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CITY OP CAMPBELL
DEf1. OF PUBLIt WORKS
10 North First St.
Campbellt CA 95008
(408) 860-2150
Perlli t
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PUBLIC WORKS PERMIT
,ror worKln9 in tne
public right-ot~- ay) X-Ret. tile
I&8ued ~~2-~~8' Application Date , /2-/otKtf
Permit ex ire in l~ aos. expire. in Q ..
APPLICATION _ Application is hereby made for a Public Works Permit in accordance with Caapbell-
Municipal Code, Section 11.04.
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A. Work address or tract I Llewellyn Ave & H<Jmilton
Utility trench location Campbell, California
B. Nature of work: Install utilities as indicated on the < - .,
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Attach five (5) copies of a drawing showing the location, extent and di.ensions of the work
The drawing shall ailOW the relation of the proposed work to eXisting surface and underground
improvements. When approved by the City Engineer, said drawing become. a part of this permit.
The General Conditions for all permits are listed on the reverse side. Special Provisions for
this permit are listed below. Pailure to abide by these conditions and provisions may result
in job Shut-down and/or forfeiture of Paithful Performance Bonds and cash deposits. (See
General Conditions 1 and 2).
E. An application fee must accompany this application. This is non-refundable.
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Name of Applicant PACIFIC GAS & ELECTRIC
Address 10900 N. BLANEY AVE, CUPERTINO 95014
Telephone: 973-8930
I. thi. work being done by the property owner at their own residence? ___yes no
complete attached Worker.' Compensation and Contractor for...
The Applicant/Permittee hereby agree. by affixing their signature to this per.it to hold the City of
Campbell, ita ~ff~ce~~, agent a and employees free, aAfe and har.l... from any claim or deaand tor
damage. reaultln~from\the work covered by this permit.
The APplicant/~rmi~~~ hereby acknowledges that they have read and under.tand both the front and
back of this p~.rr, and that they will inform th~ir contractor(s) of the information.
ACCEPTED DA~p~!~~~~F~~~l'mlttee' Febru:a~ 19, 1988
MOTES: ALL WORK SHALL CONPORM WITH THE ATTACHED, APPROVED PLANS AND ALL APPLICABLE CAMPBELL
STANDARD DRAWINGS AND CONDITIONS.
THE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AND MUST MEET WITH THE P.W. INSPECTOR ON
THE SITE AT LEAST TWO.DAYS BEFORE STARTING WORK.
NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEPORE RESTARTING ANY WORK.
SPECIAL PROVISIONS
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Street shall not be open cut for underground installations. Minimum cuts may be allowed
for connections or exploration holes. Such cuts must be specifically approved by the
Inspector.
~.vement may be cut for underground installations and must be restored 1n accordance with
the Utility Trench Restoration Standard Drawing.
Work to be ataked by . licensed Land Surveyor or Civil Engineer and two (2) copies of the
cut sheets sent to the Public Work Dept. before atarting work.
The hours of work are limited ~ outside the hours of 1-9 a.m. and 3-6 p.m. for any work
affecting a traffic lane.
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PERMIT APPLICATION PEl
PLAN CHECK DEPOSIT
BOND POR PAITHPUL PERFORMANCE
P. P. (CASH) DEPOSIT
(R-l)
($35.00)
STANDARD
AMOUNT
RECEIPT NO.
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$50.00
$500.00
(100\ OP ING. EST.)
PERMIT PEE
($200) (4\ OP BOND,$500 MIN)
(1\ OP P.P. BOND
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APPROVED POR ISSUANCE
D
FEB 22 198B
f: PWPERMIT
Rev;.aed 1/81
Public Worb Administration
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CITY OF CAMPBELL
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST STREET 95008
RECEIVED
AUG 21988
PUBLIC WORKS
ENGINEERING
/tUG 0 1 1988
Bond No.: 1150186
Subdivider: ROBERT EMAMI AND CHAO WU
Tract No.: *
Amount: 17,700.00
D~:~~~~;~~~t~~ STREET IMPROVEMENTS TO 3675 S. BASCOM AVE.~~:r~ ~-IIS-~
CAMPBELL, CALIFORNIA
AMWEST SURETY INSURANCE COMPANY is Surety on the above captioned
bond. We would appreciate your cooperation in providing the
information requested below. Please return the form to us so that
we may have current status information on the above captioned
improvements. A postage-paid envelope is provided. Thank you
very much for your assistance.
1.
Have the improvements been completed?
Yes "./' No
2.
If not, what percentage has been completed?
Is the work progressing satisfactorily?
).-0 %
3.
./' Yes No
4.
Has this work been accepted?
Yes ~ No
5. ~f not, what is the anticipated date of acceptance? /P~~
Comments: (~'^ ~ ;(6'M/'),;:~/ /',v tfr"/'c-cr
Above information provided by:
Name ~~6G,. E:4-ra.-J
Ti tIe ~8ui:. t/~1C.5 .:ziJs/.
Phone No. (40B) BG' -2/SO
Date P/z-/8B
F30 6/87
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CITY OF CAMPBELL
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST STREET 95008
OCT 0 1 1988
Bond No.: 1150186
Subdivider: ROBERT EMAMI AND CHAO WU
Tract No.: *
Amount: 17,700.00
Description of
Improvements: STREET IMPROVEMENTS TO 3675 S. BASCOM AVE.
CAMPBELL, CALIFORNIA ~:,-'*- BIB -115'
AMWEST SURETY INSURANCE COMPANY is Surety on the above captioned
bond. We would appreciate your cooperation in providing the
information requested below. Please return the form to us so that
we may have current status information on the above captioned
improvements. A postage-paid envelope is provided. Thank you
very much for your assistance.
1.
Have the improvements been completed?
Yes
......- No
If not, what percentage has been completed?
S\
2.
3.
Is the work progressing satisfactorily?
.............. Yes No
Yes ......- No
4.
Has this work been accepted?
5. If not, what is the anticipated date of acceptance? ~~C9t.A.M.J
Conunents:
6..0~7', -rD
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~1V1A-'1 AJ I^, EPF E"C-"1
Above information provided by:
. .
Ti tle JB.AL,'f: ~oICIC~
-
LrJsc>,
I
Phone No. (~,q&" -2/50
Date /~/~~~
Name
/' _ ;:::::- ~. J
(~~b S=~
F30 6/87