97-115
CITY OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell. CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working within the
public right-of-way)
Issued ,;2-1-41 cJVf
Permit expires in 12 months
Permit No.
X-Ref. file
q 7 - / /8
Application Date ....;:b /L/ /f 7
Application expires in 6 months
APPLICATION - Applic:aion is bercby IIIIIdc for. Public Wn PamIt in KiCCIIdaDllc willi Campbell M~ Code. ScICtioa lUN. (App\kIIiaa ClIpUa in 6111111111ls
if die permit is DOt issued. Applic:aion Fee is 1IOIHdmdIb1e.) \
A.Wortaddras ortnct' ~ ~U. ')(~ tptJu€ ~ ,~,~ ~ ~ ~.
Utility Iraldlloc:ation '?~ ~,,;y#,\ c> OCttlE
B. NIlureofworti~ ...-r~O tJil e:u,{'l ~1:2.. v.u1l-\~ ~e~u.\
C. Aaach four (4) copies of an qiDeered plans abowiDa die Ioc:IIioII and eIIaI fA die wort, and four (4) cop_ fA die pnIimiaary EaJiDecr'I Eaci.-e fA wort. The
... abIII abow the reIaIion of die proposed wort 10 eDstiDa IlIrf8ce and IIIIdqrouDd iIIIprovaDaD. When IIpIIIOftlI by die Qy EaJiDecr, aaid plan IIeeamra . part of
lhiI permit.
D. AU wort lbaIl comonn 10 the City of Campbd\ SlaIIdanI SpecifiI:IIioII and DelaiII for Public Wn CoaItnactioa; die GaIInI PamIt CaadiIioaIIiIIed 0II1be reverse
lide; and die Special Provisiona for Ibis permit, listed below. Failure 10 Ibide by Ibeac ClIIIdiIioaa and provisiolll may I'eIUIt in job ....-down rIII/JIor forfeiIuR of FIid1fuI
PaformlllCC Suretiea and cash deposits. (See GaIen\ PamIt CoIlditiollll and 2.)
E. THE CONTRACTOR MUST HAVE TlDS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS DEPARTMENT AT
LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK.
Name of Applicalll.~~1" ~ ~ttf\1pJ ~ ( t-.HHc Re~ ~~= ~J'6/d
AcldrcsS~' ~~1~ n)/-~ 24 HOUR EMERGENCY TELEPHONE NO.
Is lhiI wort bein& done by the property owner It tbeir own reaidClll:e?
Yes .LNo
The ApplicanllPmniaee hereby acrees by afflXiDa tbeir lipaIure 10 lhiI pcrmillO bold Ibe City of Campbell. Is officen. .... and employees free. aafe and barm1cu from
any claim or daIWId for damaaes rcsuItin& from Ibe wort CIlIYend by this permit.
IIIIdenWId boIb die from and ba of lhiI permit, IIId Ibey will inform tbeir cocmcror(s) of die
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SEE PAGE 67
WEST VALLLEY SAMTATION DISTRICT !
PUBLIC WORKS DEPARTMENT RECEIPT
Effective July I. 1996
TO: City Clerk PUBUC WORKS FILE NO. 97-//5
PROPERTY ADDRESS 350 //a...../4..... /)",.
Acer. Please collect &: receipt for the followinlmonies: y >:'AMOUNt .
I ITEM
435.535.4921 Proiect Revenue ISDCCifv llI'Oiect) S
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encro.cIunent Permit (5225)
R-I Firot Permit (No Feel. Su"-uent PermitlYr ISIOOI
UtililV Encro.chment Permit
AneriollCollector SlIed 5325
Residential SlnlellOther Areu 522Sl ;J,0l. ') --
2203 Plan Check Deoosit - rle ofENGR. EST. SSOO minI .
2203 Faithful Performance SecuriIV IFPSI 100% ofENGR.EST.1 .
2203 Labor and Materials SecuriIV 100% ofENGR. EST.I
2203 Monumentation Security 100%ofENGR.EST.1 .
2203 Cash Deoosit 4% ofENGR.EST.lISSOO minlSlO 000 maxI .
2203 Labor and Material SecuriIV 100% ofENGR. EST.I .
Plan Check &: Inspection Fee (Non-Utility)
4722 Engr.Est. < 5250,000 (lrle ofENGR. EST.)
.. 2203 EnlU.Est.>S250,OOO IDooosit8% ofENGR. EST.1S30,OOO min. .. .
4722 Utilitv < SIOO,OOO 18%1 12.<J
Minimum Clw'ge Per Location (SI20)
ConduitslPipelines up to 500 Feel (SI6O/ft)
Above 500 Feel (S 1.1 OIft.)
ManholesIV aultsIE\c. (SIOS/ea)
Pole SetlRemoval (S I OS/ea)
SlIed Tree Plantinl!iRemoval fSIOSltree1
.. 2203 Utilitv > SIOO.OOO Actual Cost + 20%.. .
4760 Proiect Plans &: Soecifications Proiect No.
4760 Standard Soecifications &: Details (SlIP. SI2/Bookl
4760 CODies of En.ineerin. Maos &: Plans IS.sO/<nft.1
4722 Penalties: Failure to restore Dublic imprDvements IS I OOlCalendar Davl
IMuni Code Section 11.34.0101
4722 Penalties: Failure to correct unsafe conditions IS I OO/Calendar Dav I
LAND DEVELOPMENT
4722 Lot Line Adiusunent SSOOI
4722 Parcel Mao 14 Lots or Less) SI,06O+S25/Lotl
4722 Final Tract Mao IS Dr More Lots) SI.380 + 52S/Lotl
4722 Certificate ofComDliance SSOOI
4722 Certificate of Correction SJOOI
4722 Vacation of Public Streets &: Easements SSSO
4722 Assessment S~ation or Reapportionment
First Split (SSSO)
Each Additional Lot ISI701
4721 Storm Drainage Area Fee Per Acre (R-I, S2.(00)
(Multi-Res, 52,250)
I All Other, S2 5001
4920 Parkland Dedication Fee
4965 PostaRe
TRAFFIC
4728 Intersection Turn Counts wo-Hour Count) S601
4728 Intersection Turn Counts lam. or D.m. oeaksl SI2S1
4728 Traffic Flow Mao lDailv Traffic Volumes) 527
4728 Camnbell Traffic Model (Full Scope A........entl 52.250\
4728 CamDbell Traffic ModellReduced Scone A........enll S7401
4271 Truck Permits SJ5ltrinl
4728 No Parkin. Sians Sl/each or S25/1001
OTHER
TOTAL S 34-5.60
NAME OF APPUCANT //1 k4 !/a./ It_ ~ S-~.:-k -1/0;'1 Jisf/'Jc;f
J1tp / /0 l,'hPj~~$. .
NAME OF PA YOR PHONE 377.... ~/Q5
ADDRESS :J.(,O tr1("~Jij~ / hAAD. r_ ^ 1:0 tl ZIP 9')<XJ f
V I
.. Actual Cost Plus 20% Overhead (Non-Interest bearinK deposit)
FOR
CITY CLERK
ONLY
RECEIVED BY
Cl0
c2:/qb -, Ra:eipt N
tptl.{,'lL-.
Date
.For Plan Check and Cash Deposits, send yellow capyto Finance.
Date! Initials
b:....fnn4. wkJ(mp )rev7/1196
CITY OF CAMPBELL
FIELD ENGINEER'S DAILY REPORT
PROJECT NO.
q7 - I I 5
LulLs-, l/4u-~y SAl\,ftTA'TION '0, S:7:
REPORT NO:
DATE :
5{- 06- q7
t/:L(.5
WEATHER:
C. L r..: Arz..
CONTRACTOR: .,..,..., FL l c.. (;)
PI PIE... ,'- I N 1<:-
INSPECTOR:
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