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ENC2017-00209 .of C4 45 U"+CHARO CRT ' OF CAMPBELL Public Works Department- August 23, 2019 Matthias Sauer 1070 Monica Ln. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2017-00209 1070 Monica Ln., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Matthias: 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. If you have any questions, please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector 70 North First Street Campbell, California 95008 TEL 408.866.2150 • FAX 408.376.0958 • TDD 408.866.2790 Encroachment Permit Final Sign Off Encroachment Permit# 2tv17-0G2 Address: 6-76 1C-A LN Date of Final Inspection and Acceptance: Inspected by: OK to release deposits: 100% 75% Comments: �� 5�� cz,etc OF CA4J 4 A� �Y •UkCHAR�• CITY OF CAMPBELL Public Works Department" August 20, 2018 Matthias Sauer 1070 Monica Ln. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2017-00209 1070 Monica Lane, Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Matthias: 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 August 1, 2018. 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 Performance Deposit in the amount of$1,000.00 is enclosed. If you have any questions,please call me at(408) 866-2165. Sincerely, Syed Wahial Public Works Inspector Cc: Inspector/Suspense Files Permit File ENC2017-00209 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 Toy 408.866.2790 / I ..�� ......................._..............� f....._........._...__ .. ....._............_.._...._._.......� ........__..._......................_. ...._........_._..__..........._. ...._._............_...._..._.___, .. __._-................. ............._........_...._....: :. I - (i i i CITY OF CAMPBELL VENDOR NO. 10015082 CHECK NO. 269409 ` at'ccount Ps�rchdse Order: 7nuorce'Nnsrifer ».... . amount Descrs to .r I 101 2203 CROB1318 1,000.00 ENC2017-00209 I J I I d I �J I 10015082 MATTHIAS SAUGR �e e12:1311.111 1 41111111 G ( ..,... CHECK DATE CHECK NO. CAMPI3ELL z-itS FARGO HANK, N.A. ~ 7f1 NOFlTH.FIRST STREETMONTGOMERY STREET 11210 08/20/18 26940'9 SAN FRANCISCO, tCA-9410A 1 GAMPBELL,.C�ALIFORNIA.95008 AMOUNT, ****; r 0 0'0 "OD ��tCprAR� VOID'AFTER_ 90 DAYS -n 0 PAY THE SUM OF. ONE THOUSAND DOLL00 ARS &- Z$RO CENTS - I , I TTHE MATTHIAS SAUER. DER, 1070 MONICA LAND I .,.. OF% 9 D CA os CAMPBELL ' 5'_ - . I , _ L u' 26 9 4 0 91I■ . i: L,2 1,0 0'0 2 4 8:11:: 4 L`:2 L B�S y1, L 51i■. a err I ...._..........._......__._....... r... ......__....._..... -' - ................ ..... .._ ............................._.._..... I ........................................: ..........._..._.__......._.. ............................_........... f. _.......... .............. _..._.... _ *fee Reverse Side For Easy Opening Instructions* CITY, OF CAMPBELL j 70 NORTH FIRST STREET CAMPBELL, CALIFORNIA 95008 ' I f , � I II MATTHIAS SAUER 1070 ,MONICA LANE CAMPBELL CA 95008 � rYRefundable �"s',if. .,- h ---_a�`-".­­� - l-g—:"1.-. I-"�-�D.- _6� 6- 4�, 's i-, �! -:,-1 h-!,9.� c -- -U_�- e.�,'-,-�_ q U "l-,­ ­ ,'- .. 1` - . _11�­ � _�� ­­ �,,�,�� _.�, --1. . -1; T -K4'li­1­l .. I 1- - , O�- , -i re'di � p, , � - inahceD` " ,^ _4­ -0` - l-'r- � , - - , , , �� 6' ,6-�_ c- k.­.,'_M_,7� p., p.�,_1 b.­l,�e 7 p"," _z, M' a-' t�tZ��'-, h 1 3� �"­,-Is'-`"�i, ,6v o r - , y �"� Address' Lihe j 1070 Monica Lzhe-1 , - S � , "­ - _ ,I .-. �I­- --�-_' - ,­ " � , ��_%...................., " , ,- I- ' �1 �1�--- -, l�­ " �- .I.�I,­ I � : I , 1 ,- ­ --,. , -� '­ . ..!, .. ­ - '. : ..,.� ,. �,. �-' ,I- � , ­ ." � ,1 "0 ­ . .. " .. �-' � " i, , , I l_.I. !, ,. I .q .�I , : , , e­2 - , ,ci y - Campbell �ik 6-bA Zip: 90QQ � - ­­ bescription ENC201740209 : A� S. Account Number 1b1-241 Amount V1"A- .00 li' _< ­ - 'Account, "m6er 101.2 03 666f � T�­ K ' I q AcdoUhtNum6e _ ,1 91,$� 7 Amount `, (F uan ceMpt�o j1) nIbe6t Etrded (Finance Dept 6u�)' P�_ ­ ; � , = .� [ -TctdEP6y9bld (Exact A�b�nf)- � ! n- , Purpose ' Pt T I66d„ >, :Y, � p6rfjf g ENC 017w 6266 p " _, I. !, RbdeitJ� 27lZ4 ii� 91M � k , 1 , f Rbdeipf# 1, Uita I '- \ - PRequested�by, � Ri 0#0 b� , I_S ­ TiII9 0 ib 8YPd W4 i _ Ap bV6tl46y T1 se. EIg"nee l Date;V - Roger Sf rz f FinancevDept Only — � C Ve ffi6d,hy �, Title a ouh ,Ql6ek l-"Dat6 , tApproved by � TitleAb PPPt0� Dpte I A, - Instructions� m�,� H ­h L* Check , MAIL,H 15 aji wgifi6hiaaMYRIPP9 interim I ,,-, Needed y ReturnsT9 j6A A�T brpPspn3 0U61 Works - 1 (NiM6) (b66itfi�6k)' ­,, 4ahee Iba§e return. tbf*-dh&dk`fd,joA ­4 _ . -v, ,�,,- - ,�- '., - - I. - - - --,, ,- . . , :- - -_ -,, .,1, ,- - �.---- �--- v��� � -I , ,� , , � - :.- �,�I I I, � .� - ��" 1'� _� -",Z: ., , "I" I ��1, - ,I� .- , P ,S�, .?�,1, �-, . r,; - � ��,, ,�. �-�,�"',,,,�,,,-,,,-�,�,�L I I I ,I t�,%4 , "-, ,-- ,- �I-,�, . . � -, , ', ,, i. ,-, I . ..,- I %,�. I �,� , I �� I ���,-,�-­,i�,-, -�7----_r , ,�,, I I, ", _�t -, , - � � ",�����,.- -,�� .,,,_". ,�:��,I:-, .�,'. ,, . - , - ,��- --- :,,V,,", .,-,- -i, ,- -� , ,, - -- - - . -1 -,� , -�� , �. �-� - I I-_ 11 .1 I� ,� -� I -� `-.1� - -� I� 71 1-I .�. - --� I I_T.-­1--1-_- `-,11 I I -11 11-1 .. ,- I - I -,, " - ,-, � -.,., ,- I - ,, , . , � - P � -1, � --- ., � m , ,, I �.1 -.� , , I , - -: � - . ., 1. - I..,I ,.--: ,. . - . � _ . � CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER Encroachment Permit#: ENC2017-00209 Name: Matthias Sauer Property Address: 1070 Monica Lane ----------------- Date of Final In ectio�n: On File: onirtk CD Cash Fai hful Performance: $�1,000.00 Labor and`-Material: $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: I inistrator J Reviewed by: Inspector Reviewed by: Land Development Engineer J:VoAnnaT\Deposit refunds\CHECKLISTS\Monica 1070.doc(Rev. 10/11) Encroachment Permit Final Sign Off Encroachment Permit# C- 20L Address: lO7U ��N�C -. W Date of Final Inspection and Acceptance: Inspected by: VJ OK to release deposits: 100% 75.% Comments: V Print Form CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. (\1C Do 7-00 2- DEPT.OF PUBLIC WORKS (Non-engineered work within the public right-of-way) X-Ref File 70 North First Street ($10,000.00 maximum value of work) Application Date Campbell,CA 95008 Application Expiration / Ph.(408)866-2150 ISSUED: �I«1, -7 Date 3 r-5 t7 Fx.(408)376-0958_ Permit Expiration Date: 1e1 if APN W 1 ' Z ` 00 Z"l APPLICATION-Application is hereby made fora 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: 11076 HOve iC-Q 1,,. + WAgL t_1r—M33 51AL::V,K B. NatureofWork: K1:N V)F ONECI) LlOuir_YAM5i Jg Vvt iN F-P�T IrAG;�1 L Z�" a< 011NL-C,r C. Attach three(3)copies of a drawing showing the location,extent PiS T/�co<{ p' g g nt 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: P(q*46n's, -S'4- y— Telephone: C(t�)eme, _G � Address: (D?oDtcczicot E-Mail,Address: Saute yy, 8 _ 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. / c ACCEPTED: ✓ - " '' Y/2C)!;z (Applicant/Permittee) (Sign) Date NOTES: All wort: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 leasttwo 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 V/ 2. re ly--de,,� +tcr �-r V,-wV-4 pnoh`te +0 6e �f4ec_1 Yr 5 3. �- STANDARD AMOUNT RECEIPTNO. SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) S 1000 2 7l Zif 2 3 R-1 PERMIT FEE $ G�,APPROVED FOR ISSUANCE: fo�C• y Engineer Date GENERAL PERMIT CONDITIONS 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. S. 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 rpi injci real ctnrm drain system other than storm water. .An lirant chall ariharc to the RFCT MANAGEMENT PRAt✓TICES established by rpl_.-t_.._..__.._._-.. he BEST the Santa Clara Valley Urban Runoff Pollution Prevention Program. Applicant shall be responsible for ensuring that 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 ae„ n7/1d CITY.OY CAMPBELL DEPARTMENT OF PUBLIC WORKS APPLICATION FOR-PLANT REMOVAL Date Submitted Application No. Pursuant to the terms of Chapter 11.08 of the Campbell Municipal Code,.an,application is hereby made fora permit to remove 1 C r`c�ur'�/i¢ C�,i f .Z -vok 1- The location of the job in the public right of way is as.follows: Cu :ofe �c c 'ro...f c !e7v Ytovvfc a C4. , C4 c4,469l! Z. The reasonsforthe removalAre.as-fi lows: - Poo� c(u�r ;1 u�.��+sS da , a:�a� (use other side of sheet if necessary) 3. The.applicanthereby.agrees,-by.affixing.his signiature to this_application;to hold the -City of Campbell,its-officers,.agents:and employeeslree;safe and harmless:from any claim or demand-for damages-to-third persons relating from the-work herein proposed. 'Name of Applicant T (signature) (print your-name) Address.-of Applicant to o �o�,c c4 �% .Sai. C-f Cheek One: Residence or Business (} Telephone Number (4ACIS) 406--4 FOR OFFICE USE Date Recommendation v (/ 10171� mouse 9 he side of�heet if necessa ,. �f Gho �scr��ec Applicant contacted in field? By � �(�. �1 Date �g PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2017 TO: Finance PUBLIC WORKS FILE NO. C 20 17-0 C 2e PROPERTY ADDRESS 0 7 a Mc,N t CJ-LqQ Please collect&receipt for the following monies: AMOUNT" ACCT. -ITEM, . :. LAND DEVELOPMENT 4722 Encroachment Permit Application Fee Noh-UtilitV Encroachment Permit Ma'or>_$10 000 $425.00 Minor Encroachment Permit<$io,000 $240.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $240.00 Inspection Fee Minimum Charge per Location $420.00 Street Tree Planting/Removal N/C _ 2203 $500 per Tree Planting Deposit Required $500.00/tree 2203 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $295.00 Site< 10,000 s.f. $885.00 Site>_ 10,000 s.f.<0.5 Acre $1 185.00 Site>_0.5 Acre $1 772.00 4722 NPDES Review C3 Re uirements For protects not required to submit numeric sizing $175.00 For protects required to submit numeric sizing Impervious Area 10,000 S . Ft to 1 Acre $740.00 Impervious Area 1 Acre or more $665.00 -4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $315 ea Plan Check& Inspection Fee Non-Utili 4722 En r. Est. <$250 000 14%of Engineer's Estimate 4722 En r. Est. >_$250,000 and s$500,000 $35,000.00+8%of Engineers Estimate 4722 En r. Est. >$500 000 $55 000.00+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of Enqr. Est.* $500 min/$10 000 Max 2203 Faithful Performance Securi FPS 100%of ENGR. EST.* 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) $4 200.00+$90/lot 4722 Final Tract Ma 5 or More Lots $5 115.00+$124/lot 2203 Monumentation Securit 100%of Citv's Monumentation Estimate 4920 Parkland Dedication Fee(75%/25%Due Upon Cert.of Occupancy) 4722 Lot Line Adjustment(includes certificate or compliance) _ .$1,990.00 4722 Vacation of Public Streets&Easements $2,700.00 4722 Certificate of Compliance $1,970.00 4722 Certificate of Correction $590.00 4722 Document Recording Fees $15.00/first page$3 ea.Additional 4722 Private Improvement in Public ROW $100.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 730.4924 Notice of Improvement Obligation Payment 4722 Assessment egregation or Reapportionmen First Split $940.00 Each Additional Lot $295.00 511.7424 Postage MISCELLANEOUS:.-_,Lobo I Other lease Specify) - I-FU t-r-Li 12Az- *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ too G NAME OF APPLICANT HATTI-f S SAC-€lQ NAME OF PAYOR M-tr S-AC-t C40 4rO6 ` 6t IC AM ADDRESS FOR RECEIVED BY, ,'- ,. MU CITY CLERK e ONLY Date Recei t# J TORMMTempW """`REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS Insurance,. liberty A4utud Company GENERAL INSURANCE COMPANY OF AMERICA (A SAFECO Company) Home Office: .62 Maple Ave, Keene, NH 03431 (A stock insurance company.) HOMEOWNERS POLICY DECLARATIONS POLICY NUMBER: POLICY PERIOD: FROM: JUNE 29, 2017 12:01 A.M. OX6036858 TO: JUNE 29, 2018 12:01 A.M. NAMED INSURED AND MAILING ADDRESS: AGENT: MATTHIAS SAUER WELLS FARGO INSURANCE 1070 MONICA LN MAC N9306-132 SAN JOSE CA 95128-4117 733 MARQUETTE - 13TH FLOOR MINNEAPOLIS MN 55402-2309 Valued Homeowners Customer Since: JUNE 29, 2012 INSURED LOCATION: POLICY SERVICE INFORMATION: 1070 MONICA LN TELEPHONE: 1-800-578-6701 SAN JOSE CA 95128-4117 E-MAIL: WEBSITE: www.safeco.com IMPORTANT MESSAGES - Your policy has changed effective June 29, 2017. -, THIS POLICY DOES NOT PROVIDE EARTHQUAKE COVERAGE. - The limit of liability for this structure (Coverage A) is based on an estimate of the cost to rebuild your home, including an approximate cost for labor and materials in your area, and specific information that you have provided about your home. LIMITS OF LIABILITY (Policy Section I - Property Coverages and Section II - Liability Coverages) Coverage A— Coverage B— Coverage C— Coverage D— Coverage E— Coverage F— Dwelling Other Personal Additional Personal Medical Structures Property. Living Liability Payments Expense $658,9001 $65,890 1 $329,450 1 $131,780 1 $500,000 1 $5,000 DEDUCTIBLES. The following deductibles apply unless otherwise stated within the policy. AMOUNT Section I - Property Coverages $ 1,000 PREMIUM BASIC COVERAGES $ 1,528.00 OTHER COVERAGES, LIMITS AND OPTIONAL COVERAGES $ 226.00 DISCOUNTS AND SURCHARGES $ -72.85 TOTAL POLICY PREMIUM: $ 1,681.15 Premium Payer: Servicing Mortgagee You may pay your premium in full or in installments. There is no installment fee for the following billing plans: Full Pay, Annual 2-Pay. Installment fees for all other billing plans are listed below. If more than one policy is billed on the installment bill , only the highest fee is charged. The fee is: $0.00 per installment for recurring automatic deduction (EFT) $0.00 per installment for recurring credit card or debit card $2.00 per installment for all other payment methods CONTINUED ORIGINAL HOM-7000/EP 1/09 Page 1 of 3 DATE PREPARED: JULY 5 2017 """REPRINTED FROM THE ARCHIVE.THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS GENERAL INSURANCE COMPANY OF AMERICA (A SAFECO Company) HOMEOWNERS POLICY DECLARATIONS ,CONTINUED POLICY NUMBER: OX6036858 Servicing Mortgagee WELLS FARGO BANK, N.A. #936 ITS SUCCESSORS &/OR ASSIGNS P 0 BOX 100515 FLORENCE SC 29502-0515 LOAN NUMBER: 292751344 POLICY LIMITS AND OTHER ADDITIONAL COVERAGES (Unless otherwise stated, all limits and coverages are included in basic coverages) COVERAGE LEVEL: OPTIMUM SECTION I - PROPERTY COVERAGES COVERAGE C - PERSONAL PROPERTY - 3.. SPECIAL LIMITS OF LIABILITY a.Money, pre-paid cards. . . $ 1,000 h.Business Property b.Rare coins and currency. . . $. 5,000 On Premises. . . $ . 3,000 c.Securities, debit cards. . . $ 5,000 Off Premises Sub-limit $ 1,000 d.Watercraft. . . $ 3,000 i .Tapes, records, discs. . . $ 500 e.Trailers. . . $ 3,000 j .Theft of rugs. . . $ 10,000 f.Theft of jewelry, watches. . . $ 5,000 k.Grave Markers. . . $ 5,000 .g.Theft of silverware. . . $ 5.,000 OTHER INCLUDED COVERAGES/POLICY PROVISIONS Limit Premium Loss Assessment Coverage $ S,000 Included California Workers Compensation $ 12.00 Inservant N/A Outservant N/A Building Ordinance or Law Coverage ( 10%) $ 65,890 Included Refrigerated Spoilage Coverage Included Fungi , Wet or Dry Rot, or Bacteria $ 10,000 Included Reasonable Repairs $ 5,000 Included Fire Department Service Charge $ 5,000 Included Land Stabilization $ 10,000 Included Arson Reward $ 25,000 Included Criminal Conviction Reward - Item' a. Information $ 2, 500 Included Criminal Conviction Reward - Item b. Property Recovery $ 5,000 Included Credit Card, Fund Transfer, Forgery & Counterfeit Money $ 5,000 Included Volunteer America ' Included Section I (All Perils Coverage) Included Section II ,- Liability Coverage Included Section II - Property Damage $ 2,000 Included OPTIONAL COVERAGES Limit Premium Personal Property Replacement Cost Included Extended Dwelling Coverage Up to 50% Included Escape of Water from Sump (Building/Contents) $ 5,000 $ 39.00 Valuable Articles Itemized Coverage See Schedule $ 175.00 DISCOUNTS AND SURCHARGES Premium Paid In Full Discount Included LICENSE, TAX OR FEE: California Seismic Safety Fee $ .15 For information on other deductibles, coverages or discounts. available in your state or to review your account online, log onto www.safeco.com FORMS APPLICABLE TO THIS POLICY: HOM-7010/EP 1/09 - VALUABLE ARTICLES SCHEDULE HOM-7301/EP 1/09 - PERSONAL PROPERTY REPLACEMENT COST CONTINUED HOM-7001/EP. 1/09 . Page 2 of 3 DATE PREPARED JULY. 5 2017 -'REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS -* GENERAL INSURANCE COMPANY OF AMERICA (A SAFECO Company) HOMEOWNERS POLICY DECLARATIONS CONTINUED POLICY NUMBER: OX6036858 HOM-7300/EP 1/09 - EXTENDED DWELLING COVERAGE HOM-7220/EP 1/09 - SAFECO OPTIMUM HOMEOWNERS COVERAGE HOM-7311/EP 1/09 - ESCAPE OF WATER FROM SUMP/SUMP PUMP DRAIN (BLDG AND CONT HOM-7100/CAEP 11/11 - SPECIAL PROVISIONS - CALIFORNIA HOM-7237/CAEP 7/09 - CALIFORNIA WORKERS COMPENSATION HOM-7579/CAEP R1 11/11 - CA RESIDENTIAL PROPERTY DISCLOSURE HOM-7030/EP 1/09 - HOMEOWNERS POLICY HOM-7376/EP 1/09 - VALUABLE ARTICLES COVERAGE HOM-7232/EP 1/09 - EXECUTION CLAUSE HOM-7001/EP 1/09 Page 3 of 3 DATE PREPARED JULY 5 2017 R Syed Wahidi From: Syed Wahidi Sent: Monday,August 14, 2017 3:33 PM To: sauermat@gmail.com' Cc: John Burchfiel;Joy Francois; Bob Siudzinski Subject: RE: Permits for street tree removal (1070 Monica Lane) Attachments: SKMBT_50117081415120.pdf Hi Matthias, To remove and replace the tree,you need to get R-1 (no fee) permit from us. To get the permit, please bring: - R-1 permit application (copy attached) - Written authorization letter from Bob S to remove the tree (Bob can provide the form) - $500 security deposit(which is refundable) - Copy of homeowner's insurance Here are answers to other Q's: ® What additional permits do I need before the work for tree removal can get started?Where would I find the forms(if any)?(answered above) • The tree has a large root stock that we will need to grind that before work on the side walk or front yard can be done. What is the best way forward: would we have the tree cut and then coordinate grinding of the roots with repair of the side walk?(Q is not clear.After you get the permit,tree can be removed and sidewalk can be repaired and once you repair sidewalk,tree roots under sidewalk can be removed) ® I understand that the sidewalk is City responsibility. How would repair of the sidewalk be triggered?when would this work likely be scheduled? (It might make sense to coordinate that with work on the front yard and root grinding). (For sidewalk repair,you have to contact Ron Taormina at City Service Yard at 408-866-2145) •®y•Gr]� Syed Wahidi �4 A� Public Works Inspector (j City of Campbell I Public Works Department o o 70 N. First Street I Campbell,CA 95008 www.cityofcampbell.com 1408.866.2165 f�RCHAR� From: Matthias Sauer [mailto:sauermatCabgmail.coml Sent: Monday, August 14, 2017 10:04 AM To: Public Works Subject: Permits for street tree removal (1070 Monica Lane) Dear Public Works Team, I have a couple of questions regarding the removal of the tree in front of our house. I had already had a phone conversation (with Bob Sindvinski (?)) about a verbal approval to remove the tree (it's a huge liquid amber and the roots are tearing up the sidewalk and drive way). In addition I'd have the following questions: i G . What additional permits do I need before the work for tree removal can get started? Where would I find the forms(if any)? • The tree has a large root stock that we will need to grind that before work on the side walk or front yard can be done. What is the best way forward: would we have the tree cut and then coordinate grinding of the roots with repair of the side walk? • I understand that the sidewalk is City responsibility. How would repair of the sidewalk be triggered? when would this work likely be scheduled? (It might make sense to coordinate that with work on the front yard and root grinding) My daily meeting schedule make reaching me by phone a bit of a challenge, but we can set up an appointment (or a time for a call), if necessary. I can be reached on this email or(408) 406-6599 (Cell). Kind regards Matthias Sauer z CITY.OF'CAMPBELL DEPARTMENT OF PUBLIC WORKS APPLICATION FOR PLANT REMOVAL Date Submitted Application No. Pursuant to the terms of Chapter 11.08 of the Campbell Municipal Code,.an..application is hereby made fora permit to remove L. The location of the job in the public right of way is as.follows: cur 4'2;de_ 1-1 CK C4 l o,7v Ylo r1 Jc a l i., Z. The reasons-forthe removal Are.as-follows: Pooh ceaurav A c��,Lr�+oS, act,:"a4 fi P;06 EGG (use other side of sheet if necessary) 3. The-applicant hereby.agrees;-by.affa'highis sigriature-to this application; to hold the -City of Campbell,its officers,.agents.and.employees-free,safe.and harmless4rom any claim or demand-for damages to third persons relating from the work herein proposed. Name of Applicant (signature) (print your-name) Address.-of Applicant t y-k sc« 40se Cam` ClS`/2';' Check One: Residence or Business () Telephone Number (4ci�') 4r06'_C"'_? FOR OFFICE USE Date Recommendation (use other side of sheet if necessary) Applicant contacted in field? By Date