88-143
..... C'" n(Jq "'tI pog
"'~:TI1~~
~~~g~11
oJ ....::s....cn
"::l~rt~
,.. ::l .0 n
i"rt!:CII...rt
~"""(lfA.....
:., ~ ~ ~ ::l g
~~ ...0
~ ...nrt~
~:T::l ~ N
~ ~.. < .....
11 ~ 1lI-..j
.. ::l >.....
Onpo.l.....O
-I::l ..... ~....
... .. ~ t1
') """'Hlrt
,. n O:T
ttCIb-....tD
'CllrtC
>"'CII~C'l
~ O>XO
) "'C ::s - n <
:T III ~
0::l:T<'1
;6~~5
'.0"' ..... CD
.. 0' 0 ::l
'1 ~ ::l rt
~ ..
""'::l C"l
>-I !: 0
"'::l ::l ~
nOrt~
1';"rt...
CD.........M
rt.... :T
"'C...
Z ~ ::l ..
O~~
. ~
......0011
::l 0
:T~
III
..
VlO"lOO>-l
rt .... 0 ::l '1
00 < 11 ~ ..
r1' tJ. ='
l1>> en a,... n
...."<l..:T
o 0 I1l
"'::l~~~
:')0...>-1....
~ H) n (I
~ .....rt
:;;;'g~'<
)~ l"":T
1 C Pl ..... III
IIlXPlIll
o. rt n 0
I '1 III ::l
..... < .: 0
Cb CD ..... n
~"""nn
o ~:TO'
I :0. I1l
I1l rt I1l
.. to-" n ::r:1l
I SU 0 .....
n :s In n
..... rt :T
o 00 "Cl I1l
::l n I1l n
) III ~ ~ ~
.... ~.
CITY OP CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 860-2150
Perai t No. r~h'- t!::f ~~
X-Ref. file
Application Date L-{ -'~i - P,P
l~ .08. expires 1n Q .
Works Permit in accordance with Campbell~
~
o
tl:l
t'l
()
o
3:
'U
L'
t'l
~
t'l
o
tl:l
>-<:
~
::r::
t'l
PUBLIC WORKS PERMIT
(tor worK1n9 In tne
public right-at-way)
.:.0 I i yo
Issued ..../ /"''/6"0
Permit exp1U~8 1n
APPLICATION - Application is hereby aade tor a Public
Municipal Code, Section 11.04.
A. Work address or tract' 219 Dillon Ave.
Utility trench location SDli41E86818
B. Nature of work: Install utilities as indicated on the attached sketch.
C.
Attach five (5) copies of a drawing showing the location, extent and di.ensions of the work
The drawing shall show the relation of the proposed work to eXisting surface and underground
improvements. When approved by the City Engineer, said drawing becomes 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 jab 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.
Name of Applicant Pacific Gas and Electric Company Telephone: 973-8930
Address 10900 N. Blaney Av~ Cupertino, CA 95014
D.
>'
'"0
'1:l
L'
H
()
>'
z
~
Is this work being done by the property owner at their own residence? ___yes no
Complete attached Workers' Compensation and Contractor for.s.
The Applicant/Permittee hereby agrees by affixing their signature to this perait to hold the City of
Campbell, its officers, agents and employees free, safe and har.less from any claim or demand for
damages resulting from the work covered by this permit.
eby acknowledges that they have read and understand both the front and
at they will i m their contractor(s) of the information.
ACCE
4-28-88
uate
NOTES: ALL WORK SHALL CONPORM WIT
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 BEPORE STARTING WORK.
AND ALL APPLICABLE CAMPBELL
NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEPORE RESTARTING ANY WORK.
SPECIAL PROVISIONS
t-:1
C)
1.
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 in accordance with
the Utility Trench Restoration Standard Drawing.
Work to be staked by a licensed Land Surveyor or Civil Engineer and two (2) copies of the
cut sheets sent to the Public Work Dept. before starting work.
The hours of work are limited Go outside the hours of 7-9 a.m. and 3-6 p.m. for any work
affecting a traffic lane.
tl:l
tlJ
~2.
()
C)
3:
''0
l'
t':l
t-:1
t':l
o
_3.
4.
5.
tp
>-<:
t-:1
::r::
t'l
PERMIT APPLICATION PEE
PLAN CHECK DEPOSIT
BOND FOR FAITHFUL PERFORMANCE
(R-l)
($3S.00)
()
H
t-:1
>-<:
STANDARD
$50.00
$SOO.OO
(100\ OF ENG. EST.)
AMOUNT
$ ~. c::C:::>
$
$
$
RECEIPT NO.
Cf'
P. P. (CASH) DEPOSIT
PERMIT PEE
($200) (4\ OP 8OND,$500 MIN)
(7' OF P.P. BOND
~i1 - $35.00 M'N)
~_~r;L~~
$ ?~. C;)(;.:;>
c.'.-'
,...
~~
APPROVED POR ISSUANCE
<;"".- l s -<e~b
R E eEl V E D uate
APR 2 9 1988
f: PWPERMIT
Revised 7/87
Pultllc Works Administration
(16) SKETCH
"Z/Cj
CONSTRUCTION COORDINATING DETAIL
FIELD COORCINATOR'S NAME
TEL NO.
ENGINEER'S NAME
(17) (.(. L\-\-~Q..LTDN
Cf70 -S930 117)
L. \Ll t\.\u-
_rEkp //;- ~K2:- 7[/-1
c / /:/ q- L/J////~=~/,/
/ / c...:....._-<--
'. !,,~"" .,.~.... .,. --.... ,-".... ~
/^ p. 0 (..... ".,', l. ... :..
J-\ .; j ~-... t .~ v~ '{j ~~ ~::, ~';'~';
-.
... "'"
'<-
'7&--16 10 f~LH
O~~~Ii~ FO~
~lXUl ON l.,,,/.
tUiJI. fa T~~tH
ON -?\\~. .
[~("I'- fC~
LJ ~ Q~ rz.6 ~..tJD
CON ov r~
4l~B&61'b
TEL NO,
1ZS-- 7l:F.:J 7
(:
'l..... .
,0"." t'" ~'. ! n...... T'~. l J C" 'r't P'\ N.
,\ j j",.\ ~~') ~ ~ .;~I" ~.,~.' ',." ~..
.. '.. 'I
,l
Public 'v\/cr:
L- z...., ~ ~ ~ : J ~
Co.,;~.t:::'::.::n must h'7vf2 these p!ar~s
on the job' site during construction",
elf -/</3
4JZ.~;2'