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92-164 ,....trrtOo"C ." 00 (tt ::r .., It t\) ot\)~e..,~ O;l ~ Il ....... .....::J~1n II> ;l '" ... ~ .,.. = .c n z:- M '" V) - ,., e...Jrt...!'tI1..... , ., -.., 0 ..., !t '< .. :l :l ~ '" ...0 .J:"o .....nnl:- ~::r:: ~ .... II> "'.. < ... ... It ......, 1I>;l >... On~""O +'!;l...ft"'... .... .. """ '1 n .... M ...." ,.. n O::r CDe'''........''''1~ ntl)nC >..."'lI>n :z: 0 > >< 0 O"'O;l'-'n< ::r .. ~ o ::l ::r < '1 i II ~ ~ il .. cr ..... ftl II> tr 0 ::l ... ~ ;l ... ~ III .....::l C'l o-l ~ 0 ...::l ::l '" no... II> """'... to..........,., ......., ::r ....c:.... :z: ~ ::l .. o '" '" . III ......... ::l . :-c.. .. . III CITY or CA)(PBELL DEPT. or POBLIC WORXS 70 North Pir.t st. Campbell, CA .5008 (408) '66-2150 CJ 2 - /{o'+ ENCROACHMENT PERMIT (tor workinq in the public riqht-of-vay) Perait 110. X-Ref. fUe I..ued 5t14~92 Application Data....5..L8/92 hrait erp r.. n U ao.. AppUcation~rv *nl'-voi'" APPLICATION - Application i. bereby aade tor a Public Work. Perait in accordance '~~~_C..pbell tJ Municipal Code, S.ction 11.04. (APPlicatio: expire. iD , aonth. if permit Dot pu~ 08 1992 A. Work addu.. or tract. LJ/'<.-G..-O/V, C7/LC:;MAAJ J ,RA Ie. l~A'j ~~(,lr. " I _.'4i.....i,J..j1l1l Utility trench location vE~ A Tl;ljC!I./t=::/J ..l);IIi(4,I..A..JIAJ6S. , II. Nature of work: !1JTI-/OLE OTTc::.cE"1<5 TCJ [)676-2MIIUEF~laUTY L'F"P7"1-l 0-3 o III t'l () o :s: '0 ~ 0-3 t'l tJ III >< :x> '0 '0 r< H () :x> z 0-3 I I I I I I I I I I I I I I I I I I C. Attach five (S) copie. of a dravinq .howinq the location, extent and di.en.ion. of the work ~he drawinq ahall ahow the relation of tha propo.ad work to exiatinq aurfaca and underqround i.prova.anta. Wban approved by the City Engineer, .aid drawing baco.e. a part of thi. permit. D. ~he aeneral Condition. tor all permita are li.ted on tba rev.r.e aida. Spacial .rovi.ion. for thi. p.rait are li.tad below. railur. to abide by the.. condition. and provi.ion. aay r..ult in job ahut-down and/or forfaitura of raithful 'arforaanca Bond. and ca.h dapo.it.. (S.. aanaral CODdition. 1 and 2). I. AD application f.a auat accoapany tbia application. ~hia i. Don-rafUDdable. r7 23 /YV lI..a of Applicant r--'AC/FfC ELL -' 8M.C~lruY..l.7.u '1'elaphona: Addre..3475R Ilk, .L""JT 57: KN 200 0AAJ .00.56" 7 (ZA --f9-~- 7C 74 Y;;s/&.34 4DO I. thia work bainq dona by tha proparty owner at thair own ra.idance? ---7a. Co.pleta and attach Workera' Coapanaation and Contractor Information tora.. ~ha Applicant/Paraittea hareby aqree. bJ affizinq thair .iquature to tbi. p.rmit to hold the City of Campball, it. officar., aqanta and ..ployaa. traa, aafa and barmle.. troa any clai. or demand for damaqa. ra.ultinq troa tha work coverad ~y thi. parmit. ~ha Applicant/permitta. bara~y acknowladqa. that thay hava read and undaratand both the front and ~ack of thi. parmit, and tbat th.y wi}l info their contractor(a) of tha iDtoraation. ACCEPTED B. M. CAP. 0 III ..5-(;;, -- 7'2 App11cant (Perm Oat. 1I0TES. ALL WORr: SHALL CONl'ORM WI'1'JI '1'JI1 A'1"1'ACDD, STANDARD DRAWINGS AND CONDITIONS. PLANS AND ALL APPLICABLE CAMPBELL 'tHE CONTRACTOR MOST BAVJ: 'J'BII PERMIT AND APPROVJ:D PLANS AIID KOS~ BET WI'1'JI 'fU P~.. .%)ISP!C'1'OR 011 'tHE 811'1 AT UAST no DAYS BEFOR.! STAR'l'IIlG WOU:. . I I I I I J I I I I I I I I CS 1I0'1'ICI GIT BIl GlftJf '1'0 l'UBLIC WORU aT LEAS'l' U BOORS BnOU U8'1'AR'l'IIlG JJrY WOU. } ':' SPECIAL PROVIIIONS _1. .traat ahall Dot be open cut for UDdarqroUDd in.tallatioDa. Kiniaua cut. aaJ ba allowad tor oonnaction. or arploration holea. 'uch cuta au.t ba .pacificallY approvad by the IDspactor. 'avemant aay ~e cut tor UDdarqroUDd in.tallatioDa and au.t ba raatored in accordance with tha VtllitJ Tranch Ra.toration standard Drawing. Work ~o ba ataked ~y a lic.n.ed Land survayor or Civil InqiDeer and ~wo (2) copie. of the cut ahaata aant to the Public Work Deptartaant bafore atartiDg work. ~ha houra of work are liaited to outaide tha hour. ot ,-. a.a. and 3-1 p~a. tor any work affactinq a traffic lane. - TWO (z.) tltlc-tile., t"'F TEfl1tDl'21l12( r"/lUII1!(, l'Vfi1V gf U56D iF IT . , h iV/11/IVTlJI/7/6 f) /?J T7-t6" 5d7751"/JeJ70/{/ c:rr We c/7'/, MI4IIV77-1f/lJ 5/1F6) TWO- WAy TlZHfFIC JAr /lL-L- 77/'0'65. III t'l () o ~ r< t'l 0-3 t'l tJ tJj >< () H 0-3 >< ,-- :,,/ _2. -" _c. , ~5. PERMIT a"LICA'l'IOJf PEl PLAN CKlCI DIPOSIT BOW POR PAI'l'UOL PERJ'ORKANCB (11-1) (U5.00) $50.00 $500.00 ClOD' OP ING. IS'1'.) (C, OP BOND, $500 KIN) STANDARD AMOtl'N'l' $ /05".00 . $ $ . It) '3-,00 UCIIPT NO. Q CASB DIPOSI'l' C$200.00) Q Si;c//5Z Date PLAX CHlCI , XKIPIC'l'IOK PII _ C')i10P P.l'. ~PPROVlD I'OR IIIUANCE ?'7Ji;//?i! ?~-"7 for CitJ anginaar BOND, fJ 5 KIli) f: PWPERMI'1' lIavha" ./88 Pe-\:2-\.,y. \ ~ q.-z..- l ~4--, 01J.~c {(/U ,I ' ~(d( /Ae;CCU't7 :;j) y'/C7 ~c7 7 V)fLeb ;7l]tJ ch ceil (f2u/c/ ,/(1 C /J:.7/~L{ c' {/ c!7(/)/c-~L C~~C7 /:' d-c>t v cV c.(circd Ji ~'cZ ,'j/dL ~{/<L// ~A4nt:2;rJ/j rti--t~~J' Jc. }1'-/U.-0~?d ,?NcZOC (CZC"7:' Cy fl7;1'(i'!CZ~ /~ .'./ uA"r' ~ tc "';(,7, vt7dLL ~/~ ~ c<.?! CL," {/ V' {}/~ 49c3 70,9/ ~ ;;jd/:.L/ cW , MAY 20 \SS2 '\ '7 ~.. /..(,,~ CL~ c!c', (I t"7:C{ d c!6 ~ /' :7'f<;. ,'/ ItL.....""I\~.....; Public WorklljbgmgSriog 0". 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