ENC2010-00036CITY OF CAMPBELL ~ ENCROACHMENT PERMTT Permit No ~ C 20 (~ ~ ~~
DEPT. OF PUBLIC WORKS (for working within the public X-Ref. File
70 North First St. right-of--way) 4 ~ $, 1 G
Campbell, CA 4500$ 1 ~ Application Date ~~
(408} $66-2I50 Issued ~ - ! ~ ~ Application Expiration Dau
Fax (408) 37fi-0958 ~ I ~I ,~ ~C, ~ d~
Perttut Expiration Date: ~-~-~ APN -7-~D
APPLICATION - Application is hereby trade for a Public Works Permit ih accordance with Campbell Municipal Code, Section 1 i.44. (Applicatiom expires in six (6}
months if the permit is not issued. Application Fee is aon-refundable.)
A. Work address or taact# 262 W Sunnvoaks Ave pm 30767450
Utihty trench location 18' from south property line on Sunnvoaks Ave
B. Nature of work Tap hole over qas main to abandon gas sevice to 7-11 store 4' x 4' z 4'
C. Attach four (4} copies df an engineered plan showing the location and extent of the work, and four (4} copies of the preliminary Erg' rr~:°V
plans shall shave the relation of the proposed work to existing surface and under~ound improvements. When approved by Ehe City n ' „ 1
part of this pertntc.
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction: tt-e General Permit Conttitltkd+li~d on the
reverse side: and tht Special Provisions for this permit, listed below. Failure to abide by these conditions and provisspns may result in jot~~vl~tt~(pj~f~rfKS re
of Faithful Performance Sureties and cash deposits lSee General Permit Conditions 1 and 2.) ADIMINI~A~Oti
E. The Conttaetor must have this permit and approved plans at the. site and must notify the Public Works Department at least two days before starting work. Notice; .
must be given to Public Works at least 24 hours before restarting any work.
Name of Applican PG&E Telephone 408-725-2153
Tint
Address 10900 N Blaney Ave, Cuper~no"'~ 14 24-xoUR EMERGENCY TELEPHONE No. 1-8 0-743-5 OOC~"e D
E-Mail Address. JJGJC)PGE COM Gp~ V G
Lc this work being done by the property ovmers at their own residence? Yes x No ~P~ ~ 8
The Appiicant/Ptxmittee hereby a~mees by affixing their sia°aature to this permit to hold the City of Campbell, its officers. agent. and crnpioy~611t1E~s
from any claim ar demand for damages resulting from the work covered by this permit. ADIIAINISTRA1101V
The ApplicanUPermiaee hereby acknowledges that they have glad and undersiantl both the front and track of this permit and they will inform their crmtractnr(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 private improvements in the public right-oP-wa ~:t~ --
r,.ti., r_.~~,~,hr rrr•i .//J ,~-~/ 04/05/10
(Applicant P~iaee) feign)
Date
PG&E 04/05/10
Contractor ff'rint Name} Dau
_l. Street shall not be open cut for underground installations. Minimum curs a~ya he allowed for conneccians or exploranan holes. Such cuts
be ~neciftcally auoroved trv the Insnoctor ntior to cu nR.
T2. Pavemeatt maybe cnt far underground installations atul must be restored in accordance with the Standard Details Trench Restoration Method
"A", unless otherwise approved by htspccwr.
~3. Work to be staked by a ticettscd Land Surveyor or Civil Engineer and two (2} copies of the cut. sheets sent to the Public Works Departtneni
before starling work.
4 Per Section 4215 of the Govemrnent Cade this permit is not valid far excavations :until Underground Service Alert (USA} has peen notified and
the inquiry identification number has beta angered haeart. USA Phone 1-804-227-2600. USA TICKET NO.
`5 Prior m any work. the property owner shall cxceutc an Agreement far Private lmprovetacats in the Public Right-af-.+ray, which shall be
recorded.
____G. PublicNarificarionRequiremen~s:
_~
~~ Pt rst sr WORKS FEE SCHEDCJ~ EQR CiJRRENT FEES AMO INT RECEIPT N0.
PERMIT APPLICATION FEE $~~~
PLAN CHECK DEPOSIT $
SECURITY PDR FAITHFUL PERFORMANCElLABOR & MATERIALS ~
CONSTRUCTION CASH DEPOSIT -z~-
PLAN CHECK & INSPECTION FEE $-~-~~-
APPROVED FOR ISSUANCE ~'' q I to
For City fingineer Date
Permit Expires 12 Months Afar Dau ot: Issuance
i. A Conlstntetion Cash D~pa;;itas ttquired. Charges wiIT be made a$aittst this deposit if dtcre is as etnergenry tali-out, ovCtirno inspection or when City
t#rdered barrii~digg is rttquired. Any such costs in txcess of the dep~it will be billed to the Pcrttrittee.
~, A erne-year maintasance period and. aro tngttired. Such peritx! wlii begirt on dato of written acceptantx by tine city.
3. Refund of the cash deposit bataace and ndued a eaacelladan ~ Faidsful Periartaattce 5uray will be inituted by rho written atsxptance of t~ wtsrk
by the City:
~. tfie Permttee_ awst in writing a 6mi iaapecnm and uxcptaaae of the wont upon corrrplettintt. A.t,~ptance by the city will be ttsariz as wuu¢g to
S. h¢ainWn safe pedesaian aad vehicular crossings and free access to private driveways, bus stops, fire hydrants and avatar valves.
6. ~ construction Traffic Coeval Plot a~ a Consattctioo 5ahaiute are required far ail lane closures, detours and street Closures. 'I4»s plan toast. be
reviewed a~ apprceved prime as any lane cinstnes.
7. The Consauaiiar Traffic Coatrai Platt ship eonfarm its ebe Caiumts A~fanuai of TraffsC Controls !or Caeutrucbon and ~tx Work Zones. dated
t94i1 svaihhie at Careens. Traffx otxstra! egnipraaot shall nmctade Type tI arrow sigas if rte.
8. Replace as diroca:d by the City Engineer any damaged or removed. improvertteats to a~ardancd with sty SGUtduds and Specifications x the sok
expense of tho Petmrttee.
9. Sawcut for aCl PCC ar AC removals, Ail PCC removals shalt be to nearest suxemark and shall be doweled w ettistin$ improvements.
10. Prior approval of inspector is required for any work door: afar normal working iwtus, at weekends tx holidays and may requirt reitnixti3etsirttt o€
~pacnoe-hats at the currerst ovatiwe sate.
i S . ~ and bamcadrieg ~ ~~ on ~ j'am' alit, Failure w provide each sigriiitg and banirsding may rtsuh in iht City's prtsvid~g ai€niatr
charging the rater tmchad"ing ai4 tabor sad rnaetr>pisF against the cash depose.
t 2 . Compaction testing of aubgrsde, base rock. and t concrete Permitter is
asphal by required unless otherwise stated by rise Cry Engineer.
!3. The Coitsractor err Perrrrittee will have a supervisory represerttuive available for contact ~ the project at all times during cnrsstrucuon. Contracux ar
Permitter shalt provide a phony number at which they can be ctxrtacted artsidc the hours of 8:Q0 a.m, to 4:l?(l p.m.
!4. Na struage of matuiais or ogngsneent wip be allowed near rho edge of pavexr~t, the vaveied way. or within tits shouklpiine which would create a
6a#,urJttus rx~iditisaes to tbs; pnblie-
GENERAL PERMIT Ct~NT1ITIGNS
O
t5. This permit shat! trot be ohnsutud as antlrrxization fix sxcavaiian awl grading i>at private property adjacaet w the wtxk or soy oliser wart; far whidi a
sdparair peirsdt rnriy be required, nor doer it relieve tier Perrnitus of any obiigauart w ai>rain art tithor
y Pennitregoiredby,iaw
i b. This permit dory rte release the Permitted from any E>abitities txtnrained in onus agccennoass or txintracts wide the City and any other public agency.
l7. This permit is not transfcrabie, Work.must bt performed by tht Permittec ~ hit designated agent or csmtractor as specified thereon.
t$. CaiC buck (call nail due ur eraxrgnrtces regarding ties permit shall be at the curreiee overtirrre rate whit a three (3) hour minimum charge pcs occttr'rtne~
l9. m t,i.fl2 of t!m Cirsnp rtrell Mui-icip:tl Codes applicant shall nix zar:ae err be ~
discharged y mat~eriat into the municipal storm drain system
diticr don stocrn water.. Applicant stiaU mere W thr BEST MANAGEMENT PRACl7CES estabtistutd by tits 5arsta Ctar. Valley ihbast 8nad~£t
Potlsattao Preverioon Program.
2t1. if dst lnibtic inte[cst rrcryires a motGfsraoan of, a a degnmrt frtxn, tine pleas oral speafic~rticros, the City stun have the anditxity w rer}uire or approve
any modificauan rx deparsare sad w specify coo atansier in which file same is ttr be made far tStyowadd or tnaiatatned feria&tiea.
21. Perinittec must provide advance nouficatinn to ail parties that may be affected by the permit acpvities, Notificarrion shall be roviewcd by City prior ttr
diavibutioc sc ; iticlur~„ d~cs Q{ wat'i; and a canister ttamc an3 phatc nttatber.
Applicant sbaB be reapoosibk far eosiering that aD those providing servicts uadEr tho appGraat errs award of and tmduatand all of fiat above «tudinoas.
O ~!/a s/G
ihise
G%/o S'/ d
oats
/~~ ,O Applicant
V C'1"
Contradwr (Print Marne}
Rsv. l l l9
APPR01, ~C~ ~~t~~-= ~^~NS°fRUCTIC
C'~:~~ s:' ~1~rn~~i~ll
Public Wor~,~ ~~rmit N,, ,
PG&E Permit Sketch for: City of Campbell u-~.~. ~ ..~,~,,,,
CoMraClor muat IMY~ tllw ap~q ~~~
Address:262 W SUNNYOAKS AVE °"'~ j°b'''' d°`l"° `°"'n~'a'"
Nature of Work: Abandon Gas Service at Main
Surface: Asphalt Cut in Street Excavation size: 4' x 4' x 4'
PACIFIC
~~ ~:~- ii ocument contaii
information that is
GAS & ELECTRIC COMPANY and Electric Company
use only by authorize
DE ANZA DIVISION
SANTA CLARA COUNTY Copyright Pacific Ga;
~~
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Page 1 of 1
Joanne D' Ambrosia
To: Doris Quai Moi
Subject: RE: ENC 2010-00037
Joy said you emailed the encroachment permit copy while I was out to lunch. Be aware that the real permit number is ENC2010-
00036 as Syed and Joy gave two different numbers to 262 W. Sunnyoaks. We are letting 2010-00036 stand and using 00037 for
another permit.
Joanne
From: Doris Quai Hoi
Sent: Monday, April 12, 2010 10:42 AM
To: Joanne D' Ambrosia
Subject: ENC 2010-00037
Joanne,
Are you able to email the approved utility encroachment permit (ENC2010-00037) to
John at PG&E and copy Bruce (Golden State Construction)?
John's email is : jj~jla),pge.ec~.m
and Bruce's email is : hrucegoldenstate_~c~sbcghbal.net
Let me know if you are unable.
Thanks,
Sincerely,
!7o-<rv~r
Doris C. Quai Hoi
Assistant Engineer (Traffic & Land Development)
City of Campbell -Public Works Engineering
Direct: (408) 866-2157 Fax: (408) 376-0958
4/12/2010
Page 1 of 1
Joanne D' Ambrosia
From: Doris Quai Hoi
Sent: Monday, April 12, 2010 10:42 AM
To: Joanne D' Ambrosia
Subject: ENC 2010-00037
Joanne,
Are you able to email the approved utility encroachment permit (ENC2010-00037) to
John at PG&E and copy Bruce (Golden State Construction)?
John's email is : jjgj_~i~.pge.cc~m
and Bruce's email is : br~uce~oldenstate~?sbcglobal.net
Let me know if you are unable.
Thanks,
Sincerely,
Dor%~
Doris C. Quai Hoi
Assistant Engineer (Traffic & Land Development)
City of Campbell -Public Works Engineering
Direct: (408) 866-2157 Fax: (408) 376-0958
4/12/2010
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