95-282
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an op CAMPBELL
DEPT. OP PVBUC WOlUCS
'70 NardI fi!It 5t.
r~~ CA 95(XII
<a) 866-2150
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APPUCA'DON - Applicatioa illIcrcbf ... Iw. PabIic Wadi:I PamiI . aa:adaDcc widll"--v-n Y,,",",?,I Code, Secd&:a l1JM. (Applic:PrinB apifts
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A. Wozt ~ or tract #
W/S 77 Harrison Ave, 30' N/O Campbell Avenue
Utility aadllocatioa 'S ; (10 otJ 01 k. .
B. Nat1Jftolwork 3x5 cut in .p.J.rkiR~ 3triI> for hydrant repair
C .Auadl four (4) copies 01_ eqiDeered dmwiq IIaoMq die Iar.aIimI. __ ud dim ... ol die.... 'DIe dnwitIc IlIaD... die n:Iaac. 01 the
pI'OIlOICd work to czilaiDllIIIfac:c aDd 1IIIdc......... '-t-~... II. ..... -w-.,.,.s b1 die 0lJ p~P-J aid dnwiq ba:aDc&. pal ol tIIiI pcrmiL
D. AU wart sbal1 CDDform to tbe Oty'1 GeaenJ r~,~ SIaDdud CoaIa\o.;Iioa ~ ud SIudud a.auaiaD DaaiII for PabIil: WOIb
~ me GeacraI Permit ~~ ..... Cl8 die ...... side; ad tbc SpDciaI ~ frx dIiI pamit. u..s below. IWbae to Uidc by
tbac c:oaditioal aDd pnMaiaaIlU1l'C111lt ill jab 1but4ln ud/or farfeiaue 01 PIidIfW PafonaIIIce SumieI aDd ~ dqaitL (See CiCDe:ral
Pamit CDaditioDS 1 aDd 2.)
P. A DClIIJ'CfUDdabIc apptic:atiaa foc IDUIt .. 1 ~J daiI AfiV:.....iolll
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Name of AppIicaDt
San Jose Water Co. T~ 279-7825
1221 So. Bascom Avenue, San Jose, CA 95128
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The AppIicaDI/pcrmincc hcftDy qrea by aftbiq dIeir......... to dIiI pamiI to baid die City oll"-..,,-o. ita dI:cm, apaD ad ulIlI c ,- fr-., WC
aDd humJcII (rom _, daiID or dcmaDd for damIpa IalIJdq tram tbc wart CIMNlI b1 tIIiI pamiI.
The ApplicaDt/permincc bereby KtDowIcdpa tIw tbey 111ft read aDd ~ bodIlbc fMat ud bIct 01 tIIiI pmait. aDd tbey will worm tbeir
alIlttactor(l) 01 the iDformatioa.
Dan ( verbal emergency)
(AppUcuI (Pcnmnec) pIiIII/lip
12/26/95
Due
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Nares: -AU. WORK SHAU. CONfORM WlIH 1HE ATrAaIED. APPROVED PlANS AND ALL APPUCABLE CAMPBEll. SI'ANDAJU)
DRA WINOS AND CONDmON5.
1HE CONI'RACI'OR MUS]' HAVE nus PERMn' AND APPROVED PlANS AT1HE SITE AND NUSI' NOTIFY 'mE PUBUC WORICS
DEPARThIENI" AT LEAST lWO DAYS BEfORE SI'AR11NO WORK.
NanCE MUS]' BE OIVEN TO PUBUC WORKS AT 12.ASI' 24 HOURS BEPORE RESrAR11NO ANY WOK
SPECIAL nOVlSJONS
_1.
$beet sbal1 DOt be opeD cut for 1IIIder&io-d 1.-11_... MiailDum ClltlIU1 be aIJoaoed for ~ or czpkntiaD bole&. Sudi ClltI m\llt -;:
~ mecific:allv atmrOYed bv tile l!lmeclmo m'ior to cuttinE. C
PavemCDt may bI: cut for UDdcI'p'OllDd i~_lII""" aDd IDUIt be reaan:d iD IICIlO1daDa: witIa the Utility Tft:Dds RaIamiaa Studad Drniq. t::l:
Wort to be araked by . IicaIed Lud s.u...,or or aviI PAP- ud twa (2) capia 01 tbe em lbeaI..c to lb& Public WorD DepanmcIIt t":
Won:: swUa.c wart. C":
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USA phone (800) 642-2444
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(1~ OP ENO. EST.)
(49(,OP SURETY, S500 MIN)
(FIRST Sl).S3O,OOO 149(,;
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PERMrr APPUCATION PEE
PlAN CHECK DEPOSIT
stJ'REI'Y fOR pACIHFUL PERFORMANCE
CASH DEPOSIT
PlAN CHECK .t INSPECIlON
Ncn SJO.OQO-SSO.OOO 109&; AIDouDI
APPROVED fOR ISSUANCE
(ace otheuidc)
TICKET NO.
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CITY OF CAMPBELL
FIELD ENGINEER'S DAILY REPORT
ITEM
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77 fl-a ~n.ro,^
PROJECT NO. 9 S- - U-z
REPORT NO:
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DATE :
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CONTRACTOR:
54.... JC>Jc WID ~
INSPECTOAR: K. ~~~rr~LL
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DESCRIPI'ION
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