96-102
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(far waddill widIIa -
pIIbIic npaoCll--r)
.... 1-/(}.--'9h,_JJ AjlJr oi_DMa 1/10/96
..... apiaa iD 12 .... f/JP AJTi=- II\Ml a:pina ia 6 ...
APPUCA1l0N - Appticaac. iI b&nlbr ..... far . PabIic WCIItII Pamia ill ... ,-- willa r...."..... ..~I Cade, s.ax. lLCM. (AppI...... apires
ia 6 IDQDtbI if the penait iI .. iIIued).
an OP CAMPBElL
DEPT. OP FUBUC WORKS
10 Nanb filii SL
r"-T-11.. CA 95(D
(a) 1166-2150
.... No.
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96-102
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A. wort 8ddJa& or tne:t #
Across from 250 Budd Ave, at California Intersection
Main Repair, 4x4 cut in asphalt
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Utility crcadIlocaac.
B. Nature d wort
C. Aaadl tour (4) capieI ol.. cqiDecred dmriac IIDriq me Iac:lIaDa, alai _ dial '.. oldie wan. nc drniq IbaII .... ... rdaIiaa of die
~ worE to c:DIa:iDC IUIDcc ud UDIIc.~__ L..t-o-- - ... WIM:a ......lMd ."... a, 11';-, said drniq ...... put of tIIiI pamiL
D. .All wart Iba1l caarorm to the aty'1 GceeraI ~ 5aDdud OldiIa-.c:IiaD Pun:J' .. _ S&adud ~ DecaiII far PabIic Worb
~ the GeaaaI Permit C--'ltWot ..... mI ... ,.....Iide; .... tIl& Special ~~ tal' ddI pcnIIit. lilted bebr. PaiiuIe to 8bidc br
tbcse ccaditioal ud ~iliaallIIIIJ' rauit ill jab 1lua&4Rni _lor tOlfci&1n ol Pai&blW PaiclnIIaIII:& SurcIiea ud QIb depaIiIL (See GacraI
Pamit Coaditioall ud 2.)
P. A DClIIIftf1mdabIc qp6catioa tee IIl1IIt a.. I ., tIIiI '"I'9lj,l."; 0"
San Jose Water Company
Name ol AppIicaDt
T~ 279-7979
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1221 So. Bascom Ave, San Jo~P. r~ q~l?A
.. t11i11IIUJt bciDI doac br tIl& propcnr 0IftICr at their an ftIidaII:&?
Ccmpictc aDd .nadl wortas' CaDpeIIIatiaD aDd Caatnctar IafOllllatiaD tom&
The AppIicaDttpermincc !lcrcby ~ br db:Iq dMIir IipaaanI to daiI pamit to ba6d 1M Oty ol ~ JIa CIftIcas, ",D aDd c. ,- fnlc. ale
ud Il.umJaI holD uy claim or dcmaDd tor damapI...atia& traaa tIl& wart cawaed ." tbiI pamit.
Ya
No
'Ibc AppiicaDtfPermince bcreby acbcIwIedpI dial tIIey bIw lad aDd1lllClalP"'w1 badl tIl& lIaat aDd bact ol tbiI permit. aDd tIIey wiD Worm their
CDDmctOJ(l) of tile Wormatioa.
Accepccd
Jane (emergency verbal)
(AppUc:ut (Pcmunec) JIIiIII/Iip
1/10/96
Deaa
NOTES: -AU. WORK SHALL CDNPORM wrm"IHE A1TACIED. APPJtQVED PLANS AND AU. APPUCABU! CAMPBEU. SI'ANDARD
DRAWINGS AND CONDmON5.
nIB CONI'RACI"OR MVSI' HAVE nus P!!RMlI' AND APPROVED PlANS ATnJE srre AND MUSI' NO'IlPY nm PUBUC WORJCS
DEPARTMENI' AT l.EASI'"tWO DAYS BEfORE srAKl1NG WORK.
NanCE MlIST BE GIVEN TO PtJDUC WORXS AT LPASI' 24 HOtJRS BEPORE JU:SI'AKI1NG ANY WORK.
SPECIAL PROVISIONS
_1.
SIrcet Iba1l DOl be apeD art tor 1IDd...........d illrl"tw-- MiaiIIlUIII ClJtlIIIIIJ' be aIJcIIRd tal' ~nou:1iDIII or apiora... ho6cL Sucb c:IJtIlPust -;
~ merific:aJJv mDt'OYed bv the fDstleetmo mior to cuniDE. C
hvaDeat may bt: cut for UDdeqrouDd i......ao- ud IIl1IIt be ftIIOl'cd ill aa:mdaDce wida tIl& Utility TnDdl Raam~ SIadard DmriJl&. t:C
Wort to be aakcd by a 6ccDIcd Lud ~ or Qvi1 P"&i- ud two (2) CJCIIIi- ol tbe all ..... ... to tIl& Public WorD DcpanmcDc t::
bcf~ IWt'iDI wart. C"':
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APPROVED FOR ISSUANCE
snOJXJ
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(1~ OP ENG. EST.)
(4<<tOP S1JREIY. ssm NIN)
so.s:JO.DOO 14l1J&;
SDJ miD)
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PERMrr APPUCA1l0N PEE
PlAN QIECK DEPOSrT
SURElY FOR PAlIlIPUL PERfORMANCE
CASH DEPOSIT
PlAN QIECK .t INSPECIlON PEE
Ncn S30.000-SSO.000 10%; AmouDt
(j - '7&
Darc
* *
h:PW pERMIT/RevA/94
USA phone (800) 642-2444
(ICII otbc1lidc)