88-209
CITY OW CAMPBELL
DBft. OW PUBLIC WORD
70 Hortb Wirst st.
Caapbell, CA '5008
(401) a"-2150
Perait 110.
'X"g-2.oC;
EIICROACHMENT PERMIT
(for vorkinq in the
public riqht-of-vay)
I..uad / tJ.d3/ j f
parait &Kp e. in 12 ao..
x-aef. fila
ApplicaUon Date d I 7 /~T.9
Application &Kp es id , ao..
APP~ICATIOH - Applioation i. bereby ..de for a Public Work. perait in aooordanca vitb c..pbell
Hunioipal Code, Section 11.04. (Applioatio~ expira. in , aonth. if perait not pullad)
A. Work addrass or traot .
Sb3 ~ 52 L~.j( I Nee' 1\)
Q\Je..
B.
utility trenoh location
Hature of vorkl ( I 0--
Attacb five (5) oo~.~o~t(:i-~1Df~fow nq~'ihr; l~cfit~n, ex ~nPi'n1~e~!tza~'-1 tbe work
The dravinq .hall .how the relation of tbe propo.ed work to exi.tinq .urfaca and underqround
iaprov..ent.. Whan approved by the City Bnqinaer, .aid drawinq becoae. a part of thi. parait.
D. The Oaneral Condition. for all perait. are li.ted on the rever.e .ide. special provi.ion. for
thi. parait are li.ted below. Wailure to abida by the.e oondition. and provi.ion. aay ra.ult
in job .hut-down and/or forfaiture of Waithful Parforaance Bonds and ca.h depo.it.. (8ae
Oanaral Condition. 1 and 2).
C.
B. AD application fee au.t accoapany tbi. application. Tbi. i.
lI..e of Applioant Co~ l L-l. ~a.,) P,o r- r tl <-5
Addre.. ~S() ~ Co w.~~ll (1l;f' ~()~f6ell
I. tbi. work beinq done by the property owner at tbeir own re.idence?
non-refundable.
'!'elephonal 377 7 ;;;..L./S
rn qsoo'X
_yea V no
coaplete and attach Worker.' coapensation and Contractor Inforaation foras.
Tbe Applicant/Peraittee bereby aqree. by affixinq their siqnature to this perait to bold tbe City
of
C..pbell, it. offioer., aqent. and ..ployea. free, .afe and barale.. froa any claia or daaand for
d..aqe. re.ultinq fro. the work covered by tbi. perait.
The Applioant/Peraittae bereby ackDowledqa. that tbey have read and understand both tha front and
back of tbi. perait, and tbat tbay will in fora their contractor(.) of the inforaation.
ACCBP'l'ED 01; k e ('-D. L.b...h (] ~ /")l.:...tJ..; (~ 8 . I b - 3 g
Applicant (Peraittee) pr nt/.iqn Date
IfO'1'.SI ALL WOU 8BALL COUORM WIH 'lJlB AftACBBD, APPROVED PLAH8 AND ALL APPLICABLE CUPBBLL
8TAMDARD DRAWING8 AND CONDITION8.
Cl ~ l'l'" HB COIl'1'RACTOa MU8T BAVE HIS PBRKI'!' AND APPROVED PLAHS AND ImS'!' KBBT WIH 'lJlB P.W. INSPBC'l'Oa ON
r:: c a l:l THB SUB AT LEAST no DAYS BEWOD STARTIHG WOU.
;J oi<1II
g 15 5 a HOTICB ImST BB GIVEH 'fO I'UBLIC woua AT LBAST 24 HOURS IBWOD DSTARTING AllY WOU.
· ... 61 H
~lIIi
m SPBCIAL PROVISIOIIS
o ;;; 5 ~
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E E ~ PBRKIT APPLICATIOH I'BB
III III Z PLAN CHBCJt DBPOSIT
aa~
l'l z ~ BOliO woa I'AIHI'UL PBUORKAHCB
~~H
liD t;; 0 CABH DBPOSIT
MH"l
0l'l0
- 0 liD PLAN CHBCJt ,
_____1. . Street .b.ll not be open out for UDderqround in.t.ll.tion.. Kiniaua cut. ..y be .llowed
for connection. or explor.tion bole.. Sucb cut. au.t be .pecificallY approved by the
In.pector.
pav..ent ..y be cut for UDderqround in.tallation. and au.t be re.tored in accordance witb
the Utility Trencb ...toration Standard Drawinq.
Work to be .taked by a licen.ed Land surveyor or Civil Bnqineer and two (2) copies of tbe
cut .beet. .ent to the Public Work Deptartaent before .tartinq work.
The hOur. of work are liaited to out.ide tbe bour. of 7-' .... and 3-6 p... for any work
affectinq . tr.ffic lane.
(a-1)
STANDARD
AKOUll'l'
DCBIft NO.
($35.00)
$50.00
$ .5"/>-- t) 0
$ C;-OO. 0(7
$ 14tOO~ C()
t
f SW,OO
$ tJ %O/c-O
.;<0 ")-3 7
.205~ 7
-rtr:::>- .
I VV?
It.ft(~
II-Z7-~
Date
$500.00
(100% OW "G. BST.)
(4% 01' BOND, f500 KIN)
fl PWPBRMIT
aevised a/II
BOND, $35 KIN)
,
APPROVED I'oa ISSUAMCB
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CITY OF CAMPBELL
--,---'- .----.---
WI~eEr.LYi ,..,~W_:!I.;O<I;
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
HELMS
JOCSeN
KRueefl
peNOYER
Department:
Public Yorks
June 14, 1990
Callahan Properties
850 E. Campbell Ave.
Campbell, CA 95008
SUBJECT: ONE YEAR MAINTENANCE ACCEPTANCE
PERMIT NO.: 88-209
WCATION: 563 Rincon Avenue
Ye have made a one year maintenance inspection of subject public
works improvements and find that no maintenance is required.
By this letter, we hereby release your assignment of Investment
Certificate No. 6220-174. Please come to the Public Yorks Dept. in
City Hall to pick up your receipt for the above certificate.
Sincerely,
Gregg Eaton
Public Yorks Inspector
GE:sd
Dat. (c l/~/J;o--
I' 3
Address
PUBLIC WORKS INSPECTION REPORT
Permit or Project No.
'CO
'~l1cvn
.
, ((X - ()o- q-
Type of workz Street-k Storm
Other (describe)
Semi tAry
Electrical
(JPRELIHINARY INSPECTION WITH DEFICIENCY LIST (attAched)
(JFINAL INSPECTION WITH DEFICIENCY LIST (attAched)
o FINAL INSPECTION - ACCEPTANCE
Si9ned plAn1O-? Y N (If ui9ned, Council AcceptAnce.)
ChArges AgAinst deposit? y
Overtime. hrs. @ S
DAte {. reAiOon.
N
/hr.
-
$
BArriCAde rentAl (Attach invoice)? y N
DAte {. reAsonz $
Other? $
S
TotAl chArges deducted from deposita $
(C4&h Depo&1t $ letis chArgeli $ - Refund $
cx.. req.)
[JONE YEAR MAINTENANCE WITH DEFICIENCY LIST (AttAChed)
~NE YEAR MAINTENANCE - ACCEPTANCE
r-tReleAtie'm4intenAnce bond. Check Request if CAsh.)
Inspector
DAte 74~1 Permit or Project No. '88-~Z6~
,
Addroas SG :5 :.... e ~ ~DC .E"l -A.")
PUBLIC WORKS INSPECTION REPORT
.
1'ype of work I Stre..t Stom
Other (describe)
Sanitary
P. c. c _
Electrical
o PRELIMINARY INSPECTION WITH DEFICIENCY LIST (attAChed)
(J FINAL INSPECTION WITH DEFICIENCY LIST (attached)
~HAL INSPECTION - ACCEPTANCE
Signed plAn&? Y ~ (If signed, Council acceptanCe.)
o@
@ $
."." c.., j
ChArge. agAinat depoait?
Overtime. brs.
DAte '.rea5on. ]).q~~~
N
Ihr.
c9w oJ ~
-
$ 3!~. 2.,/~ C;;tZE A-...~~j
~..c...,-T1a
Barricade rentAl (attach invoice)? y
DAte , reason.
~
$
Other?
$
$
$
- Refund $
Total charges deducted from deposit.
(Cash Deposit $ loss ,chArges $
DONE YEAR MAINTENANCE WITH DEFICIENCY LIST (AttAched)
o ONE YEAR MAINTENANCE - ACCUTANCI:
(ReleA.e' maintenAnce bond. Check aoquest if CAsh.)
ek. req.)
Engineer
Inspector
U
MEMORANDUM
~"I l~,....
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CITY OF CAMPBEll
To: Terry Adams
Streets Leadworker
Date: March 15, 1989
From: Vince Huppe V H'
J.D.M. Leadworker
Subject: Rincon AVe. Island Renovation
Tp.:r'l"V
----------------------------------------------------------
Here is a breakdown of the costs for the renovation of the island on Rincon
Ave. near the footbridge damaged by truck traffic.
Labor:
Pickup of five flats of hypericum and one yard of topsoil
Repair of irrigation system @ .75 hr (minimum 1 hr.)
Ground prep and placement of topsoil
Installation of hypericum @J.50 hr (minimum 1 hr.) ~
Total labor
Materials:
5 flats hypericum
1 yard of topsoil
2 each 10" P.V.C. nipples.
2 each shrub ~ circle brass nozzles
3 lbs. 16-6-8 fertilizer
Total materials
Use of Equipment:
3/4 ton dump truck with handtools: shovels, landscape picks 1 hr @ 100.00 100.00
includes shovels/l hr.
landscape picks 2.5 hr.
Total equipment
TOTAL COST OF RENOVA~ION
.
CC: Ed Fenzl
~
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1 hr @ $24.50 $ 24.50
1 hr @ 24.50 24.50
1 hr @ 24.50 24.50
~hr @ 24.50 211. aQ. CI. 2..5
4 hr @ 24.50 gS. QQ 1)'1.75
!
@ 10.50 56.18
@ 18.00 18.00
@ .685 1.37
@ 2.75 5.50
@ .135 .41
81. 46
100.00
$273.'+C
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: ...........-:..,. ..:.
CITY OF CAMIIHEll
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
July 21, 1989
Callahan Properties
850 E. Campbell Ave.
Campbell, CA 95008
RE: Final Inspection and Acceptance
Permit No.: 88-209
Location: 563 Rincon
Maintenance Bond Amount: $3,500.00
We have made a Final Inspection of subject public works construction and
find it acceptable and in conformance with City standards. Accordingly,
the work is hereby accepted subject to the one-year maintenance
requirement indicated below.
You are responsible for the maintenance, repair and/or replacement of all
work done should any failures occur within one (1) year of this date, To
guarantee this, you must either post a maintenance bond in the amount
indicated above, or maintain your existing faithful performance bond, If
you post a separate maintenance bond, your current bond will be released
by a separate action.
We will inspect the work in one year and advise you whether or not
maintenance is needed.
Your cash deposit refund less the charges for damage to City owned
facilities will follow under separate cover,
Please feel free to call the undersigned if you have any questions.
Sincerely,
.
~~
Car s M. Jocson
Ass ciate Civil Enginneer
CMJ : sd
cc: G. Eaton, P.W, Inspector
Suspense - 1 year
ENCROACHMENT PERMIT ISSUANCE CHECK LIST
City of Campbell
Department of Public Works
v/ Applicant section complete
Encroachment Permit No. ~-Zo1
Eo<
~
~~
:Z:~
~t:lt
~o:
_0
o:r...
25 ~ Plan check deposit, $500.00 (waived for R-l Homeowner),
c ~ paid. Receipt number~n,3,
t1tl5 V
gj~ Five sets of improvement plans submitted
~t:lt
~_._-------------------------------------------------------------------
v Applicant signature and date
,/
Permit Application fee $50.00 ($35.00 for R-l Homeowner),
paid. Receipt number 26t:;" 37
1/ Bond for faithful performance, 100\ of City Engineer's 7_0
estimate, (waived for R-l Homeowner), supplied or paid,
. Amount $ /C;;tJlJ 0 Form I.D. # c.?~ Z 20" OZI ~s-
L/ Cash Deposit: 4' of FP bond, $500 min. ($200 for R-l
Homeowner), ~aid.
Amount $ 6? cJ. L)O Receipt No. I L/L/i.c,
V Plan Check & Inspection fee of 7' of FP bond, $35.00 min.,
(waived for R-I Homeowner) paid.
Amount $ ft'l'.OO Receipt No. 1'-/'/'
~orker's compensation information received for Applicant
(see Information Sheet for Encroachment Permits)
All other PUblic Works requiremenes listed in the
Conditions of Approval of the development.
~,
---------------------------------------------------------------------------
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~ Worker'. comp and Contractor'. Information received for
Contractor (see Information Sheet for Encroachment Permits)
~ Certificate of Insurance with Additional Insured's
Endorsment received from Contractor (see General Summary of
Insurance Requirements for Encroachment Permits)
~ Three sets of off-site plans, stamped APPROVED (Tract or
Development and Public Works Permit number and property
address on plans)
~Permit signed for City Engineer
WEN ALL OF THE ABOn; ITEMS ARE COMPLETE, P~IT MAY BE ISSUED .
Issuer: Ini tial !l..Ii:::- and date II" '2 ~ .. ~. (t'" and file with permit
~ UPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
8/88
permchklst
FIELD CHECK LIST
FOR
D;EVELOPMENT OR TRACT
IMPROVEMENT PLANS
oW
PG~~ , r d:9- 2a 9
S63- S-81 el1JCoU
8 -~-e 8
~k,
....
1.
Are existing PCC improvements accurately shown?
yes
Re-
2.
Do existing PCC improvements meet current standards?
yes
3.
Width of sidewalk? (Do ~ include curb)
""h
ae
/
4. List non-standard improvements to be replaced.
5. Are existing standard improvements in acceptable condition?
yes -ae--
Indicate on plans location(s) and dimensions of areas to be removed
and replaced.
6. Indicate required sawcut locations on plans.
7.
Indicate any obvious~s;orm drainage facilities not already shown on
the plans. C::;,I(/ ~ e / /II Co /\I'
Is there an existing street lighting system? ~l!1Z#EAO FeD) yes 1't&
Type pole? IlIerA'-
8.
Type luminaire? l.: ~c::.,
Location of nearest electrolier? ELy ~
9. Are all existing surface utility facilities accurately shown? yes -A&
If not, indicate on plans.
10. Pavement condition: Description G (; 6 D
Acceptable as is
YeS
,
Needs overlay
Needs remove & replace
If overlay or remove and replace is partial, indicate location and
dimensions on plan.
CHECKtD:
v
Permit No. e,e-Z.O 9
5"G~-5"g? 12(^,ce>~-' AVe.
Tract No. or Address
IMPROVE!':EI;T PLAN CHECK LIST
DEVELOPf1ENT 5
ITEH:
1) Permit number and prop-
erty address on plan?
2) Site review completed?
3) Applicable standard notes
4) Engineer's Stamp, Signa-
ture and Expiration Date
S) Conformance with City
standard specifications
and details
6) Street geometries
7) Street grading plan con-
fornity with overall
street grades and/or
official grading pl&n
8) Approved roadway
structural section
9) Street lighting
requirements
10) Storm sewer design
11) All relevant conditions
of approval have been
met
12) Traffic review
13) Service Center review
Plan check co~pleted by
Reeommeded for approval
Send originals for signing
CO:'~lErlTS :
-..
Bill M. Helms Date
Engineering ~~nager
Donald C. ~i~erly Date
Director of Public Works
CHECKI:D:
v
V'..
v
v
v
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,
v
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Permit No. -(~ - -Z 0 9
"tf ~~ /
77l, ~/i'(; ~ ~81 RINCON AV~,)
Tract No. or Address
IMPROVE!{Er;T PLAlJ CHECK LIST
DEVELOPtlENT S
ITEH:
1) Permit number and prop-
erty address on plan?
2) Site review completed?
3) Applicable standard notes
4) Engineer's Stamp, Signa-
ture and Expiration Date
5) Conformance with City
standard specifications
and details
6) Street geometries
7) Street grading plan con-
fornity with overall
street grades and/or
official grading pl&n
8) Approved roadway
structural section
9) Street lighting
requirements
10) Storm sewer design
11) All relevant conditions
of approval have been
DIet
~ 12) Traffic review
~ 13) Service Center review
CO:'~lE!JTS :
Plan check co::\pleted by '\}. \C.. \l ~ -ft,f'
Recommeded for approval
Send originals for signing
"..
Dill M. Helms Date
Engineering r~nager
Donald C. ~imberly Date
Birector of Public Works
70 NORTH FIRST
CAMPBELL, CALIFORNIA
(408) 866-2100
STREET
95008
! IQCSON '
1"
~
\ KRUGER
LPENOYER _
CITY OF CAMPBEll
Department:
Public Works
March 16, 1989
Callahan Properties
850 E. Campbell Avenue
Campbell, Ca. 95008
Re: 563 - 581 Rincon / Tract 8186
Permit No. 88-209
Street cleanliness / damage to existing City facilities
Gentlemen:
During the course of onsite construction as well as utility installations
the street (Rincon) has not been maintained in an acceptable manner. It
has also been brought to my attention that some City facilities have been
damaged and have been repaired by City forces. This letter is to notify
you of these problems and to request that these problems be corrected.
It is the City's policy that the street be maintained (swept or washed
down) as needed or at least on a daily basis, Failure to do so will
require that the City hire the work done and deduct the appropriate funds
from your cash deposit.
An itemized list is enclosed regarding the damaged City facilities,
Please contact me as soon as possible and let me know whether you wish to
pay for the repairs separately or have the monies deducted from your cash
deposit.
If you have any questions or require additional information prior to our
meeting please contact me.
~
.f;{
aton
Public Works Inspector
cc: Terry Adams, Service Center Project Manager
,",. ,I .::
Date 7 ~Zj Pendt or Project No. . 88 q crY,
,
Ac2c2re:;s S, :3:'" ;e ~ ~ ..F) -A')
PUBLIC WORKS INSPECTION REPORT
Sanitary
P. c. c. _
Electrical
/flO'
-7 /,' ,.1/
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.. ' .>(
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Type of work: Stre~t Storm
Other (c2e&cribe)
[JPRELIMINARY INSPECTION WITH DEFICIENCY LIST (Attachec2)
D FINAL XNSPECTION WITH DEFICIENCY LIST (attachec2)
~AL INSPECTION
Signec2 plus'?
Charges against e2eposit?
Overtime: us.
Date 5.reason:~~G
"17', C, j
N
/hr.
-
$ 3!f.:, . 2../ J ~~ 4..~+h::-:D)
/9w oJ ~
~:c...."7'I<a
Barricac2e rental (attach invoice)? y
Date 5 reason:
~
$
Other?
$
$
Total charges dec2uctec2 from e2eposita
(Cash Depo&it $ leas chArges $
$
- Refund $
DONE YEAR MAINTENANCE WITH DEFICIENCY LIST (attached)
ck. req.)
DONE YEAR MAINTENANCE - ACCEPTANCE
(Relea.e'aaintenance bone2. Check Request if CAsh.)
.
~~~
gineer
a
CITY OF CAKP&ELL, CITY ENGINEER'S CONSTRUCTION COST ESTIMATE ~<i -76 cr
Pemi t No.
Aclclr... 5b:S/ S8/ 12h.'C Q/V bYZ?1:::. clAte 1/-/6 -iiI'
/
Surface Construction
'-....-/ Clearing & Grubbing Lump Sum Eatiute - $ 600..,I1lJ
Sawcut Concrete 37 LF@ $ 4.00 - $ /SG. (,;to
Concrete ae.oval ;3llf SF @ 3.00 - $ 9 ~~. (JD
Curb & Gutter ae.oval 'i?7 LF@ 5.00 - $ .//'.3.J; 0"6
Inlot Drein with Pipe EA@ 600.00 - $
Curb 6 Gutter ~7 LF@ 14.00 - $ It 2.18.00
Sidewalk SF @ 4.00 - $
Driveway Approach 370 SF @ 5.50 - $ ~. 03!: (jc)
,
Handicap IluIp EA@ 400.00 - $
Extruded Curb LF@ 8.50 - $
larrieecIA LF@ 50.00 - $
Street Excavation SF)x($O.lO)xl----") $
AC Pave.ent SF)x($0.30)x(____") - $
Acljuat Manhole to GracIA EA@ 375.00 - $
-
Acljuat Handhole to Grade EA@ 275.00 - $
KonlAent lox v!KonlAent EA@ 600.00 - $
Street Tree (15-lallon) ,3 EA@ 300.00 - $ 9OP#o 1)
-
Pave.ent Stripinl ($100 ain) LF@ 0.65 - $
Pavement Lelende ($100 ain) EA@ 40.00 - $
.~. Stop, Street Hue or Other SilD EA@ 120.00 - $
-.
Pave.ent Marken EA@ 15.00 - $
- -.
Pave.ent Key Cut LF@ 10.00 - $
- $
- $
Surface Subtotal "S" - $ ~ft(<f~(JO
(
Adjuat for aize: "S"<$30,OOO adel 20', "S">$lOO,OOO aubtraet 10. (+ or .) $ CZCf7.70
,
Street LiRhtinrr:
~ ---
Electrol1er EA@ 2,000.00 - $
Conduit LF@ 10.00 - $
Conductor, pair LF@ 2,00 - $
Pull lox Ea@ 200.00 - $
-I3!.Nr l~ 45:. t# I &- ~ 2t1O.cn) $ ZOO..6 U
t -
Storm Drain...
12- or 15" acp 60 LF@ 60.00 - $ ~.,,,(). 1& '.)
18" or 21" acp LF@ 70.00 - $
Street Inlet EA@ 1,600.00 - $
Manhole I EA@ 2,400.00 - $ 2 Y~D. 4'0
Ireak 6 Enter Manhole "'""- EA@ 650.00 - $
'-/ - $
TOTAL ESTIMATE $
USE FOa IOND $
13 ?~3.,;tv
/~ {)f) ~ .. [ '..)
nviaed 6/88
t'/con..co.t:....t
CITY OF CAMPBELL
Permit No,
Applicant
INFORMATION SHEET FOR ENCROACHMENT PERMITS
A separate form must be completed for the applicant and each contractor
that will work under this permit,
Name of Contractor/Applicant
WORKERS' COMPENSATION INSURANCE INFORMATION
r' . J
'Ire llN~)
(()~{/ 0
One of the following must be on file with the Public Works Department:
A Certificate of Consent to Self-insure issued by
the Director of Industrial Relations; OR
.,/
_____ A Certificate
Insurance Co.
Policy No.
. OR
,-
............................................... ............. . . . . . .. . ... ... .
This Certificate of Exemption from the Workers' Compensation
laws printed below (certificate must be signed).
CERTIFICATE OF EXEMPTION
I certify that in the performance of the work for this permit, I
shall not employ any person in any manner so as to bLcome subject
to the Workers' Compensation Laws of California.
Signed
Date
NOTICE TO CONTRACTOR/APPLICANT: If, after signing this Certificate
of Exemption, you should become subject to the Workers' Compensation
provision of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
. '
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CONTRACTORS INFORMATION
Note that all contractors must have current City of Campbell Business
License, State Contractor's License and Workers' Compensation Insurance.
Name of
Address
State Contractor License No.
Ci ty Bus ines s License No .I-.j 017 J 1-.1.-
Expiration Date
Will do the following types of work:
~Underground _____P.C. concrete
_____A,C, paving _____electrical
_____other (specify)
f:PERMINFO
REV. 8/88
ASSIGNMENT AND RECEIPT OF INVESTMENT CERTIFICATE
TO CITY OF CAMPBELL, 70 N. FIRST STREET
C4J.:pnELL, CALIFORNIA 95008 (408) 866-2150
P.W. Permit No. :i 9-0<.0 '1
TR or DEV
Lac.
,.
I am/We are the ovner(s) of a aavings account at -..l3o_fJ~ OF a vy\<:..('ICa_
at its branch ofUce at C-A.fl"\.J; h~ II , California, Investment Certificate
No. ~:t~O-11LL in the na s of ~t.t-. ::tiJc..C. ~f(l rr1..X~
and havin~ a present balance of $ ~ 500 .
I hereby grant, transfer and assign said account, said Investment Certificate, said
balance (includin~ interest which accrues thereon), and all other rights in connection
therewith to the CITY OF CAMPBELL, assignee, for a good and valuable consideration,
receipt of which is hereby acknowledged, for the purpose of insuring construction
described as follows:
I have h sically delivered said Investment Certificate and du licate of this Assi nment
and Receipt to said assiRnee.
I understand that assignee can withdraw from said account any time on hia aignature alone
upon presentation of the Investment Certificate to the issuer. I also understand that I
may not withdraw from said account unless I present said Investment Certificate and the
si nature of assiRnee ap rovin said withdrawal. The issuer of the certificate assumes
no responsibility for the conduct of the assignee and may act on the signature of the
assignee Without further inquiry.
Execu ted on II - I c.,
, 19~ at said office of the issuer.
'~~JGf.R-4-.- ~ 8ttr#/C
Assignor I
Assignor
ACKNOt.'LEDGEHENT BY ISSUER
Issuer affirms that there are no other holds on subject account, that subject monies are
available, and that the above described assignment has been noted on the Records of said
issuer.
Date UoU. 2.2 It&,
B~~
thorhed SignatureJ
Title: CU-i'ho-i u
oM u::.r;
INSTRUCTIONS TO ASSIGNEE
Please sign below for signature identification and aa acknowledgement of your notice of
AssiRnment and as receipt of said Investment Certificate. Return this Assignment and
Receipt to the issuer at its address above. Retain one copy of this Assignment and
Receipt for your files.
Date /1 /.,:zy If' '1
;:ty ~-::~~~JL/ ~~
RELEASE BY ASSIGNEE
Said assignee hereby releases and relinquishes all his right, title and interest in and
to said account, said Investment Certificate, said balance and all other rights in
connection therewith.
Date
~,//! /ro
CitY~CamPbell ~.. .... /
By (:l-?~ A J /l .1{ d---1/
Bank of America
Time Deposit Receipt
BRANCH The Prune yard
PURCHASED BY r. <'l 1 1 <'l h a n Pro per tie s
No.
622
DATE N 0 v. 2 2, 1 9 8 9
RATE 7.60 YIELD. 7.90
$ AMOUNT$ 3, 500.00
TERM 8 m 0 nth s
ACCOUNT # 6220 - 1 74 -
Properties
T e publication(s) you receive contains the terms and conditions of this account. This time deposit will be reinvested automatically for the
ame term upon maturity or on the effective date of a deposit or withdrawal made during the grace period. (The grace period is two business
days for terms of 89 days or less; ten calendar days for terms of 90 days or more beginning on the maturity date.) The new interest rate will
be the interest rate in effect on the date your funds are reinvested.
. Interest compounded daily. Yield assumes deposit and interest remain in the account for a year at the same interest rate.
, IMPORTANT INFORMATION
If you withdraw all or part of your deposit before it matures a substantial interest penalty will be imposed. A personal time deposit evidenced
by this receipt is NOT TRANSFERABLE EXCEPT IN ACCORDANCE WITH THE RULES AND REGULATIONS OF THE FEDERAL RESERVE
BOARD.
R.162 5-89
NOT NEGOTIABLE
Bank of Ameroca NT&SA . Member FDIC
fl,EFUNDABLE DEPOSIT
CHECK' REQUEST
flNANCE :DIRECTOR
'CITY OF CAMPaELL
I),; '::'-~'r.,l'~""'(/" '>',','i::
iS~l1e . cpeck . payaplelo :
L.',y t{o,J,.:I," ,,~ ".! ,", ", '
Ad<ir~ss : Line 1:
CALLAHAN PROPERTIES
.: ,;-:-,.., ,;,
850 E. Campbell Ave.
~30 ~paces)
~39 spaces)
(30 spaces) ,
2:
City
Campbell,
, (20 spaces)
"I "
Sta~e: CA Zip:
(2)
95008
(lQ spaces)
Des~ription :
Plan Check Dep. Ref.
(2~ space~)
$500.00
001.00.905.0000.4662
Release Of plan check depoist for excavation permit #88-209.
'I\"
See receipt #20537 dated 8/17/88.
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, , Vertfie4bY: ~
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Tit1.e: " Eng-; ;,;['ech;dI
Pate: 11/30/88 ,
/;,.1' ::"
Da~e: 11/30/88..
pate:
Title: P . w. Director
Account~:tle9~ivabl~
,',.,..;."
speCIAL INSTRUCTlONS FOR HANDLING CHECK:
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Mail iQ attached envelope
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08/24/88
TO: City Clerk
PUBLIC ~JORKS FILE NO. g+g-,201
Please collect & receipt
for the following monies:
(specify project)
PeJr.m-<....t eM:
Depos it
R-l :
($'35)
3372 Plan Check & Inspection Fee
3521 Other Cash Deposit (specify)
J373
3373
3372 Tentative Parcel Map Fil ing Fee ($350)
3372 Final Parcel Ma Filin Fee ($300)
3372 Tentative Tract Map Fil ing Fee $ 00
}372 Final Tract Ma Fil in Fee ($350)
3372 Lot Line Ad'ustment Fee/Certificate of Compl iance
3372 Vacation of Publ ic Streets and Easements
3372 Assessment Segregation or Reapportionment
First Spl it ($500)
Each Additional Lot ($150)
3372 Envi ronmental Assessment:.
Categorical Exemption cost
Ne ative Declaration
3370 Storm Drainage Area Fee per Acre Multi-Res.,
$2,060; all other, $2,250)
J395 Park Dedication 1"-1 ieu Fee per Unit ($1,132)
3380 Publ ic Works Special Projects
3510 Postage
TOTAL
AMOUNT
$
S-o, VT.J
<;'00. ro
NAME (1-'^..L~
P Co/~-;!t~ s
(?~~1Pt ~ -J
$ 5S-o.0(,)
PH;)NE 377- 7;1..<15
(!-Anloku J2~
V
ADDRESS ~C;D ~.
z1P1~ 1)t)X
FOR
CITY CLERK
a.iLY
RECEIPT NO.
~0531
O~{)c-o
J-~
??JJ7/rff
I I
AMOlNr PAID
RECE I VED BY
DATE'
July, 1987
ASSIGNMENT AND RECJ::1 r".I.' Uj:' INVc~'.L.t'U::N'l' ~c.t<.'.l.'H'lCA'.L't:;
TO CITY OF CAMPBELL, 70 N. FIRST STREET
CAMPBELL, CALIFORNIA 95008 (408) 866-2150
~.w. ~erllll.t No.
TR or DEV
Loc.
I am/We are the owner(s) of a savings account at Bank of America
at its branch office at Campbell , California, investment
certificate No.06226-02185 in the names of James D. Callahan
and having a present balance of $14,000 00****
I hereby grant, transfer and assign said account, said investment certificate, said
balance (including interest which accrues thereon), and all other rights in connection
therewith to the CITY OF CAMPBELL, assignee, for a good and valuable consideration,
receipt of which is hereby acknowledged, for the purpose of insuring construction
described as follows:
I have physically delivered verification of said investment certificate and duplicate of
this Assignment and Receipt to said assignee.
I understand that assignee can withdraw from said account any time on his signature alone
upon presentation of a written order to the issuer. I also understand that I may no~
withdraw from said account unless I present a signed release from the assignee. The
issuer of the certificate assumes no responsibility for the conduct of the assignee and
may act on the signature of the assignee without further inquiry.
(I IC/
Executed on . /- D
, 19~~6at said office of the issuer.
sign ~''''l^-Z) 0 r~ f ....-1--- ./
print{) ,y", .....L~ 0 (~~,-II cd,-rt r/
Assignor
sign
print
Assignor
ACKNOWLEDGEMENT BY ISSUER
Issuer affirms that there are no other holds on subject account, that subject monies are
available, and that the above described assignment has been noted on the Records of said
issuer.
Date ~/j7-yg
._~~/~
Authorized S~ature
Title: ,;;:5{)
INSTRUCTIONS TO ASSIGNEE
By
ATTACH
----- NOTARY
ACKNOWLEDGEMENT
Please sign below for signature identification and as acknowledgement of your notice of
Assignment. Return this Assignment and Receipt to the issuer at its address above.
Retain one copy of this Assignment and Receipt for your files.
Date:
/J//~/tf
City of~ampbell
By 0a/7L..L-t..A..../
~L-ILA.---
RELEASE BY ASSIGNEE
Said assignee hereby releases and relinquishes all his right, title and interest in and
to said account, said investment certificate, said balance and all other rights in
connection therewith.
Date:
/1/;2g/8?
,
~~ty o/%:~~~~~ odL~
BRAi,:CH _
PURCHASEO BY
The Pruneyard
James D. Callahan
No. 622
DATE Nov. 18, 1988
RATE **7.40***
$ AMOUNT*** 14.000 .00***
TERM***12 months***
ACCOUNT# 06226 - 02185
I I me uepOti Il r\tL;~ q.Jl
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Bank of America
PAYABLE TO
**JAMES D. CALLAHAN*
* * * *
INTEREST TO BE PAID AT:
o CALENDAR 0 CALENDAR
MONTH END QUARTER END
PAY INTEREST TO:
o CHECKING
o CALENDAR
YEAR END
[Xl MATURITY
(Terms 1 Year or less)
o SAVINGS
[] OTHER Cashier Check
/l /.,J I
...d;Vv71....:~...<.::. a ~~
AUTHORIZED SIGNATURE
NUMBER
Acceptance of this time deposit receipt constitutes acceptance of the terms and conditions for this time deposit described
in the publication you receive. This time deposit will be reinvested automatically for the same term upon maturity or on
the date you make a deposit or withdrawal (during the grace period). The interest rate will be the interest rate in effect on
I the date your funds are reinvested.
L.....--..---.......___ .--- --~
R.162 2-65
SEE IMPORTANT INFORMATION ON REVERSE
Bank of America NT&SA . Member FDIC
NOT NEGOTIABLE
...
LOS GATOS-CAMPBELL INSURANCE
1935 DRY CREEK RD. #202
CAMPBELL, CA 95008
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
TIM MCBRIAN
DBA: T.D. MCBRIAN CONSTRUCTION
850 EAST CAMPBELL AVENUE
CAMPBELL, CA 95008
COMPANY A FREMONT INDEMNITY
LETTER
COMPANY 8
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
;,.;
, ...1 ~..,._I; .
..1-
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI.
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EffECTIVE
DATE (MMiDDIYY)
POLICY EXPIRA liON
UA TE (MMiDDIYYI
LIABILITY LIMITS IN THOUSANDS
OCCG~~~NCE AGGREGATE
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERA nONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTs/COMPLETED OPERA liONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
BODILY
INJURY $ $
PROPERTY
DAMAGE $ $
BI & PD $ $
COMBINED
PERSONAL INJURY $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PASS)
ALL OWNED AUTOS (OTHER THAN)
PRIV PASS.
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
OOOllY
INJURY $
(i'tR PERSON)
BOllll Y
INJURY $
(i'tR ACCIDEND
PROPERTY
DAMAGE $
BI & PD
COMBINED $
BI & PD $ $
COMBINED
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
TO BE DETERMINED
11-15-88
11-15-89
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
RECEiVED
NOf 211988
CITY OF CAMPBELL
.~,L
11-22-88
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
LOS GATOS-CAMPBELL INSURANCE CENTER
1935 DRY CREEK ROAD #202
CAMPBELL, CA 95008
INSURED
CALLAHAN PROPERTIES
850 E. CAMPBELL AVENUE
CAMPBELL, CA 95008
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER TRUCK INSURANCE EXCHANGE
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS. AND CONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
GENERAL LIABILITY
X COMPREHENSIVE FORM
X PREMISES/OPERA nONS
UNOERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV PASS)
ALL OWNED AUTOS (OTHER THAN)
PRIV PASS
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
ADDITIONAL INSURED:
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
,----_.
I '-EFfECT'VE -
+__. ,MM'OOiYY)
I
POl.lCY EXPiRATION LIABILITY LIMITS IN THOUSANDS
DATE iMM/OOIYYI EACH AGGREGATE
OCCURRENCE
BODIL Y
INJURY $ $
11- 7 - 89 PROPERTY
DAMAGE $ $
POLICY NUMBER
60067-84-88
563 RINCON AVE.
CAMPBELL, CA 95008
11-7-88
I I
I I
- ..___u --+---t
I
BI & PD
COMBINED
$1,000, $
PERSONAL INJURY $
BODilY
INJURY I
IPER PERSON) $
BODILY
'NJURY
(PER ACCIDENT, $
PROPERTY
DAMAGE $
BI & PD
COMBINED $
~~t~~ED $
$
5T A TUTORY
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE.EACH EMPLOYEE)
REFUNDABLE DEPOSIT
CHECK REQUEST
TO: FINANCE DIRECTOR
CITY OF CAMPBELL
Please issue check payable to:
Callahan Properties
(30 spaces)
(30 spaces)
(30 spaces)
State: CA Zip: 95008
(2) (10 spaces)
Address:
Line 1:
850 E. Campbell Ave.
Line 2:
City:
Campbell
(20 spaces)
Description:
Cash Deposit Refund
(24 spaces)
Exact Amount Payable:
$243.79
Account Number:
905.4662
PURPOSE:
Release of cash deposit for excavation permit #88-209,
less $316.21 for damage to City owned facilities. See attached
memo for charges and receipt #1446 dated 11/22/88.
Requested by:
Approved by:
Gregg Eaton
Ti tle: P. W. I Ii s p e c tor
Date: 7/21/89
Donald C. Wimberly
Title: P. w. D ire c tor
Date:
Verified by:
Accounts Receivable
Date:
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Mail as is
XX (include copy of
memo)
Mail in attached envelope
Return to:
(Department)
(Name)
Other:
08/24/88
TO: City Clerk
PUBLIC WORKS FILE NO. ~-20~
Please collect & receipt
for the following monies:
ACCT.
35-) -6
3372
3521
3521
3372
3521
3373
3373
Depos i t
R-1 :
(S'35)
Plan Check & Inspection Fee
Other Cash Deposit (specify)
&
3372
3372
3372
3372
3372
3372
3372
3372
3370 Multi-Res.,
1395 Uni t ($1,132)
3380 Public Works Special Projects
3510 Postage
NAME
TOTAL
'y /f}
C4/I!~t <Z IZ-dt z.) I /l/[LPL-~:-;.r-z~<l./
(j
PHONE
AMourn
$
500. <<90
9 R'cJ.trO
.
$ (-.1 YC;co ()
ADDRESS
ZIP
,.OR
C I TV CLERK
QoiLY
RECEIPT NO.
/ t.f- '/ 10
'(i()
/ ~C+O
Q/n
/ / - (~,~ - ~ &'
AMOl.HT PAID
RECE'VED BY
DATE'
July, 1987