88-141
~ .. ~~ ~ ~ :
g~.~~t1
- ..... ~ _ VIo
· ::l "" n .
O\:J.ll n
&-- n eVIl..... n
,...., . ..... . .. .....
,:,. ;: ~ :J ::J g
t:&4r-~~,",
t-:r:Ja N
~f:"~~
.. :J ,. ....
On_.....o
~ :J t- . "" ......
- .. ". t,
n ......O,...n
K" 0 O:T
. c........" .
nVinc:
>- ..- V), .. ()
"'" 0 > " 0
0"'0 :l ....... n <
.:y " "
o ;l ::r < "
~ (~ :: ~ ~
.. (T ,....."
.. (1"" :J
'l . :J n
.. ..
- :.J C)
>-I ""
,.... ;J ~ C"",
nOn III
~- " ......
......r-n
n r... :r
,.... c t~.
-..t;. I1t ::a ~
o n. r.l..
..
........ ... '1
:J '
::rCo.
..
..
-VlO~.f""'i
... n ,.. 0 :l "
ng"<'1Q.,,
~ n roo :J
- . 1lI .,.... n
,....."U.;:r
~ 0 () II
~"':JJ6~
C)o '-r1n_
~ liW ,... n '"
".-. - n
;~::;::~~'<
c.n, ......J
j ~ ~.:;; :;
- n n 0
.. '1 ~ :J
. ,- 0( e: 0
.. ~ ,..... n
V)_nn
.. ..::ru
j :.u. .
.. n..
L...o-n:;r;.l
o .. CJ t-
'" " :J '" n
· ..... n ::r'
. 0... ~ .
::J n _ n
~..L; ~.~ ~:-
....Co.
... n
'-'
..
CITY 01 CAM~bfLL
D~PT. or PUbLIC NOkK~
10 North 'ir.l al.
CAmpb.ll. CA >>~OO.
140111 llh-21~O
VERBAL - EMERGENCY
88~14l
..j
PUHLIC NORKS P~R"IT
Tf1JrVGrrnrr,-rn-nre
public r1Vht-ot-way)
d~ 4 4/21/88
luued 't.2...2 46" ApplicAtlon DUe
fer.ll: .. Ir.. n I~ ..0.. ..pir.. ~
APPLICATION - Appllcallon la h.r.by .ade for a PUbllc Work. f.ralt ln accordanc. wlth Ca~pb.ll
Municlpel Code, iection 11.04.
Per..lt No.
X-ket. t1 Ie
~,
['
I,
...
'[1
1. Work addr... or tract .
Ut111ty trench location
I
(,
121 South Third @ Rincon
[',
c
16.
Nature ot work; Emerqency gas leak at service
Attach tlve I~I Coplea ot a draw1ng .how1ng the locatlon, e.tent and dlaen.lon. ot the work
The drawln9 .hall ahow the r.lat10n ot the propoD.d work to ell.ting .urtace and underground
1I11provement.. Wilen approved by the City tngln..r, .ald drawing b.comeA A part ot thi. peralt.
Tne General Condltion. tor all permlt. are Ii.tod on the reVerBe .1de. Speclal Provl.10n8 tor
thi. perait Ar. 11.ted below. tailure to ablde by the.. condltlon. and provislon8 lo4y rCMule
ln lob .hut-down And/or tortehure ot ra1thtul Pcrtormance bond. and ca.h depollle~. l~cc
Goneral Condltion. 1 and 21.
t:. An appllcatlon t.e mual accompany thi8 application. Thl. 1. non-rutundable.
U'
C'
~:
::
['
D.
~,
't
'to
"
(,
).-
Name of Applicant
Addreliu
PG&E
Cupertino
Telephone:
18 thi. Work be1ng donc'by the property owner at their own re~ldencel ___Y.j no
Complete attached Worker.' Compensation and Contractor lor...
The Appllcanl/~ermlttee hereby agree. by affiXing thelr 'lgnaturc to thi. permit to hold the City ot
Can,poell, it.. ottlCella, Agent II and e.'ployeclI free, "Ate and lllaclllellla tram Any elau. or demAfld tor
aAIIlAI)t:A rClau1tln<j tro/ll the "'ark COvered by thl. perI/lIt.
'J'lIe AppllC4nt/l'crlllttce hcrcby aCkno"'lcdgeli thAt they hAYC read ana under.tAnd both the trone and
bACk ot thi,6i peClult a,ta that they wl11 Intorm thc:11 COotrACtolll" of the Information.
ACCt:PTLD
~PllcAnl: lyelwltteeJ
IIUe
NOTtS: ALL 'WOflK SIlALL CONI'0lH1 WITIJ THe A'M'ACtlED, APP/tOllIW PLANS AND ALL APl'LICAbLt CAI1Pb~LL
~TANDAkD DRAWINGS AND CONDITION~.
Tilt: CONTRAC1'OR MU5T 111.111:: 'fillS PLflKIT AND APPROIIEO PLANS ANlJ I1UST I1LLT WITIJ TilE P.W. IN5PJ;;C1\Jk ON
Tilt: SITE AT Lt:A5T "WO DAYS HHOkt: STAItTING WORK.
N01'ICt: I1U5T HL GIIILN TO PUbLIC WORKS AT LEAST 24 HOURS bEfOflE Rt:STARTING ANY WORK.
SPECIAL PROVISIONS
"
r
-'
1-
-
Street ~hall not b~ open cut tOr underground ln~t~llation~. "lni~u~ cut. may be allo~ed
tor connectlons Or exploration holeb. SUch CUl~ mu~t be ~peclflcally ~prrov~d by lhe
Jllt;po:clur.
PilVllmenrll6Y be Cut tor underground lnlitAllat ione And IlU8t be rClitored ln Accord4ncc WHll
t he Utility Trench Rc~tor.t Ion Slandard Ora"'lrlCJ.
Work to be ataked by a lLcen~cd LAnd Surveyor 01 Civl1 Engineer and two 121 Cople~ ot the
cut eheclll lIent to lhe PutJltc Work Dept. bctore atart ing work.
The hour. ot work are HOlited to out~lde the hour. ot 7-!I a.m. ana J-ll p.lI. tor any won,
aftecting . tlAtjlc lane.
'l,
( ,
[1-;
u;
1'_
V2.
J.
-
~
-"-
t.
-
~.
(lJ
G
u
PEkKIT APPLICATION PEK
PLAN CHECK DLPOSIT
Ill-I)
HJ:l.OOI
r
r-
1$2001
ST AlWARD A"OUNT REC~IPT NO.
~~O.OO ~ "-
~~OO.OO ,
000' OJ' I!:NG. tliT. I ~ -
In OJ' BOND,~:lOO MINI ~
....::
(I.
BONO YOk J'AITIII'UL PERI'ORKANCE
Y. P. ICASHI DtPOSIT
PER"IT I'E~
11& or I'.P. bOND
~~~.,.,
~~~. ~ <p
4 -<,-,~ -~ "e::>
UAl:e
oj?
C@
4j}I!e8
APPROVED I'OR ISSUANCE
t: PWP~IUlIT
lIevlud 7/1J7