Loading...
ENC2008-00131CITY OF CAMPBELL ENCROACHMENT PERMIT Permit No ~~~ ~111..J~ ° ~~ b DEPT. OF PUBLIC WORhS (for working within the public /-1 X-Ref. File 70 North First St. right-of-way) ~ ., II ,-t Campbell, C.4 95008 Application Date ~, ~2~-!- {408) 866-2150 Issued ~ Z~ D Application Expiation Date ~ «~ Fax 8 076-098.-------_,. ~ ~~-30 ~e~ a ~~~ Permit Expiration Dat- ~ 12~ ~ APN ~ ~~ APPLICATION - Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application expires in six (G) months if the permit is not issued. Application Fee is non-refundab+ln~.} ~° f ) ~j ) ~ 1 A. Work address or tract ;; /~ Ln/ ~ G+ ~f e~.~...~-( Q 7` ~ irJ , '.A! ~ ,e^ ~; ,~°`nG.{ 9~t $ ti,~ ~1 '~ /.~ t p~ Utility trench tare of work K r /'YG~e'~ JrJ ,lei ? pG~z" '+r . ~ N S f ~r ~l ~ (,~/ ° r r "~ rJ N 7 t.~/ PU lz CJn/ ~V f P r ~~-r-.r-~, £~(, s f.~f .'N G y ~ 1~-~'~f ~ . ,~5 3 C'G C~ ,~i w , til/G r ~ '°*^~, Attach four (4) copies df an engin cd plan stowing 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 rite proposed work to existing surface and underground improvemertu. When approved by the City End Weer, said plan becomes a part of this pcrrrtit_ D. All work shall conform to the City of Campbell Standard Spccificarions and Details'for Public'Works Construction: the General Pemrit 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 shuulown nndFor forfeiture of Faithful Pezforrnance Sureties and cash dcpbsits. fSee General'Permit Conditions 1 and 2.) E. The Contracwr mus[ have this permit and apprnvcd plans at the rite and must notify the Public Works Dcpartmeat at least Iwo days before starting work. Notice must be given to PubticDWorks at least 2a hoots b/efo~re restarting any work\. -7 Name of Applicant P ~~ ~ ~ ~.*' "~"~ ~G 4 ~J / Telephone / Z ~ ~ ~ ~ ~ ~~ ((~~ A ' (Print na ~~~_ ..~ ,,,~ ~~~~ Address (UU ~ ~ f !~-~ ~d'i'~ ~ W ~ 24-HOUR EMERGENCY TELEPHONE NU._ -~i('~,~.~'°.. E-Mail Address =- is this work being done by the property owners at their own residence? Yes ~No -~'it ~c.~~~ ti~~c~ Tw~o~R~Ks Tnc Applicant/Permittce hereby agrees by affixing their signature W this permit [o hold the City of Campbell, its officers, agents and cmploy~~t~ar,dK-fi1~~ from any claim or demand for damages resulting from the work covered by this pmnit. The ApplicanVPermittcehcreby acknowlcdgrs that they have. read and understand• both [he fmnt and hack of this permit. and they will inform their conuacaor(s) of the information. Applicant is advised that upon issuance of this permit, property owner, or property owner's. successors, shall be responsible for any and all damages arising out of the condition of any priva.,jp~r[~rovemrnts in the public right-of-way. (Applicant Aermittec) (sign) Date Conrracmr (Print Name) I)atc - I . Street shall got be open cut for-underground ittsctllations. Minimum cuts maybe allowed for connections or exploration holes. Such cuts may b~eci.fically avoroved by Uic Inspector oiior to cutting. ~ _ _2. Pavemcat may be cut for undet•graund'ittstallations and inusrbe restored in accordance with the Standard Details Trench Rcstotntion Method "A" unless otherwise approved by ltupcctor, _3. Work to be staked by a licensed Land Stnvcyor or Civil Engineer and two (Z) eopia of Ehe cut sheets sent to the Public Works Department before. starring work. _4. Per Section 4215 of the Government Code this permit is not valid-for excavations until Underground Service Alert (USA) has been notified and the inquiry ideadfication number has oeen entered Eiereon. USA Phone 1-800.227-2600. USA TICKET N0. _5 Pror ro any work. the ptvpc: ty owner shaP cxwurc an P.greemcat far Private lmprovemeats in the Public Right-of-Way, which shall be recorded. _G Public Notification Rcgttiremcnts: 7. SEE PUBLIC WORKS ~E SCHED? 1LE FOR CiIRRENT F==C AM T RECEIPT NO. PERMIT APPLICATION F"s;E ~ .585 Q PLAN CHECK DEPOSIT ~ SECURITY FOR FAITHFUL PERFORMANCEJLABOR d. MATERIALS F CONSTRUCTION CASH DEPOSIT PLAN CHECK & INSPECTION FEE $ ! 3 0 APPROVED FOR ISSUANCE I~~ lo~_ For Ctty ngmeer Date Pertntt EXOims 12 Months' Afus Date of Issuance L}~ ~ ({ U,~ ~ S ~ L CiL PST' C©i~TTiO!rIS t. A Constructioa Cash Deposit is required. Charges will tx trade against this deposit if there is an emergency cal!-ou:, overtime inspearon or when City ordered bamcadiag is rcgttired. Aay such costs in excess of die deposit wilt be biUnti to the Permittee. 2. A ate-year maintrnan~ period and surety are rtquircd. Such period will trgia oa date of writtca accepurtt~ by the City. 3. Refund of tt>r cash deposit l~aace and trfttad or amceaatioa of the f=aithful t';: iormance Surety will be iaiuated by the written at~ptan~ of the w•a~; by the City.. 4. The Ptamittcetmtst rtgttest a writiag a final iirSpCC2ian and aectptaaee of the work upon coa~yetion..a.eceptanc by tax City will be made m wri~tSng w the Pertnittee. 5. Maintain safe pedestaian and vehicular aassutgs and free gc..ess to privart driveways, bus stops, fire hydrants and water valves. 6. A Consmxtioa 74affie Ctmrrol Place and a Consurretoa Sthednk art regaircd far all lane aiosturs, detortrs and street c6osrrres. Ttris plan must be tevie+vtd and. app4aved pricer m hay }aae ek>surrs. e . The Coasaucuow -IYaffic Caatsrsl P'tazt sba~ cooftxm. io the. Gslrsaas Maauai oi' Tree Cook for Gonstrtscrion and Maims wont Zates, datcC 1940, avaiEabk atCattnms. Tnffie caatroi egai~rnt sl>afi iaelude'E~pe II flazFiigg avow sign if ttxydszd S. Replace as dirccced by the City F..ngineer any damaged or rtsrwvtd impmvemrnts in accadanet with Crty Standards and Specifications at the sole expense of the Ptrttttttae. 9. Sawcut far all PCC or AC removale. Ail PCC rcrrtovals shall tx to nearest scoremark and shalt be doweled to existing imprnvements. 10. Price approval of itaspcct~ is rtquircd for any work dons after aortttal working lwun, on weckeads or holidays and nray require reimbussemcnt of inspecuotr cosu az the ntrruu overtime cart. l i . Adequate signing aced trarricadia€ is required. on t6t }ob site. ltaiitrre to provide such sigrittg and lras:icading may restilt in Fhc Csry's providing sittrtiag and trarxieades and ~°> the cost (iachrditg ail tabor aced matzttads) against the cash deposit i? Cotapaction trstmg of snbgrade, bast cock. and asphalt ecmer^..tt by Perrnitt~ is r^cauired unless otherwise sated by the City Etxginec i3. The Contractor or Peratittee will have a supervisory reprarntauvc available for contact on the protect ai aU times during constnrcuon. Contactor or Permitite shall provide a phone number err which they can be cootacctd outside the hours of 3:00 a.m. to 4:pU p.m. I4. No statags: of materials or egtiipmeat will he allowtd nctr the edgy of pavement, [he trave}td way. or within the shouldaline which wcwld crptr. a hazardous catdirioti to the txtbiic 1S. This petmii sinil not !X as antitorrzatioa fa excavation aced gadiag on pritaa property adjaxsa to the wart: a nay othc work frr which a scpuaue permit tray be rt>2airai. nor dacs it relieve the Pamsuec of arty ob&gstyoa to o6txta any odxr permit uiretf law. . ~I b5'. t G. This parnit does rice release tht Pettaitt~ from any liabilities canrttirted in other agttxatxats or contracts with the City and any other public ageaey. 17. This permit. is not transferable. Work must be pccfarmcd by the Perminec or his designated agent or contrtctar as specified [hereon. 13. CaII back (catl out) due m emcgeacies rc_:;vding.this permit shall beat the cttnent overtimetatt whit a three (3) hour mirtimum charge per otxutratce. I9 Pursuant m Chapter 14.02 of tax CampbeiE Muniapal Code, appiia~nt steal} not c:iatiY to Tx diischas'ged any material lain ttx mtmicipal storm drain systan other than szorm water.. Appfi,cmt shad adlsere to the BEST MANAG.-MF.l~iT PRACTICES estabiistted by the Sawa Clara Vaticy Urban Rurtof; Pcaihtuon Prcvension Pragatn. 20. !f the pnbkic rnterest rcgnires a modifteauan of, or a depatvtre from, the plans and specvteatioas. the City shall have the authority to require a approve any modification or departure and to specify the ataaner in which the same is tc lx made for Cityowncd or mainnined facilities. 21. Permiuec muse provide advance notification to a[I parties [hat trtay be affected by the permit activities. Notification shall be reviewed by City prix; in disaib:,tiG~, aa~ i:tclude dares of work and s contaer aamr. and phone numb.;:. Applicant steal! >x rtxptrnsibk for ensuring tha: all thtut provicfiag services tinder the appiiraat art aware of and tmderstxtd al] of dsc abow_ ~rtdidoas Applicant Dart Contactor (Print Namc) Datc 1\faau~wpcrm Rev. i 7 P4JFIS v ~~ ~ ~ ~~ ~' ~ ~-+J I e A lED7d~i9'97{9A) ~ 1~ aut r,t~ev, t~ W~~~AL ~ a' L~YN ~ 4 ~ ~~ r w w ~ ~ c~ 1~ s [ ` ~*. ~v VB TAC u.~ a M ~~ xv 'a L N. ~p~r. l A~~ ~ s,~ f vO• / •~` ~ / w err ~~ / .f ~E. ~ ~G~ a~ .~ ~ r 4 C C ~~ ~ ~ D' ~~ ~ ~~ ~ ~~~~ . ~ ~ 1fi <~~.~~t7; ~ arsr~ ~ ~. 1 ~ / ~ ~~ Pr,~Jr~. z S K ~ Y r7 '`{~ ~v ~~d~ ~ 7®-a3~fli ~ 4 ~ r}~i~c. ~ ,..rte X34 ~D X46 ~ " ~, ti a ~'+ts .}~ ILTl963 ' 48 ~ ,y ~tb ~~ 11 ~'~` ~ INSTALLING ONE ADDITIONAL ~~ ~ WIRE I I REPLACE .DETERIORATED POLE ~" APPROVED FOR CONSTRUCTION. City ~# Campbell Public Wori•~s ~'~rmit No. C^.i. ~ 2 ~~~'~ 1 "3 ~ ai»`roc+nr nlu~ AO-~ t~Mb oIOM PG&E ELECT.ESTIf~ATOR, I~ORGAN HI 'iSUE EGAN 408-722-5215 REP OSVALDO FLORES ~ 408-725-2098 ~~ ~~ S WINCHESTER & BEDAL DR ~"~ ~• D1AZ . REPLACE DETIORATED POLE ~' PLNi~ °' D. BRUSATO ADD 1 WIRE TO ST. CROSSING SCALE: „~ DAZE: o_„~,~ ~ PACIFIC GAS AND ELECTRIC COMPANY ~~ 30642199 I ~• m ''" c a ~ N f w D z ~ ° ° to m = m n ~ Z , 3 o ~ m v ~ ~ o ~ ~ Z ~' m `' O ~ ~~ D D Im -m .~, ~ m n ~ r ~ rn m ° a D p ~ _ N o (} D N D J J ~ r D ~ ~1 n e ~' ~ o GS p ~ c r ? ~ ~ 3 ~ o `Z N ~' N p~ ~ m ~ ~ ~ ~ N y N ~ '~ N ~ N ~ ~ ...~ ~. 2 ~ d ~ W N -~ ~~- - ~rt""~ ~cu ~ ~ °~+°c~ o~ ~ ~~ 'O ~CQ N ~ ~ _~ ~p S2 Ct2 N s "'!9 O ~ ~ p' ~ ~ c p y .... C ~ ~ vi ~ ~ C ~ c~ r#~ CD ~ _. CQ ~ m ~ 3 ~ f!! ~ gyp, `M p> !f 1 ~ tl7 O ~ ~ ~ ~ ~ ~ `< ~ ~ S n ~ pp++ 7 , . ra n ~ g.d~ Le w .o- ,y, 3 Q M ~ n ~ . . ~ ~ ~ ~ n ~ ~ . -' ~ O p p ~ N O C1 ~ bl `°S ~ ~ N ~ ~ _ ~ `~ N ti b~ ~; ~' ~'i ~~ ;'; Dam/ O ~~ /~/"' .y. n C ty./ 5'•. ,~7f PG&E, Dependency Permit Desk ~ 900 Lightpost Wny, Ste 150 Morgan Hill, CA 95037 September 23, 2008 City of Campbell Public Works Department 70 North ls' Street Campbell, CA 95008 Re: ENCROACHMENT PERMIT Attached is a permit application for the following location. NW Corner of S. Winchester Blvd & Bedal Dr., Campbell Please mail the permits and invoice to: PG&E Dependency Permit Desk 900 Lightpost Way, Ste. 150 Morgan Hill, CA 95037 Additionally please reference PM #30642199 on the invoice. If you have any engineering or design questions, please contact Sue Egan at (408) 722-5215. Thank you, Kathy Donohue Dependency Permit Desk FAX (408) 722-5373