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an OF CAMPBELL
DEPT. OF PtJBIJC WORKS
'7U NanIa fbI& Sf..
~ CA 95(XB
(a) ~2150
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96-111
Affli .~... n.. 1/26/96
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A. Wort addras or UlII:f #
205 Kennedy Ave, x-str Railway Ave
UIiJity treDdllocatiaa
B. Nature 01 wod:
Emergency Main Repair, 2x2 cut in asphalt
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C. AaadI four (4) capia 01.. ~ cIIniac.... -1ac:8Iiaa. __ ud AI 01 tba wart. De cInIwiac 1baII... die I'IIaticxa 01 tile
~~ wort to clliIaq IUIfacc ud .-..1......... L-t-.....- .... wa... -wo....4 II)' - ClJ P-"p-, IIid dDwiac bealaIIa. pm 01 tbiI permiL
D. AU wam shaU axUOJDlIO tbc Oty'l Oaaeraa r_ 01111... SIudud CaManIaiaa l'rcMIiaaIud 5aadud ~ DeaiII far PlIbIic WodII
c.c.anxuoa: the Geaaaf Permit Cl:IIditiaIll& ..... CD rbe ....Iide; ... 1M ~ PnwiIia. far dIiI pamic. lilted below. PIIiI8rc ID abide by
tbae CIlDditioal ad pnMIiaaI may rauk ill jab 1Iaua.... --Iar fCllfcialm 01 Fai&hfuI Paianauaa 5unltieI ad ~ dcpaIiaL (See GaIaaI
PemUt Qladitioall ad 2.)
E. A DClIII'Cl1mdablc .,plic:alioa fee mUll... J~ tbiI.".:...... ,
Name 01 ApplicaDt
San Jose Water Company
T~ 279-7825
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1221 So. Bascom AVenllP. Srln .Tnqp ('J}. qJ:jl ?~
Ccmpiete aDd actldl Worbn' Caaapcuaaiaa ad Caaa.c:Iot IIIIomIaIiaa fClllDL
Tbc AppIic:uI/permittee bcreOy ..,.. by UIb:iq dIeir........ ID dIJI paIIIIi& 10 baMI tile ar, 01 r.. J,l~u. * da:a, ..... ad CIIIfl'llr..4ld fnc. ale
ad IIanttIcII from ..,. daim or cIcmaDd for daIup. ....atiq fn:lIII me wazt c:awnd II)' WI pcnaiL
Tbc AppIic:aDt/permittee bcreby acbIowIecIpa tbat tiler ... read ad ~ bocb me m. ad b-=t 01 WI permit. ad tiler wiD WOI'IlI tbeir
CllDtractOl(I) 01 the WonDaboa.
Accepcec:!
Jane (emergency verbal)
(Apptical (Penaittee) priDl/lip
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1/26/96
Nares: -AU. WORK SHALL cx)NFORM wrm 1HEA1TAaIED, APPROVED PlANS AND ALL APPUCABLE CAMPBELL st'ANDARD
DRAWINGS AND CONDmON5.
11m cx)NI'RACI'OR MUst' HA VB nus PE.RMrr AND APPROVED PlANS AT1HE srm AND MUst' N011FY 1HE PUBUC WOJUCS
DEPARTMENI' AT I.EASr TWO DAYS BEfORE st'AlmNG WORK.
NanCE MUST BE GIVEN TO Pt1BUC WOJUCS AT LEASI' 24 HOURS BEfORE RESrAR11NG ANY WORK.
SPEaAL PROVISIONS
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Sbect Iba.IJ DOt be opal cut for ade......... lalClUltioaI.. Miaimum cutllD81 be aJIoW'ed fe. eoaMeDaal or czp60ntiaa ha6ca. Sudl cutI.!!1E -;:;
be mecificaUv IDDrOnod bY the fDmerrnp!lrimo to ~ C
hvmlCDt may be: cut for 1IIICicrpoUDd ine_n_tj(w ad lIlUII be ftIIIlftd iD 8IZiD1dIDce wida 1M UIiJity Tft:lIdI R.eaontiaa SaDdud DnnriD&. =
Wort 10 be Itakcd by a IicaIed LIDd s.uw,or ar aviI P.l\~- ud IWIlJ (2) cap. 01 &be CIII ..... ... to the Publk Woris Depanmcal t'r.
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AMOUNT
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(ICX)1J(, OF PRo. EST.)
(4" OF SURElY. S500 NIN)
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< h:PW PERMIT/Rcv.4/94
* USA phone (800) 642-2444
PERMIT APPUCA110N PEE
PlAN alECK DEPOSrr
SUREIY fOR PA!IHP1JL PERFORMANCE
CASH DEPOSIT
PlAN alECK .t. INSPECIlON
Ncn $3O,ooo.SSO.OOO 10%; AmouIl pater:
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