88-153
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CITY OP CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell! CA 95008
(408) 860-2150
88 -/~i~
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PUBLIC WORKS PERMIT
'tor worK1ng 1n ~ne
pUblic right-ot-way) X-Rete tile
Issued <:;. ~ ~ J' Application Date $Uf:!P:l
Permi~ e. r~ 1n l~ mos. expires .
APPLICATION - Application is hereby made tor a Public Works Permit in accordance with Campbell-
Municipal Code, Section 11.04.
Per.it No.
A. Work address or tract .
1387 Camden Ave.
Utility trench location SDlf41G66917
Nature of work: Abandon- - utilities as indicated on the attac:nen sketrn.
Attach five (5) copies of a drawing showing the location, extent and diaensions 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 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.
Name of Applicant Pacific Gas and Electric Company Telephone: 725-2114
Address 10900 N. Blaney Ave. Cupertino 95014
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Is thia work being done by the property owner at their own residence? ___yea no
Complete attached Workera' Compensation and Contractor for.a.
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of
Campbell, its officers, agents and employeea free, aafe and har.leas from any claim or demand tor
damages resulting from the work covered by this permit.
:~~~:~~~~:~~~~n~l~o~:ith~~~Yc~~~n~::~(:~do~n~~~nl:~~r:::~o~~n front nnd
ACCE . foot 7e May 26, 1988
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NOTES: ALL WORK SHALL CONPORM WIT 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 BEPORE STARTING WORk.
NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEPORE RESTARTING ANY WORK.
SPECIAL PROVISIONS
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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.
~llvement: may be cut for underground installations and must be restored 1n 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 aheets sent to the Public Work Dept. before starting work.
The hours of work are limited ~ outside the hours of 7-9 a.m. and 3-6 p.m. for any work
affecting a traffic lane.
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PERMIT APPLICATION PEE
(R-l)
($35.00)
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STANDARD
$50.00
$500.00
(100\ OP !NG. EST.)
AMOUNT
$ ~. c.:c.::>
$
$
$
RECEIPT NO.
PLAN CHECK DEPOSIT
BOND FOR FAITHFUL PERFORMANCE
P. P. (CASH) DEPOSIT
PERMIT FEE
($200) (4\ OF BOND,$500 MIN)
/ (7' OF F.P. BOND
&i",~;;-~ MIN)
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APPROVED POR ISSUANCE
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Reviaed 7/87
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