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CITY 01 CAKPbfLL
D~PT. or ~UbLIC WOkK~
'0 Noeth 'leat Mt.
Ca.pb.ll, CA ,~OO.
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88':'157
PUbLIC WOM~S P~kKIT
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Applicelton O.t. 6/3/88
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APPLICATIOH - Application la beeeby .ade ror . 'wbllC Work. 'IIr.lt in accoedanclI with Caa~bel1-
"wnicipal Cod., lI.cUofl 11.04.
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~. Woek addee.. or tract .
Utility tr.ncb loc.tion
It. Hatwr. ot worll: .
38 Mission 125' wlo Winchester
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Emerqency main repair
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Attach tlv. f~1 Copl.. ot a drawing ahowlng tb. location, ..tent and d!aenalon. ot the woek
The dr.vlng atlell .bow the r.l.t10n of the propo..d work to eXletln9 euetece aod underground
L.proveacnt.. When .pproved by tb. City Engin..t, a.id drawing b.co... . part 01 thle pee.lt.
Tne Gener.l COodltione tor .11 per.lta .re 1lat.d on the rev.rae alde. SpecIal Provlelona toe
thi. per.it .u H.ted below. Palluu to abide by then condit lone and peovlalona ur. eeliw!c
in 10b ahut-down .nd/or tort.Leul. o. '.lth'u1 'eetoe.ance b~od. and c..h depo.lt.. See
G.neeal C~odttlone 1 and ~,.
E. An appl&c.tlon '.e llIUat acco~pany Chi. application. Thl. I. non-ee'undable.
Hellle ot Applic.nt San Jose Water Co. Telephon.:
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I. thi. wock beln9 done 'by the property owner at thei, ovn feildcnce? ___Y.. no
Coaplete att.Ched WOlkee.' Co.penu.tion and Contractor tora..
The Appllcent/~cr.lttec hereby .gee.. by .tfixin9 thelr .'~n.ture to thla perait to hold the eler 01
ea..pt..:ll, It. olllcee., .I)eote and ...ploy.e. free, A;at. .nd harale.. tl~. aoy claL. oc delllal,d tor
de..g.:a le.uHJn'J teo... the wOlk COVered by chL. per.-lt.
The A~~lJcaot/PelaLttee hereby .Cknowledgea th.t tbey have r.ad and underetand both tbe tronc ana
baCk ot th~' pel.it .nd that they will lotor. their conte.cturf., ot the lnfor..cion.
ACCt:I'Tt:D
<<PP&lcant lrCIllIlttee,
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MOTtS: ALL'WOkK 511ALL CONI'OICK WITtt THt An-ACHED, APf'ICOVtD PLANS AND ALL A....LICAbLJ: CA"Pbt:LL
STANDAJtD DHAWIN~S AND CONDITlUH~.
Tile CUNTkACTOk "UST IIAVt: TillS PI::ICHIT AND APPkOVt:D PLANS ANII "UST H1:I::T WITH THE P.W. INSf'J:;C1\)k ON
Tilt: SITt AT Lt:~T 'l'WO DAYS 1lJ:;10k1: STAJtTING "OiK.
N01'lCE "U~T Ilt: CJV&:N TO PUbLIC WORKS AT LEAST 24 HOUkS b2YOkE RESTARTINC ANY WORK.
S~ECIAL PROVISIONS
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Steeet A;hall not be open cut for undergeound io~t.llation'. "Inl..u. cwt. .ar be .llu~ed
toe conllection:> oe caplorAtion bolell. ~uch CUt. .u..t be .Pt"ClI1Cally approved by rhe
llIlOr-ecl",r.
PiV1.~.ay be cwt tor undcrqrouna tnllt.ll.tion. And .uat be ec.tored ln accora.nce WltR
the Utll1ty TrenCh Mc~toratlon Standard DrAwing.
Wurk to be .t..cd by · l1ccn.cd Land &urveroe 01 Clvil Eoqln.ee .nd two (21 COple~ ot the
Cut .hecla lIelll to lhe I"ubllc "oell Dert. belore at.rting work.
TI~ houra ot ~or. are Il.itcd to out. de the houe. ot 7-~ .... .nd J-' p... tOr .ny woe~
.tt.ctin9 a trattic 1.n..
~~ 4 Ja=.,r,c.A cE TJlE r;^,77~E ~l~~S&:"D ~..eE'A CA-UJ;~ ~ 7N€ W~
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~~RMIT A....LICATION 11:1
,LAN CU&CK PEPOSIT
ItONU ..Ok rAlTlIl'UL PtICI'OkK.AHCt
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ST...DAIID AltOUNT
5~O.OO 5 50.00
$~OO.OO I
noo, 0' EIlIC. tf>T. I $
fn or ~ND.$~OO HINI $
fl. 0' ".1'. !tONO h#IVe..l>
IH.OO HIN) $
($200)
Pt:lon'J' I'&t:
APPkOV&:D 1'0k
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