97-156
CTTY OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 Nonh First St.
Campbell. CA 95008
(408) 866-2150
Fax (408) 37~958
~NCROACHMENTPERMIT
~fcr. working within the
public right-of-way)
_'5I!!i7
Permit expires. 12 mos.
P "'lit No.q 7 -/5t.o
.:C. File
Application Date 6" - / - q 7
Application expires in 6 mos.
APPLICATION - Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code. Section 11.04. (Application
expires in 6 months if the pennit is not issued Application Fee is non-refundable).
A. Work address or tract #
Utility trench location
B. Nature of work R cPUHr IE'
.:it J;) 3D
HAR.Rlcl
CROSS S71l..EEr 15 LI'rrL€70rv
U N~E" 6-R.Ol.U\/D SoG f.LJ' Ce-
S. D. #
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C. Attach four (4) copies of engineered plans showing the location and extent of the work. and four (4) copies of the preliminary Engineer's
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by
the City Engineer. said plans become a part of this pennit.
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit Conditions
listed on the reverse side; and the Special Provisions for this permit. listed below. Failure to abide by these conditions and provisions may result in
job shut-down and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions 1 and 2.)
E. TIlE CONTRACI'OR MUST HAVE THIS PERMIT AND APPROVED PLANS AT TIlE SITE AND MUST NOTIFY TIlE PUBLIC WORKS
DEPARTMENT AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEASf f4 HOURf
BEFORE RESTARTING ANY WORK.. " A:,)xjA,~ ~J ~
Name of ApplicantlPenninee Pac 1 fl c Gas & El ectn c Company Telephone (408) 725-2022
Address 10900 North B1 aney Avenuf>. Cuperti no. CA 95014'
Is this work being done by the property owner at their-own residence? Yes
No
RECEIVED
The ApplicantIP~rminec hereby agrees by affixing their signature to this permit to hold the City of Campbell. its officers. age~ lIP~oyees free.
safe and harmless from any claim or demand for damages resulting from the work covered by this pennit. MAY U 0 ~,
TIle ApplicantlPermittfe hereby acknowledges that thef have read and understand both the front and back of this pe~,~Q. ~)l-mform their
contractor(s) of information: >-\OMINISTRA TION
~ lAM" I-1-IfR-T2... 7.;2~.;l.:z7 5-8- 97
Date
FACTS TAG #811
SARA TOGA SUBS TAr ION
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DEAD LEG
1230 HARRIET
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PACIFIC GAS AND ELECTRIC COMPANY
SAN FRANCISCO, CALIFORNIA
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E96948
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