88-187
CITY OP caMPBILL
DBP'l'. OP PUBLIC WORD
70 Horth pirst st.
c..pbe11, CA '500a
(408) 866-2150
PUBLIC WORD PBRMIT
(for workinq in the
public riqht-of-w.y)
I..ued f ~I Cf ~&>9
pera! t ezp res I n 12 aos.
perait No.
88-137
X-Ref. file
Applic.tion D.te zLl if 2 (;
Applic.tion asp es'ln 6
aos.
APPLICATION _ App11cation ls hereby ..de ror a Pub11c Works Permit in accordance with c..pbell
xunicip.l code, section 11.04. (Applic.tion expires in 6 aonths if perait not pulled)
A. Work address or tr.ct . N. S. Hacienda - 100 Ft West of Sonuca
utility trench location
B. Nature of workl Locatinq and reDairino oas lenks
C. Attach flve (5) copies of a drawinq showinq the location, extent and di.ensions of the work
The drawinq shall show the relatlon of the proposed work to exlstlng surface and underground
iaprov..ents. When .pproved by the city Bnqineer, said drawinq beco.es a part of thls perait.
D. The General Conditions for all peraits are listed on the reverse side. speclal pJbvislons for
this permit are listed below. r.ilure to abide by these conditions and provisions ..y result
in job shut-dOwn and/or forfeiture of raithful Performance Bonds and cash deposit.. (See
Gener.l Conditions 1 and 2).
B. AD application fee .ust acco.pany this application. This is non-refundable.
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N_e of Applicant Pacific Gas & Electric
Address 10900 N. Blaney Avenue, Cupertino, CA 95014
Is this work beinq done by the property owner at their own residence? ---yes ___no
Telephone I 725-2114
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Complete and attach Workers' compensation and contractor Information forms.
The Applicant/permittee hereby aqrees by .ffixinq their siqn.ture to this permit to hold the city of
c_pbell, its officers, aqents and employees free, safe and harmles8 from any clai. or demand for
d..aqes resultinq from the work covered by this permit.
The Applicant/peraittee hereby acknowledqes th.t they have re.d and understand both the front and
b.ck of this permit, and that they wlll lnform their contractor(s) of the information.
ACCEP'l'ED
NOTBSI ALL WOU SHALL COlflPORJ( WITH 'l'BB ATTACBBD, APPROVED PLAIIS UD ALL APPLICABLB CAKPBELL
STAIIDARD DRAWINGS AND CONDITIONS.
'l'BB COIl'rRACTOR MUST DVE THIS I'BRKIT UD APPROVED PUBS UD MUST HZBT WITH TBB I'.W. IIISPBCTOR ON
'1'BB SITI AT LBABT TWO DAYS BlrOR! STARTING WOU.
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NOTICB XUST BB GIVEN TO PUBLIC WOJUt8 AT LBUT 24 BOORS BBNRB RBSTARTIIIG AllY WOU.
_3.
street shall not be open cut for underground inst.ll.tions. Kini.ua cuts .ay be allowed
for connections or asploration holes. SUCh cuts .ust be specific.llY .pproved by the
Inspector.
P.vement aay be cut for underqround inst.llations and .ust be restored in accordance with
the utility Trench Restoration Standard Drawinq.
Work to be staked by a licensed Land surveyor or civil Inqineer and two (2) copies of the
cut sheet. sent to the Public Work Deptartaent before .tartinq work.
The hours of work are liaited to outside the hours of 7-9 .... and 3-6 p... for any work
affecting a tr.ffic lane.
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SPICIAL PROVISIONS
_1.
/2.
APPROVED lOR ISSUAIICE
t" or r.p. BOND, $35 XIN)
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_4.
_5.
PERMIT APPLICATION rll
(R-1)
($35.00)
STANDARD
AKOUlIT
$ .,SD. 00
$
$
$
$ $5-00
RECIIP'l' NO.
CASB DEPOSIT
('200.00)
$50.00
$500.00
(100' or BNQ. EST.)
(4' or BOND, $500 KIN)
Q
PLaB CRECK DEPOSIT
BOND roR I'AITBlOL PBRNRKAIICB
PBRMIT rBB
Date
ror