Public Works Deportment
l~gllt E
~'~,~ ~ ors
Assessment Se_m'enation or Rea0portionment
A. First Split $~50.00
B. Each Additional Lot 170.00
Certificate of ComoHan¢o
Certificate of Correction
Encroachment Permit AvuHcnfion F_~
A. R-1 (Owner Occupied Residence)
1) Engineer's Estimate* < $5,000,
(Limit One Per Pr~ Per Year)
No Charge
No Charge
2) Subsequent R-1 Permits
100.00
100.00
B. Non-Utility Eacroachment Permit
Street Tree Plantin~oval Permit 105.00
t~,_UtilityEncroachmentPermit~_,. ~ o/~,e~ o/¢",,,~.l
I) Arterial/Collector Street 325.00
2) Residential Streets/Other Areas 225.00
Plan Check, Inspection Fees and Dem~__'_s for Encroachment Permit~
A. Non-U~ity Enc~oachn~nt Permits - Plan Check & Inspection Fees:
1) Engineer's Estimate* Up m $250,000
12%
2) EnDiz~er's Estlmnte* Great~' Than I:150,000
+20% Administrative
(Deposit ,. 8%of
+20% Adminim~ve
lO&O0
.i__cs'n~ I Co~.s
3) Plan Check Deposit
21 of Ensineer's 2% o'f~'s
Estimate* (SS:X) ~* ($500
4) Construction Cash Deposit
4% or~'s
70 Nor',h First St.-
c, q bci], c^ 9sooBjUN 1 g 1998
(~8) 866-2150
F~ (~8) 376~958PU8UC WORKa
ADMINISTRATION
ENCROACHM~ PERMIT
(for working within thc
X-Rcf. file
Application
Application
APPL/CATION - Application is her~y made for a Public Works ~ in a~ance wi~ Cami~efl Mural Codg, Section 11.IN. (Al~lica~o~ e~ in 6 mon~s
A. Wo~o~.-~# N/B Winchester F/S Campbell, Bus Stop # 326002
U~g-/m:~=~o. N/B Winchester F/S Campbell, Bus Stop # 326002 ..,~/_./~v_.,, //..~'~/~,_~
C. Aizac~ four (4) cepics of aA en~ plans sbow~ ~ loc31Jo~ and c~en~ of ~he work. a~MJ faur (4) copies of ,h~ p~li~ End'S ~ air work. Thc
pLIm sl~l show 'h" n~ion of ~c proposed wodc m exis~ suKnce ~d -n~p~u~l ~_ When aiq)roved by fh~ Ci~ EAlimef, ,~4 pL~I becamm a pla of
D. All work shall co~orm to the City of Campbetl Standard Specif'~ and Details for Public Works Consm_~ the Genfl=al Pmnit ~'_~,,~;~,- lisml on tl~ my=se
Performance Sumies ami cash dc~s~. (See General Permit Co~__'_~_~ 1 a~12.)
E. THE CONTRACTOR MUST HAVE TH~ PERM1T AND A.~ROVED PLANS AT THE ~ AND MUST NOTIFY THE PUBLIC WORKS DI~ARTM~*4T AT
~ T'WO DAYS BEFORE STARTING WORK. NOTIC"E ~ BE GrV~N TO PUBLIC WORKS AT I..EAXT 24 HOUR~ BI~OR~ im.,.~S'I'ART'{I'CG .,MCY WORK.
zq~meor~L~ Vallev TransDortation Agency
(prfl~ :arac)
~3331 N. First Street, San Jose,CA 95113
Ta,~ho,~ 321-5856
24 HOUR EMERGENCY Th'I_h'PHONE NO.
L~ tl~ work bc~ dong by the property owngr at tJ~ir own residencg? Yes No
T~ Appi~ hcre~y ~ by ~Y'txing ~heir siLmamre m t~is permit to hold [he C'~ of Can~. its officers, agents and employees fx~e, safe and Innnkss from
~ ~ or dem~t for damqe~ resulting from cbc work covered ~ d~ pefl~.
information.
(Applicant) (~) J '
PERMrr APPLiCATiON FEE
PLAN CHECK.DEPOSIT
SECURrf'Y FOR F~ PERFORMANCE/LABOR
CONSTRUCTION CASH DEPOSIT
/
S~ ~onio, TX 78212
COMPANIES A~ORDINQ COV~AGE
(2[0) 734-6677 Y~(2[0)734-677~
CLEAR CHANNEL HOLDINGS, INC.
ELLER MEDIA CORPORATION
2850 E. CAMELBACK RD., STE.300
PHOENIX AZ 85016
CO~Y
c 4//c, 0 $199~1
COMPANY
UNITED PACIFIC ~ ~.
-
THIS IS TO CERTIFY THAT THE POUClF.~ OF INSURANCE us'rED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE pouCy PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE I~UED OR MAY PERTAIN, THE INSURANCE AFFOROED BY THE POUClES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUClES. MMITS SHOWN MAY HAVE RF__EN REDUCED 8Y PAID CLAIMS.
CO i
LTR i ~ OF ~IJRa~CE
A
,~ o~ & C~OR'S PROT
iANY AUTO
ALL OWNED AUTOS
B
POUCY NO. Vq
POUCY NO. VQ 8546~2
POUCY NO. WD ~
OTtlER
I~Ugy ~
04/10198
O4/lO/98
°4/lO/981
KAJC¥ EX3'F~TWN ]
o~'m (m~oo/Yy) I
04/10/99 a~m~
/ PERSONAL & ADV ~L/JRY
EACH OCCUFRENCE
FIF~ DAMAGE (A~y ~e fire)
i ~,4~O EXP (,~y o,~ ~a...,)
04/10/99
BOOILY
(Per
8OD~Y I~
(Per
~0 ~Y
AGGREGATE ! S
i$
04/10/99 ~c STA~D- ..
IH. EACH
Js~__nnn ~_
SI nile nnn
I sl nnn nn,j
003792009 CERTIFICATE HOLDER/LESSOR IS AN ADDITIONAL INSURED AS
THEIR INTEREST MAY A~PEAR. THE CITY OF CAMPBELL IS ALSO ADDITIONAL
INSURED PER ENDORSEi~mTT ATTACHED.
FAX TO BERNADETTE 510-834-9410 FAX TO HOLDER 408-321-7569.
~HOULD ANY OF THE ABOVE DESCRIBED POLIC-~ BE P. JI3~, ~ 8~=OR~ THE
VALLEY TRANSPORTATION AUTHORITY
PERMIT & UTILITY SERVICES UNIT
3331 N. 1ST STREET
· ~1~i~" - ~"~' -':1~ ' - - ..................
POMCY NUMBER:
Yq 8346801 COMMERCIAL GENERAL LIABIUTY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Nmne of Person or Organization:
VALLE'Y TRANSPORTATION AUTHORITY
(If no entry appears above, information required to complete this endorsement will be shown in the Declara-
tions as applicable to this endorsement.)
WHO IS AN INSURED (Section II) ia amended to include as an insured the person or organization* shown
in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you.
~ INSHRP. R' .SH~ AGREE TO T~ATVE ALL ~S OF ~~ON A~S ~ CI~, ~'
CI~ OF ~B~ ~~O~ A~, ITS O~C~ O~CTALS, ~~S ~ '
~0~~ ~ ~OSSES ~SING ~ ~0~ P~~ ~ ~ CO~~ ~ ~ CI~.
P~Y ~O~NC:
S~ECT ~ ~ O~ ~ ~ P~SIONS OF ~ POLIO, SU~ ~~~'~ P~VlD
~ ~S ~~ S~ BE DE~ P~y, B~ O~Y ~ ~E~ ~ ~O~
P~~ BY OR ~R'~ N~ INS~ IN CO~C~ON ~ ~ ~ DES~B~
CG20 10 11 85
~~/~lie'y~Trc~nLs;c~r;ation Authority
June 1, 1999
RECEIVED
PUBLIc WORKs
~DMINI~¥RATiON
City of Campbell
Mr. Peter Eakland
Department of Public Works
70 North First Street
Campbell, California 95008
Subject: Bus/Ad Shelter Installation/Electrical Encroachment Permit Requests
Dear Mr. Eakland:
Enclosed for your review are five Phase l/I Bus/Ad Shelter locations. The package
contains the site drawings, seMce point locations with load calculations, electrical
connection details and Check # 163333 for $500.00 as payment for the $100.00 Permit
Fee for each site. The five locations are as follows:
Location Bus Stoo #
E/B Campbell N/S Kim Louis
E/B Campbell F/S W'mchester
E/B Hamilton MD Bascom
N/B Bascom N/S Fewtrell
N/B Bascom F/S Campben
296015
326003
346102
346003
346109
If you anticipate any delay in the issuance of these Permits or need additional
information please contact me at 321-5824.
Sincerely,
Deborah V. Dionne
Penuit and Utility Services Unit
Valley Transportation Authority
CC:
Spike Cryderman, Eller Media
Les Miller, Construction Manager
William A. Kindricks, Business Relations Manager
George Tacke, Senior Management Analyst
Steve Newgen, Construction Inspector
File
3331 North First Sheet · San Jose, CA 95134-1906 · Administration 408.321.5555 · Customer Service 408.32].2300
ELLER MEDIA COMPANY A / P DISB[--~EMENTS
163333
05/20/99 COCAMP520SHELTER CONSTRUCTION PE
500.00
.00
500.00
ELLER MEDIA COMPANY A / P DISBU"~EMENTS
163333
05/20/99 COCAMP520SHELTER CONSTRUCTION PE
500.00
.00
500.00
CH: 163333
05/24/99 CITY OF CAMPBELL
500.00
t. Installation shill confo)~n to'July ~~specs and plans.
~?. Shelter wiring will meet I~.£.C. requirements.
3. ~Conductors 'wi 11 match exs t sit ng 'ci rcut t conductors ·
4.. Shelters will be fused at tie in point and tt~ shelter with FI~I~ 3 fuses.
5. Grounding of shelter done in leg of shelter with #8 bare and 3/B bolt.
6. Limit one shelter to individual lighting circuit.
7. Shelter load shown on sheet EL7.
8. See individual plans for s~ectftc information on each site.
!
s.ttch ~/fuse-
~e.-21a. tie ,.'-~
~lter Box -t /
·
5/gk lo' '/
SHELTER SERVICE CONNECTION-
EEXISTING~ LIG~HTINGi PULLBOX
To S/L pull box
or Service point
" 120 VOLT SHELTER PULL BOX
COt, a~U~T
B£LL ~
only on
S/L service
County Bus Shelter
/L ctrcu
Sheet 1
" 240 VOLT SHELTER PULL BOX "
~'3 1/! PRECAST COIqCP. EIE
BOX IL~IN~WTIH LID MARKED
"County Shelter"
WAIERrROOF 2 POLE I'USED
--- SPLICE CONNECTOR RATED 30A.
600V W~i'H TWO 3! A~ FUSES
SIDL~/ALK OR
OF CUR8 GRADE - '-.
WAIERPROOF
s ~: CXA. CO~K..CI~ oR
3/4 ~ r.~LV. SI E~L _
._ 3G' TAll.
TA.m~D EI4D
~ ARC)ti( ID
GROUt
PAPER
LENGTH
COeaqECTOR
~RINK TUBING ,4~lD INSULATED SPRING CONNECTOR
SHRIt'~IK TUIIIN(~ ~~OR (TYPJ
cc~o~o~
SECTION.
.~V~IRE COt~ECrOR
CROTCH DETAIL.
APPROYED BY
CONDUCTOR SPUCllqG
SPRING CONNECTORS
~'1~'7_ -~pARTMEHT OF PUBLIC WORKS
Sheet 3
2 POLE 30A~ 600V
I POLE 30A,. 600V~
1
FUSE DETAIL
1L FL/SI
I"~HDUIT LEHGTH 'I.'T~B__LE__
I~'W' ~ '.~ ~0'- ~" ,,ut,.
/~ox I~ HOT t~t-qU1REO AT.
-/EttcT~ou~
· :-....: .:.
:.:-..-:.
- PRO~P.~ L~E
- p.~.&t.., stc BOX
- U.G. s'm.tkml~'g'
· . :~,coHix~tt~tr ' ' .....
~ BOX
O e ~ ~~ D~w~r
~ p ~ &~. SECOHDA~Y/U,
~ . I SERVICE PULL BOX LP~~K~~~_~)i E-3:
~ .,.~..' I ~~~ ~ 1~~ ...
Shelter Lighting Oiagram
Eller 14edla Inc.
· .- Shelter Housing
see tndivld~3a! location n~aps for
conduit, wire size and voltage or
service point.
SQUARE 0 IFSZZIR
S~RI~S
SWITCH with 3 amp fuses
~ (~ pole ~40 volt)
~ULLU .5 KVA SQUARE 0
500
TRANSFORI4ER(~en required)
pEc (~ R£quxR£O)
GroG~d rod tn pull boxl
WHITE
BALLAST
LAMP
LAMP
BALLAST
LAMP
BLUE
(
Sheet 6
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