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CIT\ 0' CAKPbtLL
D~PT. or PUbLIC WOkK~
10 North 'lret ~t.
Campbell, CA >>~OO'
C .Ob I IIh-;H ~O
PUbLIC WORKS PEkMIT
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Pee.it Mo.
X-ltet. tlh
Appl1catlon Oat. 2/25/88
..plr.. ~
APPLICATIOH - AppllCatlon la hereby .ade tor a P~bl1c Work. faralt In accordance _lth Caa~ball-
Munlclpal COda, JI.Ct 10n 11.Ot.
1. wOck addU.. or tract. Milton Ave. w/s 3' n/s PL Latimer
Utillty trench lOCatlon
Ia. Nat~r. ot ..or II ; .
C.
Broken gate valve
Attach tlva I~I copl.. of a dra..ing .howing tho location, ..tcnt and dlaenalon. ot the _Ock
The dravln9 aball ahov tha relation ot the propO..d ..ork to ..l.tlng aurtaca and underground
i.prove_ent.. When approvad bW tho City Engineer, .ald drawing beco... a part 01 thl. perait.
Tne General Condition. tor all permita arc 11.tod on tho revec.e 11de. ~pcClal Provlaiona tor
thla permit are ll.ted below. tal1ur. to abide by theee conditione and provialon. ..y reeylt
In 10b .hut-down alid/or torteiture ot Falthtul PertormAnce bond. and Ca.h depoolt",. ISce
Gonerel Condltlon. 1 and ~I.
t. An appllCatlon toe mu.t accOIDpanw thi. application. Thi. 1. non-rotundable.
D.
NAIDe ot AppllcAlit
Addecau
1. thi. woek bein9 donc'by thc property owner at thelr own re~ldcnCe? ___y.. no
SAN JOSE WATER CO
Telephono:
Complete attachod WOckera' Compen.ation and Contractor tor.a.
The Applicant/Permittee hcrebW agroo. by att~.in9 thelr .i~nAture to thia permit to hold the City 01
CallIPtu:ll, h. olflcerlio, a'lent. and e..ployee. tree, ..ate and har8l1e... troAl anw clan. Oc delAA1"j tor
dAI,u.90:. rCliou1tln';j tro," thc work COvcrod by thi. perlltit.
'J'he AppllCAnt/pcr..1ttee herebw aCknowled<Je.. that they have read and UnderlltAnd both the tront and
baCk of th~i perNlt al~ that they -111 Intoc. thell contractorltil ot the lnlormAtlon.
ACCt:I'TCO
~PJlCant ,refulrree,
IIffe
NOTtS: ALL 'WORK SIlALL CONI'OkH WI1'U TUt ATTAC"ED. APPkOVtD PLANS AND ALL APi-LICAbLt CMtPb~LL
STANOAkD DliAWJNCS M40 CONOI'I'ION~.
Tilt: CONTkAC1'Ok "US1' UAVt: 'rillS Pt:kHIT AND APPROVt:D PLANS AHO KUST "t:t:T WITH THL P.w. IN:)I't.:CWk ON
Tilt: SITE AT Lt:^ST 'l'WO DU!> ljl;;10kt: STAJtTING WOaK.
N01'JC1: "U~T DE GIVt:N TO PUbLIC WORKS AT LEAST 2. HOUkS btrOkE kLST^RTIHG ANV WORK.
S~t:CI^L PkOVISIONS
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Str~et .11411 not be open Cut tor underground InatAllation~. "lni~um CutM mAW be alluwed
tor connections oe exploration holeM. Such CUt~ mu~t be ~r~citlcallV approvrd bV th"
lutip"ct..,r.
pava~e~r-.4W be cut lor und*c9round InMtallatiooa alld .uat be re~toced In accoca4nCe wlth
the Utllhw TrenCh Jtc:titoratlon Sl4ndard Drawilll).
Work to ue *tAked by a llcen.c:d LAnd Surveyor 01 C1vl1 Engineer and two 121 COpies ot the
CUt .lIeu ~ 1I1:lll to the Puul ic Work Dept. belore atart ing work.
The r.our. ot" WOrk are llllited to uut..ldc: the houre ol 7-!j a.lII. and J-tl p.lI. tor IlnW WOCk
atfectln~ A (raftic lano.
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~t:RHIT APPLICATION ,t:K
PLAN CUECK DEPOSIT
~Hj) 'Ok ,....ITIII'UJ. PEkl'Oltl'l.ANCE
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C$J~.OOI
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$
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CI00. 0,. ENG. tST.1
AHOUNT kt:Ct:IPT ~O.
,. P. (CASU) D~POSJT
Pt:RftIT t't:t:
C$~OOI Ct, 01 ~NO,$~OO HINI
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APPkOVED t'Ok lSSUANCt:
t: PWPtkttJT
ltoVillod 7/1J1
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SJW SURFACING REPORT
CITY C:;'gi// SJ No. 25431
PERMIT ~~-- // / DATE 2-':?'.:(-Qg
CONTRACTOR ~~~V c;>.M'ii- CF~~TE~::OR
S.I.O. or EST. No. 76/00 I~;~ECTOR-=-~' @
PURCHASE ORDER No.
LOCATION ..:3 '//...~iI /7P ,,'i:-L/l-/j ~ u:.,~0.T LriTiA7iZ6
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/ ~~r <!Or 1k'e~5-t
DESCRIPTION
(SHOW SIZE, STREET
NAME, LOCATION &
SHOW NORTH BY . I
AN ARROW.) ---.J
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AC ,t!( CONCRETE 0
DEPTH IN .// ,I
INCHES ~
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ROCK 0
(ACl
(CONCRETE)
(ROCK)
OIL & SCREEN
o
TAMPING 0
o
(OTHER)
NEW CONSTRUCTION 0
MAINTENANCE .
SURFACING CREW FOREMAN
DATE
FORM 55C - REV 5.88
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