95-274
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B. Nanm ol work D LL /) t' (C.O ~~ ci~ 1\..) (;) l') LAo. f - T --D K- S'V.'(J - J
C Attach four (4) copicc ol u cqi.aeeRd drniac IIbowiIIc tbc IocatioG, ateIlt _ cIim~DIioaI ol tbc wort. The drniac :n Ibow tbc ~~ dicJ~q -~2 .
propo5Cd wort to eziaiJlllUlfacc _ UDderpouad Impa~tL WbeIl approved by tbc aty EqiDccr, aid drawiac bccaaIcI . pat ol tbiI permiL
D. AD wort Iha]J coaform to tbc Clty'1 GcDcnl CaGditioal, Studud CoaItNctioa PIOViIioaI _ StucSard Coaa:nacdoa Details for Public Worts f
CoastnICtioIl; tbc GcDCral Permit CoDditioM Iiaed OD tbc KVale IicSe; _ tbc Special PIOViIioaI for tbiI permit, Iiaed below. Pailare to abide by ~
these CODditioal _ pr'OYisioaImay result ill job lbut4JwD _lor fodeiture 01 PIithf1II PaforJlWlCe Sureties _ calla dcpoIitL (See GcDCra1 ~
Permit Coaditioas 1 _ 2. , J. ~
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)or wortia& withiD tbc x," . file
public ri&bt~.....,) - J
IIIued / c.l- 6--~~ ) AppIicatioG Date /~ /5 / q \~
Pamit Cllpira ill ~ IDOL ;JJ.IJ AppIic:atioll Cllpira ill 6 IDOL
APPUCAll0N - AppIicatioll II bcrcbJ macIc for. Public Warb Pamit ill KICIOCdaDce witb ~~D NuaidpeI Code, SoctiOIlIUM. (Applicatioll Cllpira
ill 6 moatbs il tbc permit is DOt iIIucd).
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a~"Y Oil CAMPBElL
DEtT. OF P:mUC WORICS .
10 North P'U'It St.
CampbeU, CA 9SCm
(0) 866-2150
4/H-~ 11 eLl')
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A. wort addl'Cll or tract #.
Utility treDCb Iocatioa
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Complete aDd attach Worters' Compclll&tioa aDd Coatractor bformatioa fCInDS. .,. . 199s
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The AppIicantfPerminee bereby agrees by atfixia& their llpanm to tbiI permit to bold tbc aty ol CampbcD, ia ofticers, ~!Iff ~ Jree, lllCe
8Dd bannleII from uy claim or demud for damap rcsultiD& from tbc wort COYCrccS by tbiI permiL S 4 TI 0 ^
The AppIicantfP~r::r. 'tt~ .~~ackDowledp. :d..t they ~. rea4. ,'" """. rstaDd both tbc froat _ back ol this permit, and '1 will inform. tbcir
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./ (Applicant (permittee) print/sip
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Is this wort being doae by tbc property oner at their on 1'CIidcDce?
Yes
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NOTES: AlL WORK SHAll. CONFORM wrIlI1HE A1TACHED, APPROVED PLANS AND AU. APPUCABLE CAMPBElL STANDARD
DRAWINGS AND CONDmONS.
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1lIE CONfRACI'OR MUsr HAVE nus PERMIT AND APPROVED PLANS AT 1lIE srm AND MUsr NOTIFY 1lIE PUBUC WORICS
DEPARTMENT AT LEAST lWO DAYS BEFORE srAR11NG WORK.
NOTICE MUST BE GIVEN TO PUBUC WORICS AT LEAST 24 HOURS BEFORE RPSTAR11NG ANY WORK.
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-B SPECIAL PROVISIONS
Street Iha]J DO( be open cut for \1IldergrouDd iIl&taIJatioaL NiJlimum CIItI may be aJIoRd for COGDeCtioaI or expIoratioG boles. Such CUtl must
be mecificaUv atIDl'OY'Cd bv the lDSDCctor mior to cuttin2.
PavemeDt may be cut for UDdergrou.od instalIatioas &lid mUll be restored ill aa::orduc:e with tbc Utility TrcDCb Restoratioa Staodard DnwiD&-
Work to be staked by a licensed Lud Su.rYcyor or CviI EqiDeer _ two (2) copicc ol tbc cut IbeetlleDt to tbc Public: Worb DcpmmeDt
be~ ~~
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RFrFrPT NO.
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PERMIT APPUCAll0N PEE
PlAN amCK DEPOSIT
SURETY PaR FAITHFUL PBRFORMANO!
'"' CASH DEPOSIT
~ PlAN OIECK &: INSPECIlON
e Next $30,000-$80,000 10%; AmowI greate
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t: APPROVED PaR ISSUANCE
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-< h:PW PERMIT/Rev.4/94
* USA phone (800) 642-2444
Date
(lee other Iide)
TICKET NO.
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FROM RAYMOND ST CONSTRUCTION
FRQM:OMNIFAX
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(TUE) 12, 05' 95 06: 52/ST. 06: 51INO, 3561782365 P 3
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APPR'~:~\/E:.C . l~nf\!0TRf fCTION
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Public Vvorks ':\};'ITiit No.~--07'7,tC
Contractor must have these plans
on the job site during construction.
P{. - I? ~ ~ s
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OI.lC \ bl"ore y.~.c~ et.l.1
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FROM RAYMOND ST CONSTRUCTION
FROM=OMNIFAX
(TUE) 12. 05' 95 06: 52/ST. 06:51/NO. 3561782365 P 2
TO:
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PACIFICD8ELL. c;oma(1.8l)
A PdieTe'esic Conocrenv
Inspel:tor WOrk Order A...d Props. Report
E6l. Dr A.O. No.
^,tI-7CjS- S
Geo. Code AI 'f -10 Ort/cs
. CirY~~f1be/1
"if( 0 r I ~e L'-~f'f>
Indlv\duBl Ordsr No.
Localion (St.. Hwy.. Rd.. ere.) ~
l)J l~(,~U~ S ~-~" R l ud. . <:k.. k'c...., ..,~\.I
Conduit Sectio"5 MH CluanBtl R.m,rlc&
No. MH MH Duct LOF ADd Sll,lg MHNo. 0818 Duct and MH CO"dillons - weIer,
DalS Dale mud, sewBge, ()ulllron5, Jadder,
, 56 t'6[P J}l.LCr t1~&>"~ 't'li'1 ,..:t~... Via
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9 ~ "rove fhese plans
~ site during con",rucflOn,
'0 00 the ;0
..nhole crllBnlng And Dllct Slugging
DutIJ
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Date
Start
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TotalJ Houts end eo.,.
Rodd1nll Mrs.
ROdding Cost
SllI911lng tofra. (6)
Slugging CoSl
0.a'1ln9 Hr. (C)
MH Clellnlng CaSl
DATE:
TO:
FAX#:
FROM:
SUBJECT:
PERMIT #
95-274
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CITY OF CAMPBELL
Public Works Department
FAX MEMO
February 19, 1997
PacBell -- Chuck Jensen / Inspector
(408) 727-9345
Randy Westfall / Public Works Inspector
Utility Cut Deficiency Report
DEFICIENCY
Work was done at the SE comer of South Winchester Blvd. and Kennedy. The
work was done without notice to the City, and only partial flags of s/w were
removed and replaced. Our specs. require that the concrete be sawcut and
removed to the nearest scoremark. Please schedule remedial work, and
coordinate with the City prior to doing any further work. Was work done by a
subcontractor, or by PacBell forces? The workers may have been trying to stay
away from a large crack at the joint they would normally have removed to, but
they made the wrong decision, and did not give us a chance to have any input.
Call me and we can discuss it.
Deficiency must be corrected within 10 days. Work must be performed under a current
encroachment permit. Notify Public Works prior to any work being done and for inspections,
by 8:30 a.m. on the day before work is to be done.
Telephone (408) 866-2165 Fax (408) 376-0958
70 North First Street' Campbell, California 95008,1423 . TEL 408,866,2150 . FAX 408,379.2572 ' TOD 408.866,2790