ENC2004-00117CST': ~= C~.'~'- --- ~,CF.~iA.C:-i,::~T is i~•.::
DFP'T. OF PL'BL'C L~'ORkS (for worlrin8 within the
70 North First St. public tight•of-vay)
X-Re2. file
Campbell, CA 95008 /
(408) Sb6-2150 Luued ~ ., (~ - ~; (.r Lcuion Daft ~;~ 1.~
~P
Fu (408) 376-0958 Permit el~ires in 12 mos. Application elites is 6 mos.
APPL~GTION - Appliasioa 's hrrrby madc for a public worts Permi a a¢ardaoce rah Campbe~ ~ Cods. Se1~1~ ~~'~W~itp i~ 6 moatht
it ~e permi b trx awed. Applies//ion Fes h mo-rdltndabk.)
A. Mortaddras ataa/ ~~h Tro,+~ O~ t/ ~ llayh;~~yN /Tdf~ _~l~l~~$ ~.1 e~ 1.U~4
t~ trees
s. Naaus d Bros
C. Attach four (t) oopio d an ra~iaecsd penis thoviat the loctrioa and e:xea d the evert, sod foot (t) mDia d ~c prdimiatry Eatioea't &timsc d e~ost. Tlc
pIm sewn ahw the rs4arioa d the protwsed wort m orariat aw~iace sad ®der~wme f~+rvremiem. wee ~Qevrad br the Cary Fes, acid pi. eecoma . pn d
Chit permi
D. AD sort shat! conform m the City d Cst~brll Staadud Spec>tiatioas sad Desub far Public wart, Coeutrtr~tiaa t5e Geaeal P~cmis Caod'~ors [load ors the rnase
tide; sad ;he Special Provnbm for this permit, lined Delasr. Falttrs m abide by these oooditioos sad ptwsioot tary nwk m jab thss~s aod/ar t1atisaus d FaithfW
Petformarrr Sureties sad ash depcxin. (5a Cer~cal Permt Coodioon 1 aed Z.)
E. THE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PVSLIC wOR]LS I>F?ARTt.~Nr AT
LEAST Two DAYS BEFORE STARTING WORK. NOTICE MUST BE OIVfN TO Pi7BLIC WORKS AT LFJtiT'T 7A }TOURS BEFORE RESTAItT]NO ANY MORIC
kame d Applioa P~1,L , ~ ~ L lY ~4 d- G ~e ~~/.~c Taiq~me
Address : ~V D c~ ~~'~ ~ ~E;:~ .ire, ~~t r1 ~~osL~ ~%( / ~ILD TFIEPHONE No.~:/ D -Z~~- /// (~
L this wort ~ dooc by the property weer at their ore raideacs? Ys ~ No
The Applian.'Prrmiaee hereby aYras by affiiint their riSmcus m t!ss permit m hold the Cq d Ca~+bel, b elfiect, ahem sod empbles fret, tak and barmiest tram
acy claim or daaaad fa donates resukirK fivm tee cart covered by this permit.
Tee Apption/Permmec eenby actnovledta that they beet read and aadersraad bah tee trout and Duct d tei permi4 and racy .il iadbrm Heir cmtractor(t) d me
mfarmation.
~d
(Apps) ~iltN Date
~C1AL PROVISIONS
_I . Sava shall sot be open as far aa6erIIvund israSsioes;. ltiaismm GND l~ be: al3asred !err caemee:tiae er e~iazdoo holes. 5bd [ilttt
t+o+oved by tee irsst+euar oar to torture.
_2. Pavement mry tx eu: for tmdcilouad tar-",•;,,~•• and soot be Rsrased : roeoeda+ae viQs the tJt~y Ttraie! Rtssaettioe Sbodrd thy, IVlethod 'A' 1SadiiIl,
unkss admix apprmRd by Iatpeaae.
7. wod m be s:akod by t lic:ssrd Land SLrvryor or C~ Et~aarr sad tt'o (~ a4ia d the a[ thaw neat o the Ptrt>ac wads Depaesmea helots atartiej cart.
mot. Per Beetles a2LS d the eovaamenr Code tt3s perm: b as rand for ss~vseioan sal VadcQa®d sa.is Ate:t (tom hr tars antJlSed asd ~e iogoiry
;dmtificatioo tatmDes has been raced haeoa. itSA Phoec 1~127.2ti0t). tISA TAT N0.
~S. M!4 t-.t7~ t r.1 5~ FE ~t_r~~S72t/~*+ ~--~--ES s .
~ P'LrBLIC WORKS FEE SCHIDULE POR CURR]~L~
PEAMI7 APPL1CATlON PEE
PLAN CRE(at DEF03IT
SURETY FOR FAJTI{f1JL PF.RRORMANCB {}00~ Of ENO. ffiTJ
COMTRUC710N CASH DEPOSTr
PLAN CHECK 3 ITtSPft.'170N FEE Qdiaimom S•20~
APPROVED FOR
-- -- - ~M
~~ ~ ~~
~~~
for ~ Eo~matr
rr
JUN-23-2004 10 30 PG&E P.03i03
GENERAL PERMIT CONDITIONS
1 A Construction Cash Deposie is required. Charges will be made against this deposit if there is an emergency call-out, overtime inspection or
when City oroered barricading s required. Any such cosu in excess of the deposit wall be bslled to the Perntitree,
2 A O11B'Y~ rttatntc»ancc pcriotl and surety arc required. Such period wall begin on date of wnttcn accepancc by the City.
3. Refund of the cash depaait balance and refund or cancclla0on of the Faithful Ptrformancc Surcry will be inideted by the writien acceptance of the
work by the C+ty,
4. The Pemtittee must request m v+ritittg a final inspection and acceptance of the work uprnt completion. Acceptance by the City will be madt in
wokng m the Perminee.
5. Muntaia safe prdestnan and vchtculaz crossings and free access m pcivue driveways. bus stops, fix hydranrc and water valves.
6 A Construction Tyafte Control Plan and a Construchon Schedule arc required for all lane closures, detours and strait closures. This plan must be
reviewed and approved prior to any Lane closures.
7, The Cemstrucbon 7Yaffic Control Plan shall conform [o the Caluans Manual of Traffic Controls for Construction and Maintenance Work Zrrttes.
dated 1490, available at Cattram. 7`raffic ccngol equipment shall mclude Typo ll flashing arrow signs if rcquirt:d.
8 Replan os drrected by the City engineer any damaged or removed improvetents m accordance with City SnndaMs and Spcoificauonz at the
Solt eapenic of tht Perrivttec.
9. Sawcut (or all PCC or P,C removals. Au PCC removals shall he to nturest scorcmark and shell be doweled tp existing improvements
10 prior approve! of inspector is n:gwtYd for any work done after normal working hours, on weekends or holidays and ntay require reimbursemehl
Of inspection costs at thr, cumertt ove+rtimc rite.
I 1 Adequatt siFnine and brmcadinb is teyuired on the job sate. Failure w provide. such sigtitno and barricading may result to tht City's pmvlding
signing and barricadac and clurg;no the cost (including all labnr and materials) against tltc cash deposit,
12. Compaction testing of snb~rade. base rack, and asphalt concrete by Pcrmittee +S required unless otherw+st sated by the City Engine¢r.
13 The Contractor or Pcrrnitrcc will have a supervisory representative available for contact on the project at all amts during construetion.
Contractor or Permiuec shall provide a phone number at which they can bt contacted outtidc the hours of 6:00 a.m. to 4,OQ p m.
Id. No stongc of matctials or equipmett will be allowed near the edge of pavcmem, the traveled way, or w;thin the shoulderhnt which would Create
a hnrardous condition to the public.
15, This permit shall not be construed as authoriLtion (or excavation and grading on private property ad)acent to [he work or any other wort: for
whrch a separate permit Inay he required, nor does it rehevc the PCrm;ttCe of any obligation to Obta;n any other perrrrit required by ktw.
1tS. This permit does not release the Permitree fmm any liab+hdcs contained in whet agrcemrnts or contracts with the Cicy snd any other public
agency.
17. This permit is not transfe:~ble. Work must be performed by the Permtttce or h;s tlaignated agent or comraaor es specified thereon.
18 Call back (call Out) due to emergencies regarding this permit shall be at the euvrnt overtime rate with a three (3) hour minimum charge par
occurrence.
19. Pursuant ro Chapter I4.U2 of the Campbell Municipal Code. applicant shall not cause to be discharged any material into the municipal storm
dctin system othu than storrrt water. Applicant shall adhere t0 the BEST' MANAGBMEIVT pRA(.'fICES esutbbsited by the Santa Clara Valley
Urban Runoff pollution Prevention Program.
20. of then pu'nirrtnterGCt requires a modifieabon of. or a depollute from, the plans and specifications, the Gt shall hav
PPr y od![icatitm Or departure and to s acif Y e the authority to requue or
P Y die manner in which the same is tp be made for City-owned or maintained fuihtir,.
Applicant shalt be responsible for ensuring that all thrice providing scrwces under the applicant are aware of and understand all of the above condtbons.
c
~/~3~d~
Applican -
Hate
Contractor (Print Namc) -
Date
1'tforrnstpwperm
Revised 1.20.Oa
TOTAL P.03
JUN-23-2004 10 30 PGaE P.01/03
Paci~t Gas and Electric Con~any
~ ~ . ~ 308 SloclCOn Avenue • San Jose. CA 95126 Fax (408) 2981089 - IrAema18.6247099
LJ'~ti'ri
To: ~ l ~ c ~ Ca vv. h e. () Fto..o r G ~ L - O 1 a~ Vt ci \ ~A ~ y~ ~f. Z
Fa~c Q D '- 3 7 w- ~ 9~$ Pages:
Phone: Data
Re: ~;
O Urgent D For Renew D Pkwse Reply ~As Requested
STATE HIGHWAY / ON-STATE HIGHWAY
(CIRCLE ONE)
FOC
a
a
MEDIAN
~ 350' TO WINCHESTER BLVD.
FOC
D
H,4~1/L l0/V A I/~ WORK AREA
WORK ON NORTH SIDE OF HAMILTON AVE. 350' e/o WINCHESTER BLVD. REFER T0:
SIGNALED INTERSECTION AT WINCHESTER BLVD. WAPG PG. 2 ~
EST: JARED WENGER C0:
ADE: YEL GiBSON
suPV: sNEUEir Kiss NOnF'
TRANFORMER REPLACEMENT OTHER
REP: YfTCN KIRK :
PINR SHT: 1 of 1 SHEETS
:
scA~E:
N.T.S. oArE: ~ PACIFIC GAS AND ELECTRIC COMPANY ~~30355476 REV.