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ENC2017-00075OF C4� U •1 9- C• a' o F G� CkCHAO CITY of CAMPBELL Public Works Department April 17, 2018 Jeff Galdes 57 Carlyn Ave. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2017-00075 57 Carlyn Ave. Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Jeff: The City of Campbell has made the final inspection of the subject Public Works improvements and finds that no remedial work is required. Your warranty requirements and any surety, therefore, are hereby released. Sincerely, Syed Wahidi Public works Inspector 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 • TDD 408.866.2790 Encroachment Permit Final Sign Off Encroachment Per mit#�— 2G i7�vec-�S Address: �� C✓(`� V, Date of Final Inspection and Acceptance: Inspected by: Il� OK to release deposits: 100% �5% Comments: Encroachment Permit Final Sign Off Encroachment Permit #�� Address: �h /vc Date of Final Inspection and Acceptance: Inspected by: 5VJ OK to release deposits: 100% V 75% Comments: i CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER Encroachment Permit#: ENC 2017-00075 Name: Jeff Galdes Property Address: 57 Carlyn Ave. Date of Final Inspection: On.File: Bonds CD Cash Faithful Performance: $ 2,000.00 Labor and Material: $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: Reviewed by: I r Reviewed by: 1K "I-Iolt� I Land Development Engineer JAJoAnnaT\Deposit refunds\CHECKLISTS\Carlyn 57..doe (Rev. 10/11) 1 CITY of CAMPBELL Public Works Department April 17, 2017 Jeff Galdes 57 Carlyn Ave. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2017-00075 57 Carlyn Ave., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Jeff: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins as of March 29, 2017. The permittee is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. Your Faithful Security Deposit in the amount of $2,000.00 is enclosed. If you have any questions, please call me at (408) 866-2168. Sincerely, John Burchfiel Sr. Public Works Inspector Cc: Inspector /Suspense Files Permit File ENC2017-00075 70 North First Street • Campbell, California 95008-1436 • TEL 408.866.2150 • FAx 408.376.0958 • TDD 408.866.2790 3W IYJ30 I ' JL1a Vrl+uw IIyyI I ��4�t�fNdRTH FfRST STREET° F. C" CAMPBELL CALIFORNIA 95008 JEFF GALDES 57 CARLYN AVE = CAMPBELL .CA 95008 000000 D AND YOU CAN SEE A HEXAGON -SHAPED TRUE WATERMARK WHEN HELD TO THE LIGHT Ref urndable Deposit Check' Request - _ ' r 'To: Finance`Director, ` Check Payable l o.es. Jeff Gald_ 'Address• -,Lune '1: : 57'Carlyn Ave.: , Line 2: ; City Campbell State: ,CA Zip:• 95008 Description: . 57 ,Carlym Ave: Account Number.: . 101.2203.,_, Amount: _ $2;000:00 _ Account Number: 101.2203_ Amount: _ Account'Nurnb'er: .401.540.7448- Amount: (Finance Dept on Interest Earned (Finance Dept only) C 'r Total Payable: (Exact Amount) ` rpose: •ENCZ017-'00075 f Permit #: ENC2017-00075. Receipt.#::.: .__ .. 268554 ._ Date: 3/14/201,7 Receipt # , Date: Requested s T.Itle: Sr. Inspector- : Date: 3=3('.1 ohn' . urclifiel - :' Approved tiy: � Title: Sr.'.Engineeu. Date:- Roger S-torz Finance Dept.Only: - Verified by . : Title: _Accounting Clerk-.R :: -'Date: Approved by:. , .. _ Title: Accountant. Date: ' S ecal: I4nstrucfiions _For Hariddlifn Check. . Mail -•As Is% .' Mail''in Attached Envelope:-. Interim/Check: _ 'Needed,ft ' Return To: J,oAnna Thomason. .. ,. - Public' Works . - (Name) (Doodrtment), 'Other: _Please4'retutn check-_to:JoAnria '.`Print Form CITY OF CAMPBELL R-11 ENCROACHMENT PERMrr Permit No. DEPT. OF PUBLIC WORKS X-Ref File (Non -engineered work within the public right-of-way) 70 North First Street ($10,000.00 aximum value of work) Application Date Campbell, CA 95008 Application Expiration Ph. (408) 866-2150 ISSUED: r a Date Fx. (408) 376-0958 Permit Expiration ate: APNS APPLICATION - Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application expires in 6 months if the permit is not issued.) A. Work Address: 57 Carlyn Avenue B. Nature of Work: (Widening Driveway approach C. Attach three (3) copies of a drawing showing the location, extent and dimensions of the work. The drawing shall show the relation of the proposed work to existing improvements. When approved by the City Engineer, said drawing become a part of this permit. D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit 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 shutdown and/or forfeiture of Faithful Performance securities. NAME OF APPLICANT: Jeff Galdes Telephone: (408) 833 5046 Address: 57 Carlyn Avenue E-Mail Address: jjgaldes@gmail.com The Applicant hereby confirms that this work is being done by the property owner/applicant at their own residence. The Applicant hereby agrees by affixing their signature to this permit to hold the City of Campbell, City of Campbell Redevelopment Agency, its officers, agents, and employees free, safe and harmless from any claim or demand for damages resulting from the work covered by this permit. The Applicant hereby acknowledges that they have read and understand both the front and back of this permit, and that they will inform their contractor(s) of the information. - i I/ 7 / ACCEPTED: c (Appl NOTES: All work shall conform with the attached approved plans and all applicable Campbell Standard Details and Conditions and applicable insurance requirements. The Contractor must have this permit and approved plans and must arrange to meet with the Public Works Inspector at the site at least two days before starting work. Notice must be given to Public Works at least 24 hours before restarting any work. Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert (USA) has been notified and the inquiry identification number (Ticket No.) has been entered hereon. USA Phone: 1-800-227-2600. Ticket No.: 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 design, installation or condition of private improvements in the public right-of-way. SPECIAL PROVISIONS 1. Prior to any work, the property owner shall execute an Agreement for Private Improvements in the Public Right -of -Way, which shall be recorded. 2. 9 STANDARD AMOUNT RECEIP1 NO. SECURITY FOR FAITHFUL PERFORMANCE 000%Of Engr's Est.) $17,60ZAO 'Lbi55q R-1 PERMIT FEE $ APPROVED FOR ISSUANCE: for City Engineer lbatel Permit Expires 6 Months after Date of Issuance. GENERAL PERMIT CONDOTIONS 1. Payment of a security to insure faithful performance and completion of the work is required. This security is refundable upon completion of the work and written acceptance by the City. 2. A one-year maintenance period for all work is required. Such period will begin on date of acceptance by the City. It is the applicant's responsibility to remove and replace unacceptable improvements within the one-year maintenance period. 3. Refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work by the City. 4. Submit project schedule 10 days prior to proposed start of work. Special provisions may be required for work within City facilities and downtown Campbell. 5. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing to the Permittee. 6. Maintain safe pedestrian and vehicular crossings and free access to private driveways, fire hydrants and water valves. 7. Replace as directed by the City Engineer any damaged or removed improvements in accordance with City Standards and Specifications at the sole expense of the Permittee. 8. Sawcut for all PCC and AC removals. All PCC removals shall be to nearest scoremark and shall be doweled to existing improvements. 9. Adequate signing and barricading is required on the job site. Failure to provide such signing and 'barricading as specified by the City Engineer may result in the City's providing such signing and barricades and charging the cost to the Permittee. 10. The Contractor or Permittee will have a supervisory respresentative available for contact on the project at all times during construction. 11. This permit shall be kept at the site of work and must be shown to any authorized representatives of the City of Campbell or any law enforcement officer upon demand. 12. No storage of materials or equipment will be allowed near the edge of pavement, within the traveled way, or within the shoulderline, which would create a hazardous condition to the public. 13. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other work for which a separate permit may be required, nor does it relieve the Permittee of any obligation to obtain any other permit required by law. 14. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency., 15. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 16. Prior approval of inspector is required for any work done after normal working hours, on weekends or holidays and may require reimbursement of inspection costs at the current overtime rate. 17. Call back (call out) due to emergencies regarding this permit shall be at the current overtime rate with a three (3) hour minimum charge per occurrence. 18. If the public interest requires a modification of, or a departure from, the plans and specifications, the City shall have the authority to require or approve any modification or departure and to specify the manner in which the same is to be made for City -owned or maintained facilities. 19. Pursuant to Chapter 14.02 of the Campbell Municipal Code, applicant shall not cause to be discharged any material into the municipal storm drain system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff Pollution Prevention Program. Applicant shall be responsible for ensuringthat all those providing services under the applicant are aware of and understand all of the above conditions. Applicant Date J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf Rev. 02/14 -47.. PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1, 2016 TO: Finance PUBLIC WORKS FILE NO. ENC2017-00075 PROPERTY ADDRESS 57 Carlyn Avenue Please collect & receipt for the following monies: 77 4722 Encroachment Permit Application Fee Non -Utility Encroachment Permit Major ?$l 0,000 Minor Encroachment Permit <sio,000 Initial R-1 Permit Subsequent R-1 Permits within Two Year Period Inspection Fee Minimum Charqe per Location Street Tree Plantinq/Removal 2203 ($500 per Tree Plantinq Deposit Required) 2203 Plan Check Deposit 2% of Engineer's Estimate Utility and R-1 Permits 4722 Gradinq & Drainage Plan Review Sinqle Family Lot Site < 10,000 s.f. Site 10,000 s.f. < 0.5 Acre C3 cr_ LU Li.1 CM r Site 0.5 Acre J 4722 NPDES Review (C3 Requirements) w I-- C1.1 For projects not required to submit numeric sizinq LL. IT r-, For projects required to submit numeric sizing LU C.n Q- I— =, Impervious Area 10,000 Sq. Ft to I Acre UJ J-U Cxz Impervious Area 1 Acre or more rl—n ::1 =1 IT C.) Cn Lj— 1=4 4722 For projects sent to Consultant for review UJ �X W Lij a'Ld = -X W Iz LX LU 4722 Additional treatment facilities Plan Check & Inspection Fee (Non -Utility) 4722 Enqr. Est. < $250,000 14% of Enqineer's Estimate 4722 Enqr. Est. >_1250,000 and :5$500,000 $35,000 + 8% of Engineers Estimate 4722 Enqr. Est. >$500,000 $55,000 + 7% of Enqineers Estimate 2203 Emerqency Cash Deposit 4% of Enqr. Est.* ($500 min/$10,000 Max) 2203 Faithful Performance Security (FPS) 100% of ENGR. EST.* $2,000.00 2203 Labor and Materials Security 100% of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi -Res $2,385.00) All Other $2,650.00) 4722 Parcel Map (4 —Lots or Less) $4009.00 + $87/lot 4722 Final Tract Map (5 or More Lots) $4,871.00 + $118/lot 2203 Monumentation Security 100% of City's Monumentation Estimate 4920 Parkland Dedication Fee (75%/25% Due Upon Cert. of Occupancy) 4722 Lot Line Adjustment (includes Certificate of Compliance) $1,893.00 4722 Vacation of Public Streets & Easements $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 4722 Document Recording Fees $15.00/first page $3 ea. Additional 4722 Private Improvement in Public ROW $50.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 4722 Notary Fee (per siqnature) $10.00 4722 Assessment Seqreqation or Reapportionment First Split $895.00 Each Additional Lot $281.00 511.7424 Postage MISCELLANEOUS,.7-- - 7-7 101.730.4924 NOI Reimbursement for *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $2,000.00 NAME OF APPLICANT Feg 6,q ,Jkr, NAME OF PAYOR a, -3 S PHONE ADDRESS Aleai,e ZIP FOR RECEIVED, Ely CITY CLERK OE ONLY Date Receipt# . ..... ..... . ... C:NUs,,sVoge,,\0e,V,p%F­,1s