95-242
Cl1Y Of CAMPBElL
DEPT. Of PUBUC WORKS
'70 North Pint St.
~ CA 9S(D
(8) ~2150
PJliCROAawENT PERNO'
(for WOIkiDa witbill tbe
public~ri&bt4) __
I8ue4 ~ 96 Applieatioo Date 10 / 19 / 9 5
Pamit . ill ~ Applieatioa apna ia 6 IDOL
APPUCAnON _ AppIic:atinn iI baeby ID8de for a Public WClIb Permit ill acllOIdaDcc witb CaIDpbcIl MUDidpaI Code, Sec:doD lUM. (~tPo apna
ill 6 IDOIItbI if tbe permit iI DOt iIIued).
ait No.
X-Rd. file
95-242
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A. Work addJaI or tract #
1082 winchester, x-st. Sanford
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Utility tIeDda Ioc:atioD
B. Natme ol1lOlk
Emergency cut in S/W, move meters
C. Attacb four (4) copieI of .. eqiaeeNd clnwiD& IbcJwiaI tbe Ioc:atioa, alCDt ad diJDerIo1il3IIf of tbe WOJt. ne clnwiD& IbaI1Ibow tbe JeIatioD of tbe
propoIOd 1IOIk to ClliItiJIIIUIfaI:c ad ............ad impnMIDe8tL WbeD lIpIII'Old by tbe Clty BqiDecr, aid dmriD& bccaIIIeI a part of tbiI permiL
D. AD wort IbaII ccafonD to tbe Cty'1 GcDcnI ~ StaDdud o.tructioD PIOViIioaI ad StaDdud o.tructioa DctaiII for Public Worb
Coastructioo: tbe GeDeDl Pamit CCDditioollilted OIl tbe ftMlIIe Iidc; ad tbe Special PIOViIioaI for tbiI permit, lilted below. Failure to abide by
tbeIc CODCIitiool ad proviIiaaI may IeIUIt ill job lbut-4owD ad/or foIfeitme of faitbfu1 PaformaDce Sulctia ad CMb dcpoIitL (See GeDeDl
Permit CCDditiooll ad 2.)
E. A DOII!CfuDcJablc appIicatiaa fee III1IIt ~"-J thiI fIJIIlI...tiaa..
NamcofAppticaDt Pacific Gas & Electric T~ 725-2176
10900 No. Blaney Ave, Cupertino, CA 95014
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II tbiI wort beiDa daae by tbe property 0WDeI' at tbeir 0WIl Jaideace?
Complete ad attach WorkeIs' CompeIIIatioo ad CaatractDr IDformatiaa fonDL
'Ibe AppIicaDtfPenDittee bcreby ..... by alfbliIlI tbeir lipame to tbiI permit to bald tbe Clty of CampbcU, its ofticerI, apDlI aDd CIIIJIIoYeCI free, ufe
ad bumIeII from any claim or dcmIDd for damapI ftlIUItiJII fIom tbe 1IOIk covered by tbiI permiL
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Addrea
Tbe AppIicaDtfPenDittee beftby ackDowIedpI that they Jwye IUd aDd UDderItaDd both the fraat aDd back of tbiI permit, ad they will iDform their
caatractor(l) of tbe iDformatiaa.
Bill Lake (emergency verbal)
(ApplicaDt (Permittee) priIlt/.
10/19/95
Date
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NarBS: ALL WORK SHAlL CONFORM wrIH nIB ATI"ACHED, APPROVED PLANS AND ALL APPUCABLE CAMPBELL SI'ANDARD
DRAWINGS AND CONDrnONS.
nIB CONI'RACI'OR MUsr HAVE nus PBRMIT AND APPROVED PLANS AT nIB SlTB AND MUsr NO'IlPY 1HB PUBUC WORKS
DEPARTMENT AT LEAST TWO DAYS BEFORE srARnNG WOR
NonCB MUsr BB GIVEN TO PUBUC WORKS AT LEAST 24 HOURS BEFORE RBSfARnNG ANY WOR
SPECIAL PROVISIONS
PBRMrI' APPUCAnON PEE $210.00
PLAN 0mcK DEPOSIT ssoo.oo
SURElY FOR fAlI1lF'lJL PERFORMANCB (1~ Of ENG. PST.)
CASH DEPOSlT (4,*, Of SURElY, $500 MIN)
PLAN CHECK 4 INSPBCI101G~$O-S.1O,ooo 14,*,;
Nen $30,000-$80,000 10'*'; Amowl tbaD , S2lIO miD)
APPROVED FOR ISSUANCB ~ _ _
for Oty .
h:PW PBRMrI'fhv.4J94 (ICe otber aide)
USA phone (800) 642-2444 TICKET NO.
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Sbcet IbaII DOt be opeD cut for UDdc!p'oUDd iaIhI'lan.- MiIlimum cull may be allowed for ~ or aplmatiaa bola. Such cull mUll
be --,fito.llllv IlDDI'OI/ed bv the IDmector mior to c:uttimL
Pawmeat may be cut for UDdcIpouIlcl iDltal"n.- ad mUll be ratOIecl in acamIaDce with the Utility TICDCb Ratoratiaa StucIard J>rawiD&.
Wort to be Itabd by a IiccaIed Lad Surwyor or Civil P..aaiDeer ad two (2) copia of tbe cut IbeetIlCDt to tbe Public Worb Deputment
before startiDI WOJt. - .
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_1.
srANDARD
AMOUNf
RPrF.WT NO.
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CITY OF CAMPBELL
PG6 GAG ~t-((Jt/Ic6 ~f~.
lor 2, iJ i~h.1feJ .
PROJECT NO. 9~.; 24 2-
REPORT NO: I
DATE: It/. I q{
WEATHER: {4-1 t2
INSPECTOR: K. rJ~~-rfALL
FIELD ENGINEER'S DAILY REPORT
CONTRACTOR: IG -:S
ITEM
DESCRIPTION
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