95-241
CTY Of CAMPBELL
DEPT. Of PUDUC WOIUCS
70 Nortb PiIIt St.
c.mpbeD. CA 9SOCIl
(408) 1166-2150
BNCROAawBNI' PERMIT
(for warkiDc witbio tbe
public ript4-way)
IIIued /0 -/7 - ~3:~
PcnDit cxpin:a ill 12 ....ItJUJ
rmit No.
..<:-Rd. file
95-241
Applicatioll Date
Applu..tioIl cxpin:a ill 6 ....
10/18/95
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APPUCAnON - ~ II heRby...... for a Public Wom Permit ill accordaDce witb ,..~u Nuaic:ipaI Code, SecdoIlll.CM. (~v.tiQIt apireI
ill 6 1DOII1III if tbe pcrIDit II ~ iIIued).
A.. Work addnII 01' tact #
935 Scott Court, X-st. Gay
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Utility treacb IocadoD
B. Nature ol wort
3x4 cut in dirt for main repair
C. AtIIlCh four (4) copia ol.. ~ cImwiDa IbowiDa tbe IocadoD, atcat ad diIIIeIIIioaI 01 tbe WOIt. The dmwiD& IlIaD .. tbe reJatioa 01 tile
~ wort 10 ClliIIiJIIIUIface _ lIDdap'oacI.....~ WIleD approved by tbe Oty &,iDecr, laid dmwiD& beccmaeI a put 01 tbia pcmUL
D. AD wort IbaII coafoJm 10 tbe 0ty'I 0eDaaI C'<lIIlIidaaI. StaacIaId CclaItructioD PnMIioaIlIDd Staadard CoaItructioa DetaiJI b Public Worb
CcaItructioa; tile Geaen1 Permit C&lacIitDIIiIted OIl tbe reveille tide; ad tbe Special PnMIioaI for tbia pcrIDit. lilted below. Failure 10 abide by
tbeIe eoaditioal _ proviIioaIlIIIIf ..wt ill job aut..... _/01' forfeiture ol faithful Paformaace Sureties aDd c:aIb depoIitL (See GeaeIlIJ
Penait CaDditioall aDd 2.)
E. A DOIUCfuDdabIc appIicatioD fee IDUIt f<<" f"I"1 tIaiIlJlIIIicPq,..,.
San Jose Water Company
Name of AppIicaDt
T~
279-7825
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Is tIaiI wort beiJIa dCIIle by tbe property OWIICI' at tbeir on raideace?
Complete aDd attach Worbft' CompeDIatioa aDd Ccatract01' IDfonaatioa formL
The AppIicaDt/pmDittee bereby....... by aftixiq tbeir Iipature to tIaiI pcnDit to bold tile Oty ol c.mpbell, ita olficcm, ...ta lIDd ~ flee, ufc
lIDd barmJas from all)' claim 01' dcmaacl for damapll'ClUltiDg from tbe wort covaed by tbiI pcmUL
Y.
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Addrea
1221 So. Bascom Avenue. San Jose. CA 95128
The AppIic:aDtfPermittee heIeby adatowIedpa that they haft read ad UDCIentaDd both tbe frCIIlt ad bKk of tbia permit, ad they will inform tlleir
CIClDtDctOI(l) of tile infomaatioD.
Jane (emergency verbal)
(Applic:aat (Permittee) pliat/lip
10/18/95
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Date
NOTES: ALL WORK SHALL CONPORM wrrH 1HE ATfAOIBD, APPROVED PLANS AND ALL APPUCABLB CAMPBELL SI'ANDARD
DRAWINGS AND CONDmONS.
1HE CONTRACI'OR NUSI' HAVE 11DS PERMIT AND APPROVED PLANS AT 1HE SITE AND NUSI' NO'I1PY 1HE PUBUC WORKS
DEPARTMENT AT LEASI' NO DAYS BEPORE SfAR'I1NG WORK.
NonCE NUSI' BE GIVEN TO PUBUC WOIUCS AT LEAST 24 HOURS BEPORE RB5I'ARnNG ANY WORK.
SPECIAL PROVISIONS
_1. StRet IbaII DOt be opeD cut for U8dapoUDd iDmJIaac.. MiDimum c:uta IIIIIf be allowed for ~ 01' CIpIoratioa boles. Such c:utI mUll
be IDeCiIicaIIv lIDDl'OVed bv the IDIIleCtor Drior to cuttin2.
_2. PnemeDt IIIIIf be cut for lIDdcJpluDcl iDItalIatioal aacI mUll be I'CIknd ill aa:ordaace with the Utility TIeDCb Ratoratioa Staadard l>nIwiDg.
_3. Work to be Itabcl by a IiceaIed Laad s.uw,or 01' CiYiI &,iDeer ad two (2) copia 01 tbe cut Ibeeta teat. to the Public Worb DcpartmeDt
before ItartiDa WOIt.
APPROVED FOR ISSUANCE
1210.00
SSOO.oo
(1009' OP !!NO. PSI'.)
(4~ OP SURBl'Y, SSOO MIN)
(I!IR5I' $0-$30,000 14911;
miD)
s:l11.lJl
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61.
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SI'ANDARD
AMOUNI'
RFrFlJ1IT NO.
PERMIT APPUCAnON PEE
PLAN amcK DEPOSIT
SURBl'Y FOR PMIHPUL PERFORMANCE
CASH DEPOSIT
PlAN amcK a INSPBCllON
Nat $30,000-$80,000 10911; AmouDt
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h:PW PERMITfRcv.4f94
USA phone (800) 642-2444
(lee otbeuide)
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TICKET NO.
1-
~I'1'Y
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OF CAMPBELL ..
I
FIELD ENGINEER I S DAILY REPORT
PROJECT RO. 9 S -- 2 t.( /
C/JS
.s { d f--r c. -I- .
REPORT 80:
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DATE: I /16/a /'
.k - .J 7:. {;r-~ I J 7 "
WEATHER: (( o;~
CONTRACTOR: S ~ 'J(y.Fe.- w~f~v" CcJ. ~SPECTOR: ~ /,h _ . ~_
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I'1'EM
DESCRIPTION
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