92-147
an or c::&IIPIIBLL l!Ift!ROAaDmII'P PmIIft'r
DBPl'. or POIILtc .... (for vorJt1DlJ w11:1l1D tba
70 NortJl r~ ft. public n_t-oAf.....y) X~. tUe
CUpbell. ~ 110" ~' 7 ~...,~ /
(COI) "'-2150 . Iuued /.:)g / ~ AppJ,1c:aUaa Dab 4/22 92
Pen1t .ira' ill 12 _. . AppJ.1c:aUaa apina ill , _.
APPUCA1'%OII - Application 18 benby _d. tor . AIb1ic WOZ'b Pend.t 1A aaccmIuIca w1t1l t'__~~
JlUn1c1pa1 Code, secUon U.OC. (Application apiru ill 6 IIDRba if puait: not palled.
A. lIarJt addrua or tncn: . Southeast corner of Railwav Ave. & Sam Cava
'--it Bo.
92-147
U1:111t:y tnnc:A location
B. Ha~ at lIarJu Rmpnilp.ncv aa s 1 PM k rpPM i r - 1v.1' roll+- in M 0::: ph a 1 t
c. Attach tiv. (5) copi.. ot a drawinl) abovinlJ tba location, extant UId cl1IIana1ou of tha van
ma drawinlJ aball abav t!la n1ation at th. prapa.ad varJt to exiatiDlJ aartaca lUId WldUl)rOaDd
iapzoavaanta. Whan approved by the Cit:y EnlJinaer, ..id draviDlJ bee..... a part ot tIlia penit.
D. '1'b. GeneraJ. COnditione tor all paE'Bib are luted on the NYan. atda. Spacial Prav18iona tor
th1a permit an luted b.lov. raUur. to abide by thu. concU.t1ou lUId p&'OVia1ou uy nault
in jaJ:J abut-dawn and/or tortei~ at Faithful Perfonaanc. SUrati.. and CUh dapoeits. (Sa.
Gen.ral COncUt1ana 1 and 2).
B. An application t.. ..t .Ct"-.pany th1a .pplication. 'l'h1a t.. ia nan-~..
Hu. at Applicant Pacific Gas & Electric 'l'alepban.z (408) 725-2176
10900 North Blaney, Cupertino CA 95014
Addr...
I. thi. varJt beinCJ ckan. by th. property own.r .t their awn nai.danca? ~ -no
COIIplet. and attac!l Warkara' Callpanaation and COntractor Intanaation tozu.
'lb. Applicant/Permitte. heRby .CJne. by .tf1xinlJ their ailJft&tura to thu permit to bald the City ot
Campb.ll, 1b otfican, &lJante and -.ploy... tre., _t. lUId hazml... fraa any c1aia or duaand tor
damalJ" nault1nlJ tftlJl th. worJt covered by tb1. p.E1Iit.
Th. Applicant/Permitte. hareby .c:JcnavledlJ.. that th.y bav. nad lUId uncI.ntancl both tha front and
becJt ot t:bia paait, and that th.y wlll intorm thair contractar(.) at the iDtormat1an.
AC~ Julie (Emergency Verbal) 4/22/92
Applicant (Permitte., printt.iqn Dat.
HOTES: ALL WORK SHAL'P. CONFORK WITH THE A'rl'ACHED, APPROVED PIANS AIfD ALL APPLICUI.E aHPBELL
STANDARD DRAWIHGS AND COHDI'l'IOHS.
'l'JIE CCHTRAcmR MUS'!' HAVE TBIs PERKI'l' ARD APPROVED PIANS QIf-SftZ ARD MDS'l' JIIft WITH 'l'IIE P.W.
INSPEctoR 011 'l'BI: SIft AT LEAs'l' 'l'WO DAYS BEFORE STAR'l'IHG WORK. UPLICUIT MUS'!' COH'l'AC'l' 'l'IIE IHSPEC'OR
'l'O ABRANGE PIEI.D IID"l'IHG.,
1fO'nCE MUS'!' . G%VEH 'l'O PUBLIc WORKS A'l' LEAST 2C HOURS BD'OU BBSDRlIBG AllY WORK.
S~CYAL PROVTSYO~S
_1.
Street aball not be opan cut tor undeqround inatallatiana. II1niaua CUb .Y be allowed
tor connac:tiou Ole' exploration hola.. SUc:b cub IllUBi: b. ftt.ei~!eal1v lIm1rmt.... bv the
rfl!l~.~or -orfor ~b eu~fPJfI.
pavaaam: -y b. cut tor undarvraund !naull.t1ona lUId _t be natorad 111 accordanca with
the utility 'l'ranc:b Raatontian Standard DrawinlJ.
WarJt to b. BUbel by . l1canaad Land Samrayor or CivU EnlJUlaar and tva (2) cop1.. of tba
cut aba.te .ant: to tha Public Work Department b.ton -.tartinCJ worJt.
'l'h. houra ot work are l1a1ted to cuteid. th. hOIlZ'II ot 1-' .... &ad 3-6 p... tar Uly work
atfactinlJ a tzatfic lan..
..J:::;:::.2.
,.
-
_4.
_5.
STAHnUD
AMmJHop
RECEl;P'I' NO.
PERlIn' Al'PL'IcurOll I'D
PIM alEa aaosI'.r
SDREft l"OJl l'AD'IIrDL PERFoRlWla:
CUll DEI'OSI'.r
PLAH alEa " IHSPEC'ZION FEE
$100,000 - $500,000
APPROVED FOR ISSUARCE
. \~. e:w::;,
.
$
.
$ \C1'S' .e~
$105.00
$500.00
(loot or ERG. BI'l'.)
(n or SD1Ia'r, $500 lIDO
($0-$100,000 lot,
. 7t, $100 MIN)
~
~
4~"'L-
Date
t: PW PERMI'l'
Revised 10/91
ter City Enq.
(SEE OTHER SIDE)
Lane
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