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CITY 01 CA"~b~LL
D~~T. or PUbLIC WOKl~
10 Noeth rlr.t Bt.
C.m~b.ll, CA >>~OO.
1.0bl IIh-21)0
Ho. 'l??- / } 0
PUbLIC WOKKS PLkKIT
Trr:JrWrrnrrrrn-rn1!
p~bllC el~bt-ot-waV)
luued ~ /2-/ .YI"
Per.lt IIPlr.. In l~ aOa.
P.r.lt
X-ket. Ul.
AppllcaLlon DUe 2/19/88
..plr.. ~
APPLICATION - Application ia neeeby ..de tor a P~bllc Work. Peralt in accocdance with Ca~~bell
Municipal Code, kectlon 11.0..
l. WOCk addre.. or traCt .
Utility tCench locatIon
E/o 3rd St, 20' n/o Watson Dr.
II. Nat~ca of """ell; .
Mi'l in repi'l i r
C.
AttaCh five I~I copi.. ot a dea""ing Inowini the location, alt.nt and dlaenaion. of the ""OCk
The dr.""in~ Ihall aha"" the e.lation of the propO.ed work to Ililtlng .uetace and underground
iapeovcmentl. When approved by the City trl4)lnaec, laid dcawing becolII.. a poCt ot thl. pecall.
Tne General Condition. toe all permit. arc li.tad on tho reverae .ide. Special ~eovl.ion. toe
thl. per~it arc li.ted below. ~ailure to abide by theae condllion. and peovl.lonl aAY re.~lr
In 10b ehut-do..n Alld/or tortelture ot Pa1thtui l'ertocm4nce bonde and ca.h depolllca. ISee
Geneeal Condition. 1 and 21.
t. An appilcation tee IIIU.t accompany thi. application. Thl. 1. non-r.tundanle.
Name ot Appl1Cant San Jose Water Co. Telephone:
D.
,'\cld r c: lOll
II tni. wock bcln'.l done 'by the property owner at [nell own r."ldence? _y.. no
Complete attachad WOckerl' Compcnllatlon and Conteactor tor...
The Applicallt/~cr~ittee hereby agrae. bV attlllng thelc alqnaturc to thl. peellllt to Ilold the Clly ot
Cau,plH:ll, it. otflcera, a'Jentll anl.l aa.ployce. tree, ...te and I.arlllle... teolD any cIa". oe l.Iel&ol.d tor
dOII.ag". ee.~ltlll';j trolll the woek covo:clld by thIIl perudt.
'J'tu: AppllC'Hlt/~o:n.ltllC"e hereby ac...nowled<jelO that they hove eead and undeelltand both tile: teont ana
baCk ot thl" pe:emlt al~ that they will Intorlll thele contractuel..) ot the Intoemotlon.
ACCt:~T&::D
<<PPllCAnt IrecmlttttJ
ilff,
NOT~S: ALL 'WORK SIIALL COtlI'Ok/'l WI1'U Ttlt ATrACIIEO, AI>~/tOlltO PLAtl~ AND ALL A~I'L1CAbLt CA/'IPbt:LL
STANDAkO DliAWINGS ANO CONOITION!>.
Tilt.: CONTkAC1'O/t /'lUST IIAIII:: TillS Pt:/tHIT ANI> APPkOllt:D PLAN!> AtW "UST /'I~I::T WITH THI:: P.W. )N:ihCTOk ON
TilE SITE AT Lt:AST 'I'WO OAY:' b~fOkt: STAJtTING WORK.
NO")Ct: /'lUST bE GIVEN TO ~UbLIC WORKS AT LEAST 2. HOUliS btl'OkE kESTA/tT1NG ANV WOliK.
SPECI^L PkOVISIONS
_1.
Str~~t lOholl not b~ open cut tor underground In~t~llotion~. Hlni~u~ CUt. mov be .ll~"ed
toe connections or elploeation bolcb. SuCh Cuta muul b~ ~r~cltlcQlly Approved by tIle
I IIt;pa:Cl ur .
l'ilVl!me'J1r"4Y u~ C~t tor undaeqrounl.1 ioutolllll ionll alia ..Ult be re&itor"d In aCCOeiJ.."ce ..un
the UtllltV Trcnch Rc~torlltlon Standard Drowing.
W~r'" [0 Ot &itAkcd by · liccn~cd LAnd Suevcyoe or Civil Englneee and two (2) coplc~ ot tilt
cut .hee:t~ IItlll to lhe: Pul.l!Lc WOrk Dept. betore: ItArtlnlJ ..or....
The: t.ourll ot won oee Itmited to outlalde: the hour. ot 1-!j a.m. ana )-ll p.lI. toe <loy ~OCll.
Attectlo~ a trattlc Ian..
2.
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l't:kHIT AP~LICATION rEK
PL4N CbECK DEPOSIT
UONO rOlt I'AITIII'UL PE/tI'OIUU..NCE
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STANOAkO
AHOUN'r
kI::Ct:JPT NO.
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1100' 01' ENG. ~ST.)
t. P. ICASU) Dt~SIT
PEHHIT rEt:
(~2001 (., 0.. UONO,~~OO MJN)
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APPliOVEO fOR ISSUANCE
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