ENC2009-000530411512009 12:39 4082991089 PGE 308 STOCiCTON SJ PAGE 01102
~.~ ~ yr ~.-rtilvlrliLl.L ENCkOACI~MENT PE~.2MI'1' _. E ~ C 2Ap ~-'
DEPT. QF PUBLIC WpItICS Pccmt`t Igo. ~QS
70 Nol'th First St. ffoz wozlczng within the X-Ref. Mlle
Camgbal~; CA 95Q08 ,pebiit: righut-af--way) ,
(4Q8} 866-2150 Issued I
Fax~(408} 376-0958 Permit eapir in I2 months APPIicatiou Dale • R' _ ` C
~r~~~,,, ~ ' APpIicatioa expires••Sn i5 moatQs ~}'I~~
APPLICATION - Appliradan is hetidy tnede for a Public Works Pot~roit;n ~~ ~W/~ boU Muniei s1 ~~N ~~~ '~`,`=~ ~ ~ ~ ~ F
if tha petntit is Clot issued. Application Fee is non- Catap P Code. Seumn lI.U4. (Application rzphec !a 6 m~ N 0 ~
reRrttdshtc•) ~ ~ E
a. Woc'k atldreas or ttycx p ,~,~ dtJ~S'% .~D.S'G~<-l~,L°;~ G f[/_' G'i~~"IPQFGG W "° U c
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Crtility tregeh taratzon U12 T /•/ .$'/.a ~ (1~~ /~C~'~li..~ ~Ji~ ~l' Lit-/ . --~-~ ~ ~ m ;
odd 1~~ ' a ac
S. NattueofwoNt CA~.~c~ ~"Xl~Tix/~ ~larlvT paG~
C. Atraatt four (4) r4pie of gn engiruxred plans shtrwinB dte togtioo and rxtent of dte wo
ptaus shalt show the relazinn of nc~ ~, and four t4) copies of thr prclimiuery fitigitKer's i;'atittt,te of wot'k. The
Chia p~rtait. , ~~°~ work to ezisdrtg surfer and nndergmurld improvementr. Whm r+pproved by dte City ~ehrert'. Paid plan beromCS a pros of~
A. All work shall coafatm m rhC City at Campbell Standard SpeGfiCatioru atni Dr~Jg fur Public Wotlra CbnsCrutsion: [lCe General Pa'tfsit Cmlditioao iisred an tht rLwetx
side: anti the Sprc}al Provisions for Chis pamit, [istt~ below. Failarr• ro abide by thae conditions and provisions may souls in job sbttt~owa aadlor farfciurie of Faithful
Perforrraaee 5uraia and ravh deposiCS. (See General Permit Conditiotls 1 and 2.)
E. THE CONTRACTQR MUST RAVE THTS.PERMIT AiVl7 APPROVED PLANS AT THE SCf£ AND l~ftJST NpTIF1' THi-s PUBLIC WORKS DBPAiLThiENT A'f
LEAST TR+O DAYS 9FFORE STAR'1'IN6 DVORI{, NbTICE MUST B& GIYSN TO PUBLIC WORKS A7' LEA57' 7,4 HOURS BEI7DRE RESTARTING ANY SYORK.
l~fatttc M Appliotlt r~i~Clf !G Ca'~S' L/rMt'/ t~~~~'%~t /~ G'l7. '
...1,..-..._, Telepborle ~at~ ~~~-,i~I~.~
Addrrsa •.~~~~ -~~~~~'~~•71V /,~ l1~i . .~%~~.IG.S E ~~/~ ~ '
. , ,,.... Z4 HOUR EMERGENCY TELEPHONfi NO.t S~G~,J [~4}'~~I JI,j
Ii this work~bL+itig dahe by the pPaPCrp' ownr°r et their o+vR residcncel ~ . , ~. ,
Yes ~- No . - , .... , , . .
The Appttranypq hereby eQras by affixing their eiettatu[e ro this permit to hold the Ci of Cam bell; its offitxrs, nrS and em I .
, at>,y c[aitn ar detttgad for demaycs resulting from tha watt coveted by tbii perrrlie. ~ P ?6e P oY~ free, safe end harmless f4om .
TIiQ +t-PPticauJPermiaa hereby Acknowledges that they have read an4 undorsttind both the fT6nt and bagit of dt)S ptrmi!• end they will ittfotm their camrattat(s} of the
itifonnatioa.
i C:. rr~I . .J.
/dQ
SPECL0.L PItgVISCDN
-.1• Siren sha11 not'be open cut for uitdc ound itlsmllatlo ; ~ •' -, - ~• ~ • 1 -' : • ~ ~ :, ;
. * ~bk die 7rshecrnr'at5a`-[o at~ine.. tu. $Y[iuimum ate ~tgy be s]lawed for catu,ot+oas er.~up)oruiori doles. 31rdt ~tix tnsy be sxati ~i ~'
,._,_Z. Paverttent [clay be cut for undetgTannd ir+snliationi-~mi! must°bC.reamtcd'in.accoCdaece wish the Udll- 'T ~:
' aPP~'Pd.'b 1 e~tar. ,
orherwkse y a'Eita~ttseQ Csrtd Surveyor or Civil Erjgtnerr :.. . , - ~; toradoa ~Sisrtdazd Dads, N3dhoQ 'i(',~itftp
ez 5eehea d2u ue r ~ ~ .. .....' ~~;o. th~ s : -. - , ... ,+. ,
4_ p ` ~ r}le• Gavcmtaait Cove this ~ ~ ~ ~° ~) *AP~'Of du cut sheers ~e 'Public Waeks ~,befatr; s . work. .
iident~fieation norltber has }~ germ¢ u aid;v.Ilid Yar;dtea'vaiionr urirs'1 [3ntkjgrotenC'.y5etvicc:l-lttti`([1$+Ay imf been: notified end the irxEaltry ~ % x;: ~. ' `
:.:~S;F ., . ilereotr. ,VSA Pho 'Bd~~:7;Z600, ..:t1SA'TICKST,ND, ' ,
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.SE PiIH WD S'1;5E CH&Cl FOIt,. '`, -~' 'x. ~•~ , Y'';~.~ . ;..
.. ES~ s t •~ } ~~i '.i4MOl :r. i'_ CEIPT'H '
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-PERMIT APPi.[CA'ITON FEE - .- s ~:. '. ~ ~ .
Pi..~N CHSGK bEposrr " - .. ~ • . s ,. ., ~~~ . ,
'sECVRi~'y FOR Ie.AITHF[R. psRFdRMANCER.AgpR.Bk'•MAT&R~(.s .. ~, ~ h ~ • ',5-..~„_
COIY~UCTION CASH DEPt7SIT - ; ~ S ,
PLAN CEIECK $ INSPECiTON FE'$ - ~ `:'s. r. ':: ~-},° ~-+~~ ~,; ~ ..
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-'ApPROVFaL1FOR IS5UANCfi ~•"''`' ''~~, ,,,
• _ •. .' ~ ',tor Clty Eaginecr ~ ~ .~
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0411512009 12:39 4082991P89 PGE 308 STOCE<T0N SJ PAGE 02!02
GENERAL PEIi:141IT CON ITI NS
1. A CON$TRIICTTQN CASH DEPt?51T is squired. Chargas wil! be made against this deposit if there is an emergency tail-out, ovenime inspection
or when Ciry oMesd batTicading is requin:d. Any ouch costs in ozcess Of the depOSit wt~! bo billed m the Permittee.
~• pv CNE-',fEAR tvlA]AfTENANCE PERIpD AND SIJRl;TY as required. Swch perlod~ will licgin on date of written aeecptaaee by tiro City.
3. R.1=FUNLI of ilae Bash deposit balance and ~efutsd ar. eanctIIation of the Faithful perForrry~nen $r~rtry wi[1 bt inidarrd by tha written ataeptutce of tftc
work, by the Ciry.
4. The Pcrmittee 1vlVST REQUEST lN. WRITlNO a final inspection ntnd acceptance of the Work upon completion. Acceptance by the Ciry wit] be made
in writing to the Petmittee.
. '
S, MAINTAIN safe pedestrian and vehicular crossings and free access m private driveways, bus snips, fire hydr.~ttts and water valves_ '
ti• A CpATS"T~tUC'x'ION TRAFFIC CONTRO7~ PLAN and a CONS°I'RLICTIpN SCHEDULI3 is required for all jartc closures, demurs and street cEostttcs.
This plan must be REVIL'pErEA and .4pPROVTsD prior to any ]one closures.
7. The CpNy~UCTION'TItgFFTC CONTROL PLAN shall cnafotm with dt~c Caitrazts Ntaaua] of Trrffrc Cotrrtols fbr Cottstrtrciian and Mainttnarice
Work Zones, dared I990, avay'lable at Gal~ns..Traffte eatttroE equipment shall include Type II flashing.arrow signs if requited,
8. REPLACE IN 1S>7YD any damaged or renrtoved existing imptovemettts, ittctuding planting.
9. 5awcut for sl] PCC or AC teraovals. All PCC sntpvals shalt ha ra ntarest acorerriark and steal] bedoweEed to ezisriag improvements,
I0. pVEltg'11~~iF ~gp~~dTt p~M~ wiE] be chatgcd against the rash deposit for inspection requited outside the hours of B:Op a.m_ to 4:00 p.ax,
ar the current avestime rate, nunim~ one hoer charge.
ll. $A'I`t:IRDAY II`1SP}sCTIONS must be arranged itt advance, Saturday inspeetiuq time is charged at ate current ovnrdtne taro with n three hour
minimum. Advsace payment fbr the estimated time is roquired.
12. Adequate sigtitrg and lighted idARRICADIN ._.... _ _ . ., : ,.%,. .,,.. ,..~.,,,., .:,. ,.~_...,.~,. ,~ ~ .., ... ,~..,.
G is requited on the' job site. Failure W provide such sigauttg and banzicadittg, may result in the CEry's
ranting stlali signing and barricades and charging the cost (including all labor and mararials) against. ffrc cash.dtposit.
13. Compaction testirtg of subgtade* base rock, and asphalt canetete by Permitree is REQ7;)IgED unless otherwise.stated by nhe Ciry Engineer,
14. The Conuractor er petmittee will have a SLTPERVtSpRY IiEPRESENTAT]VE available for contact oa the projoct at all rimes during consptedon.
Cotmactor or Permittee shsl] provide A phone number ar which May can be connected outside the hours o;F$:00 a.m- to 4:00 p.m.
I5. Ho STORAGE Of tndtenials or equipment wil! be xltowed near the edge of pavcrtrcrtt, the traveled way, ar within ate sltwlderliaa which' world create
a hazardous cottdltion to Me public.
16. This perrttit shall not by construed as anrharizauon for excavasinn and grading on private property AD7ACENT' to the work or any other worst far
which a separate pcnvit may be rnquirrd, nor dots it relieve Me Permitbee of any obligation to abmin arty other Parrett required by law,
t7, This permit doss NtjT RELEASE Me Petmi[tee from any Iiahiiitics contained in other agreements or coronets wiM Me City and any other public
Its. T1us permit is NOT T1L4N5FER2Zp+gLE. Work must be perfotmod by Me Petzruttee tsr hiv destgtiamd $gent~or contractor as specified tlu:ROn.
19, CALL BACK (ca]1 out) due to amergencies reggrdittg Mss permit, shalt be at the current ovtttime ~intte with' g rhzre (3~ hour inFnte.,,,m char a eT
occurrence. g p
20. Pursuant ro Chapter 14.02 of the CsmpbcIl Municipal Code, applicant shat[ trot, cause na be disaliarged any material unto the mewicipal smxm drain
systetri ether than arorm water: Applicant shall adhsre to the 13>r$T MANAGEMENT PRACTICES esOtbIished by rite Santa C1aia yatlry Nonpolni Bourne
1?ollucion Ciinnvl Progrartt:
. Applicant shalt he trsponsible .for ensurin that ail those rovidin
. $. p g services under the npplicant Aro aware of and undersrsrtd all of the above conditions:
'.. ~~
AppLeane •~,
.. ~ Date
04f15f2009 12:30 4082991RR9 PGE 308 STOCKTON ~J PAGE 01f02
~~i'~l~7C' 11~8S ~tJlf
~' ~181Gf~7r~C ~t~p~~y°
308 Stockton Avenue - Sin Josc, CA 95126
Fax
Fax: (408) 299-1089 - Intema] 8-h24-1089
70: ~~~~ _-~--~ar~,~6e// _ From: ~r ~,~;a Tuas~~ ~P~ ~r6,~
Fay: ~~ 3 7~ -- 0 95~ -- Pagan: 2
thane: ~~~~) ~~G -- 2/S~ _ Date: ~'/~"~ d 9
C] Urgent ~P~r Review
^ Please Reply
^ As Requested
HST RiJ•N SH~~~