2055 S. Winchester Blvd. (1995)
Please collect & receipt for the following monies:
. Acer. ITEM
435.535.49211 Project Revenue (specify project)
ENCROACHMENT PERMIT
4722! Application Fee
Non-Utility Encroachment Permit ($225)
R-1 First Permit (No Fee), Subsequent Permit/Yr ($100)
Utility Encroachment Permit
Arterial/Collector Street
Residential Street/Other Areas
Plan Check Deposit
Faithful Performance Surety (FPS)
Monumentation Surety
Cash De osit
Labor and Material Surety
Plan Check & Inspection Fee INon-Utility)
EngLEst. < $250,000
Engr.Est. > $250,000
Utility < $100,000
Conduits/Pipelines up to 500 Feet
Above 500 Feet
Manholes/Vault~--
~ole Set/Removal
Minimum CharQ8 Per Location
Street Tree Planting/Removal
Utility> $100,000
Project Plans & Specifications
Standard Specifications & De.1-a~~_
Copies of Engineering Maps & Plans __,
Penalties: Failure to restore public improvements
(Muni Code Section 11.34.0101
4722 Penalties: Failure to correct unsafe conditions
LAND DEVELOPMENT
4722 Lot Line Adjustment
4722 Parcel Map (4 Lots or Less)
4722 Final Tract Map (5 or More Lots)
4722 Certificate of Compliance
4722 Certificate of Correction
4722 Vacation of Public Streets & Easements
4722 Assessment Segregation or Reapportionment
First Split
Each Additional Lot
4721 Storm Draina e Area Fee Per Acre
TO: City Clerk
v
. J,/"'
2203
4760
4760,
4760
4722
/"
V
PUBLIC WORKS DEPARTMENT RECEIPT
Effective July 1, 1995
PUBLIC WORKS FILE NO. _~;?~ L~~
AMOUNT
~ "----,-._--.
~~L.._
2203:
2203,
2203'
2203'
2203
($325)
($225)
1$500)
(100% of ENGR.EST.)
(100% of ENGR.EST.)
(4% of FPS)($500 min.)
(100% of ENGR. EST.)
~.. ]3L2!i""____ ,~ ~L
.-.......----~ d'IJlf'./ 'V-..
~~Sij_xJ~L
",,_/L~
4722
2203
4722
112% of ENGR. EST.)
IDeposit 15% of ENGR. EST.I"
~.QL!t..L..-----,---
($1.10/ft.)
1$105/ea)
($105/ea)
($120)
($1 05/treel. ___
JDepositJ.5% of E_NC3_R~ EST.)""
ProI"..C..t...NcJ'
l$l/Pg $12/Bo,o,kl
1$.50/sQ.ft.)
($ 1 OO/Calendar Day)
1 $ 1 OO/Calendar Day)
($500)
1$1,060
($1,380
($400)
($300)
1$550)
+ $25/Lot)
+ $25/Lotl
.-4~4?C.
($550)
($170)
IR-1, $2,000)
(Multi,Res, $2,250)
(All Other, $2,500)
--- .4'7~--
4965
TRAFFIC
4728
4728
4728,
4728
4728'
4271
4728
OTHER
Postage
Intersection Turn Counts (Two-Hour Count) ($60)
Intersection Turn Counts (a.m. or p.m. peaks) ($125)
Traffic Flow Map !Daily Traffic Volumes) ($27)
Campbell Traffic Model (Full Scope Assessment) ($2,250)
Campbell Traffic Model (Reduced Scope Assessmerl$740)
Truck Permits ($35/trip)
No Parking Signs ($lIeach or $25/100)
TOTAL
s._4D~-3
NAME OF APPLICANT
ADDRESS
PHONE
ZIP
RECEIVED BY
FOR
CITY CLERK
ONLY
i Date
Rcceipc:1t-
"For Plan Check and Cash Deposits, send yellow copy to Finance.
"Actual Cost Plus 20% Overhead lNon-interest bearing deposit)
Date/ Initials
h:\recfrm3.wk3(mp)rev.7/11/95
cm OF CAMPBELL, cm ENGINEER'S CONSTRUCTION ESTIMATE
Add~ss:
I Surface Construction
Mobilization
I Construction Traffic
Control/Phasing
! Construction Staking
Clearing & Grubbing
By:
PERMIT NO'1
Date: :
Date: :
12-Jul-95 I
Approved:
i Lump Sum Estimate ''m.OO.....
Sawcut Concrete
Concrete Removal
Asphalt Concrete Grind
Curb & Gutter Removal
Curb & Gutter, Type A2
, Rolled Curb
Sidewalk
Driveway Approach
Curb Ramps
extruded Curb, Type AI-B3
Median Island PCC Cap
i Adjust Manhole to Grade
j Adjust Handhole to Grade
Signing, Striping, Markings, Markers
! Install Monuments
@
.l\OO.lJ.CL ~
$0.00
~(jJ.t() -:
$0.00'
$0.00
..
..
$0.00,
S23.00 1
S0.50 I
..11
SI6.001
$0.00:
12" RCP CL. V
IS" RCP CL. 111
21" RCP CL. 111
24' RCP CL. 111
Storm Drain Inlets
Storm Drain Manholes
Connect to Exist. S4"
Connect to Exist. MH/DI
Adjust Drain Structure to Grade
Remove Exist. Inlet & S" CMP
Traffic Signal/Street Lighting
Remove and Replace
State Type IS SUeet Light
12' Mast Arm
Pull Box # 3 1/2
I 1/2 PVC Conduit wiNS Conductors
PG&E Service Points
15 Gal. Street Trees w/Irrigation
Roadway Excavation
Class 111 CSJ Aggregate Base
Type A 3/4" Max. (Medium)
Asphalt Concrete
Type A 1/2" Max. (Medium
Asphalt Concrete
Grade SS-I Fog Seal Coat
EA@
LF@,
LF@
LF@
LF@
EA@
EA@
EA@,
EA@;
EA@!
EA@:
S4O.00
$0.001
$0.001
~)~~c.5.tt)"'1
lD'\'6.00 ....1
$0.00:
$0.001
$0.001
$0.001
$0.00
----.
$0.00
SO.OO
SO.OO
so. 00
so. 00
so. 00
SO.OO
$0.00
$0.00
$0.00
--
SO.OO
SF@I '~.5D
SF@:",,\.~
EA@I
LF@I
SF@I
EA@I
EA@'
Lump Sum Estimate
lo\D
<to
"'1
...'
SSOO.OO'
SIO.OOO.OO
S550.00
S !\t()\QD
L\DtJ.Dt>
,
Lwnp Sum Estimate
I
I
i
S2,OOO.00 I
$0.00,
EA@I
EA@,
LF@I
EA@i
EA@I'~'S
.....1
SI5.001
S20.00 !
SO.OO,
$0.00,
SO.OOI
SO.OO,
...
$0.00'
$0.00
CY@i
Tons @
'-\ :~
Tons @ I ~().t()
--
\l\.a,.QO
..
Tons @
Tons @
~,&.\~~ ..
'~rs
,~~
10% CONSTRUCTION ENGINEERING ~ 4..\~
- \c1~
I, \a~b06.
SUBTOTAL CONSTRUCTION ITEMS .ll
10% CONTINGENCY
10% PRELIMINARY ENGINEERING
I h:\conste5t.wk3(mp)
. TOTAL ESTIMATED COSTS:
USE FOR BOND:
PUBLIC WORKS DEPARTMENT
CONDITIONS OF APPROVAL
~u \.\.....\.":;.i~ PefLV-'tl ~
APPLICATION NO: h.p~\.C-I-q-'-D~ ~. ~ 'S--=s;a \
ADDRESS: <'L-DS'~ ~,'-^l\~~
BY: Harold Housley. Land Development Engineer
APPROVED BY: Robert Harary. City Engineer
DATE:
THE APPLICANT SHALL:
X Streets and Related Improvements:
A. Install curbs and gutters
X B. Install sidewalks (and. IlRHdicap ramps) \>.... 1 \ ~
\~~ vJ ~L-^- c:-::;.', \ ~ \2.-\ ~Tl~J \
~,~~q - "'r~~
x
C.
Install driveway
~
D.
Install
feet of pavement along
~
E.
Install asphalt concrete overlay
~--
F.
Install seal coat
1
CONDITIONS OF APPROVAL
?
~
x
x
~
~
~
x
7/3/95
G_ Install street lights in accordance with City of Campbell Street
Lighting Policy
Traffic Control Improvements:
Install traffic control improvements including pavement stripes, markers,
markings, traffic control signs, street name signs, signal conduits, and related
improvements, as required by the City Engineer. Comply with the City
Traffic Engineer's memorandum dated
Streetscape Improvements:
Install landscape, hardscape, and irrigation improvements in the public
right-of-way in accordance with the City of Campbell's Streetscape
Standards.
Landscape Improvements:
Install trees, irrigation, and related landscape improvements, in the public
right-of-way per Title 11 of the Campbell Municipal Code.
Screening of Utility Facilities:
Screen all above ground utility equipment within the public right-of-way and
on private property to the satisfaction of the Community Development
Director.
Parcel Map:
Submit Parcel Map for approval by the City Engineer and record said map
prior to issuance of building permits.
Final Map:
Submit Final Tract Map for approval by the City Engineer and record said
map prior to issuance of building permits.
Street Improvement Plans:
Provide Street Improvement Plans for review and approval by the City
Engineer for all improvements and landscaping within the public right-of-
way_ 'T~ p~:;:. ~~LL \OC-\-.L)VJe: '\{'lC=:
tc.-t::---<:.c'>-~'f.--.)~~Tl~ Q) \3""- ~ oFF<; rre
~TDt2-tA--\ \:)~\ f.-) tLJL-eq- "rO
~.~ e. L?r2-~ C2..i.-,'-( ~'T~~~
2
CONDITIONS OF APPROVAL
x
~
x
Grading and Drainage Plans:
Provide grading and drainage plans for review and approval by the City.
Easements for grading and drainage shall be shown on the Final Map and
offered for dedication, as appropriate.
Soils Re{>ort:
Provide a soils report, prepared by a registered Geotechnical or Civil
Engineer
Storm Drain Design:
Design of improvement plans for storm water conveyance facilities shall be
based on a 10 year storm frequency.
X Hydrology and Hydraulic Calculations:
Provide hydrology and hydraulic calculations l \L~c::::::
tb~\t--..:)~c=q~ ~:::::"~IJ.........-~ '"'l7-~ l L~C:__L......U~-~E-
AP'f---I ~~-~\- C:J~
~
x
x
~
7/3/95
Structural Section Design
Design a pavement structural section based on a traffic index per the Traffic
Index table provided by the City Traffic Engineer, a soils report provided by
the applicant, and related information as determined by the City Engineer.
Registered Civil En!!ineer/Land Surveyor:
Cause plans, specifications, calculations, reports and designs for street
improvements, grading and drainage improvements and the Record Map to
be prepared and sealed by a Civil Engineer, Land Surveyor or Architect, as
applicable, licensed in the State of California and submitted to the City
Engineer for approval.
Standard Specifications & Details:
Comply with the City of Campbell Standard Specifications and Details for
Public Works Construction.
Subdivision and Land Development:
Comply with Title 20 of the Campbell Municipal Code concerning
Subdivision and Land Development.
3
CONDITIONS OF APPROVAL
x
~
x
~
~
?
7
~
-qC --
,.
~
7/3/95
Streets and Sidewalks:
Comply with Title 11 of the Campbell Municipal Code concerning Streets
and Sidewalks.
San Tomas Area Neighborhood Plan:
Comply with San Tomas Area Neighborhood Plan design standards.
Disabilitv Standards:
Comply with the Americans' with Disability Act and the California Disability
Access Regulations, whichever applies.
Storm Water Management:
Comply with California Storm Water Best Management Practice Handbook
for Construction Activity, dated March 1993, prepared by Storm Water
Quality Task Force.
Right-of-Way Dedications:
Provide right-of-way dedications
Title Report:
Furnish current Preliminary Title Report(s).
Record Title Interests and Easements
Comply with Section 66436 of the Subdivision Map Act regarding existing
record title interests of others.
Reciprocal Ingress and Egress Easements
Provide reciprocal ingress and egress easements
Access Rights:
Relinquish access rights to
Underground Utilities:
Install electrical, telephone, and cable television facilities underground, in
accordance with the provisions of Chapter 20.36.150 of the Campbell
Municipal Code and as required by the City Engineer, prior to occupancy.
4
CONDITIONS OF APPROVAL
~
~
-~?
~
-~
Utility Construction Coordination in Public Right-of-Way:
Submit a Utility Coordination Plan and Schedule for approval by the City
Engineer, for installation of electrical, gas, telephone, cable television, sewer,
water, and storm drain improvements to minimize damage to City streets,
sidewalks, and related facilities.
Sanitary Sewer Service:
Install a sanitary sewerage system to serve all lots in conformance with the
requirements of the West Valley Sanitation District.
Water Service:
Install a water distribution system to serve all lots in conformance with the
requirements of the San Jose Water Company.
Other Utilitv Services:
Install electrical and gas facilities in conformance with the requirements of
Pacific Gas & Electric Company. Install telephone facilities in conformance
with the requirements of Pacific Bell. Install cable television facilities in
conformance with the requirements of TCI Cable.
Flood Control:
Comply with the Santa Clara Valley Water District's letter dated
X Storm Drain Area Fee:
Pay the then current storm drainage area fee prior to
. Current amount is $ per acre.
~
0/
~
~
7/3/95
Park Impact Fees and Park Land Dedication:
Dedicate land or pay fee in lieu of dedication, prior to recordation of the
Final Map, as required by Chapters 13.08 and 20.24 of the Campbell
Municipal Code.
Transportation Improvement Fees:
Reimburse the City a proportionate share of the documented costs of the
transportation improvements located in the vicinity of the project.
Security:
Provide guarantees to design and construct all public improvements by cash,
bonds, letters of credit, or other legal instruments acceptable to the City
Attorney.
5
CONDITIONS OF APPROVAL
~
~
~~
~~
~~
~
~
x
7/3/95
Monumentation:
Furnish the City with security guaranteeing the cost of setting all monuments
as shown on the Final Map Parcel Map
Taxes and Assessments:
Comply with Sections 66494 and 66493 of the Subdivision Map Act regarding
taxes and assessments.
Reimbursements Owed to the City:
Reimburse the City of Campbell for street and related improvements as
agreed by letter
Street Improvement Agreement:
Complete and record the City of Campbell's Street Improvement Agreement
for construction of public improvements.
Condition. Covenants and Restrictions:
Submit Covenants, Conditions and Restrictions (CC&R's) to the City for
review, which contain provisions for a Homeowners' Association to have an
unqualified right to assess owners of individual units for reasonable
maintenance of common areas and improvements.
Management and Maintenance Agreement:
Furnish and record an agreement, acceptable to the City, prior to recording
the Final Map. Agreement shall demonstrate that the project will be
maintained in accordance with the intent and purpose of the approvals; and
provide for the on-going financial responsibility for the life of the project of
each lot created by the proposed Map (upon their sale) to the Homeowners
Association for the maintenance of common areas . The agreement
to include a Consumer Price Index factor (CPI) for fee adjustment, and shall
be incorporated into the CC&R's for the project.
Encroachment Permit:
Obtain an Encroachment Permit, pay fees and deposits, provide bonds and
insurance certificates for all construction within the public right-of-way.
Encroachment Permit includes the one year post-construction, maintenance
period requirements.
6
CONDITIONS OF APPROVAL
x
x
~... 7~
~. .
Dust Control:
Implement the requirements of the Bay Area Air Quality Control
Management District including the following mitigation measures:
A. Water all exposed or disturbed soil surfaces to control dust, as
necessary, but not less than twice daily;
B. Water areas of digging and grading operations;
C. Suspend grading or other dust producing activities during periods of
high wind;
D. Water or cover stock piles of soil debris, sand and other dust
producing material;
E. Sweep construction area and surrounding streets daily.
F. Cover trucks with tarp during hauling.
Completion Prior to Occupancy:
Complete construction of all required off-site and on-site improvements prior
to occupancy of any structure.
Coordination of Improvements with Capital Improvement Proiect:
h:condapp.frm(mw)6.0
(Master Copy - 1st Edition)
7/3/95
7
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PUBLIC WORKS .EVIEW SHEET - BUILDING P!. .IT APPLICATION
:mq::ii:i!MIlsgFJp14..~.vjl~mll;lill~li~.lm~~~I~!~~ill1~~iHi~.I.$grrrtrii;@11;i~;1i;;;;i1:;1i;iI!iiIiIililiiii
rERMIT ADDRESS: _ ~
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NAME OF APPLICANT:
RECEIVED
JUl111995
ADMINISTRA TIOI\;
DATE
!m9:::!:iC~':i~i1:[~i~qempi!I!~![![ii~z::!I!5s~ni:gAmgi;:iiiii[ll*ltl:i[mi[iiI:[~:[!ii:iii:~I:i:Ii]i[miim!:!:!illi~tlIl]l!::im:i:i:::!iii~lli:iirii@[i[iii!iiirriI:I!:i:l:i!IiI:!:!
CHECKLIST YES NO CHECKED BY:
Street Improvements Required
Dedication Required
Storm Drain Fees Paid
'iii::!ii:.i:ii:iiiii:i!iiIiiiIii1i!IIi!i!ii:i!!:i!i:::i:!iii!:IiliiiiiM!iiII:iiIIIi:!iliIIiiiI!I:iii:ii!iiI:iiiiIiii:i:Ii:ii!i!:iiiIiiiiiiiiii:i:iii:i:iii!i:iiII;iiiIrmliii:iIiiiiii;i]!:[iiiiiili!Iiii~iIi!iliIiiiIiIIiiilii:i;iiiIIii;iiiIi!:!:::!:iiiiIi;;ii:lriiiiii;ii;iiiiliIiiiiiiiiii;i::'iiii::::::;!:i!;!iii!:!i:!
IpW - ENGINEERING REQUIREMENTS:l
IAPPROVED BY:
IDATE: