96-118
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CITY OF c:.uIPBEl.L
DEP1' . OF PD.9LIC WOJUtS
70 North ri~t St.
ca.pbell, CA .5008
(408) 866-2150
CIIIIIID ~r.uou 11-1
>> PD I:IICROACRImIft' PaIIrl'
(for workin9 vit.h1n tile
public ri9bt-of-way)
($3,500 value of work)
x.n.;2 f.,
C}b-I/p"
.. '. 110.
ll....t. fUe
Applicat1cm Date J -6- 9&
Application apina iD 3 _.
APPLICATION - Application i. bereby ..d. for. Publ Puslt iD accordance with CUpbell
lIunicipal COd., Section 11.04. (Application apina iD 6 .-tba it the pualt 18 DOt 18.aed)
A. "ork addre.. , , '-:. () R- lOG t;--z..~-r D /L
B. .atur. of work: P J2..(.J /...J r S / 0 e7.,L) 40/<.
C. Attach three (3) copi.. of a dnv1ncJ abov1nV tIl. location, extent and .u..n.iOll8 of the work.
The draving aball abov the relation of th. propo.ed work to ex18tiDcJ 1JIIproveMnta. Dan
approved by tile City En91naer, Aid dnvin9 baclOM. a part of t:hia pualt.
D. All work ahall confora to th. City'. General CODditiOll8, Standard conauw:tion Prov18iOll8 and
Standard Con.truction DetaU. for Public "orks construction, '1'Ile General Pera1t CDnditiOll8
li.ted on the rever.e .id., and special Prov18ions for t:hia pualt, 11ated belov. Failure to
abide by the.e condition. and prov18iona ..y raault iD job abut-dovn a:IlI4/or forfeiture of
Faithful Perforunc. Surety.
.... of Applicant I. A- L A)(;) '1'8lepbonea '3 '7)' ZJ' 7 Y
Addr... J , ~ 0 1'2. 10 C:J c..~-y l) r~
Complete and attach "orksra' COapenaation and c:ontractor lDforut1an fOZll8.
The Applicant/Permitte. bereby agr... by affixing tIleir .iCJftAtura to thi. penait to bold tile City of
Campbell, its offic.~, aqMb and aploy... free, Afe and baral... frail any claia or daaDd for
damage. r..ulting trOll the work cov.red by thi. penait. .
Appli t/Permi ovledg.. that they bave read and UIIdu1ItancS both the front and
ba k ot this rmit, vi 1nfora their contractor(.) of the iDforut1an.
S-T4 9 P "
Date
NOTES: ALL WOD: SHALL COHP'ORM WITH '1'BE A'1'TAc:BED, APPIcuy6fl PLUfS AlII) ALL APPLICABLE CAIIPDLI.
I'1'AHDARD DETAILS AND CONDITIONS.
THE CONTRACTOR MOST HAVE THIS PERMIT AND APPROVED PlANS AND IIOST AmWfGB '1'0 IIDT 1fITB '1'BZ P.W.
INSPECTOR AT THE SITE AT LEAST TWO DAYS IIEPORE STARTIHG 1IORJt.
.
NOTICE MOST BE GIVEN '1'0 PUBLIC WOU:S AT LEAST 24 BOURS Ul'ORl!: RICS'l'AR1'DfG AllY mJUt.
SPECIAL PROVISIONS
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5/t-J AN!) C~. fOL.L.bvJ A7T4c)1O'J f,15$T fH4/t/4 G6fl?f:/JI AeAcT)cf,s
tolC. CONcdeTf5 J,.j<lIUL. LlSG cA-wIMIII! CL4f.5 'Il' .' (p~.s4a Co..v~,~/IJ(J
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~ARD
Mmmft' D~ RO.
.. 775. 6 ~ qO'7 ~ 9
.2-5-9C:, .
Data
SIJRETlC lOR FAI'l'BPUL
APPROVED lOR ISStJAHCE
(100' or BIIG. a'l'.)
f: R1 PERKIT
-.vised 6/92
(sa 0"l'DR 8mB)
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City of Campbell- Check Request
To: Accounts Receivable
Please Issue Check
Payable to: Mr. I. Alne
Address - Line 1: 1160 Ridgeley Drive
Line 2:
City: Campbell State: CA Zip: 95008
Finance Only:
Description: REFUNDABLE DEPOSIT INTEREST EARNED
Amount Payable: $ 193.75
Account Number: 101.2203 101.540.7448
bate and Receipt No: 2/5/96 #90739
Permit No: 96-118
Purpose: Refund of 2S~ TPt-;:Iin,::lon frnm JfI::.;-rh-F,,1 por~o~~agcQ dQpg~it
Requested by: Title: Date:
Approved by: ~(~/ Title: City Engineer Date: 4/12/96
~c e e Qu~nney
FINANCE ONLY:
Verified by: Title: Date:
Approved by: Title: Date:
Special Instructions For Handling Check
Mail As Is: x Mail in Attached Envelope:
Return To:
(NAME) (Department)
Other:
.
rev: 3/25/95
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line I:
Line 2:
City:
Description:
Amount Payable:
Account Number:
ate and Receipt No:
Permit No:
Purpose:
City of Campbell- Check Request
Mr. I. Alne
1160 Ridgeley Drive
Campbell
REFUNDABLE DEPOSIT
$581.25
101.2203
2/5/96 #90739
96-118
State: CA
Zip:
Finance Only:
INTEREST EARNED
101.540.7448
Refund 75% of FPS np-po~ir of $77~ 00
Requested by: Randy Westfall
Approved by: I J 1./2 . ct ~
M~e Qu~n~
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is:
Return To:
Other:
rev: 3/25/95
Title: PW Inspector
Totl City Engineer
I e:
Title:
Title:
95008
Date:
Date:
Date:
Date:
Special Instructions For Handling Check
xx
(NAME)
Mail in Attached Envelope:
(Department)
PUBLIC WORKS DEPARTMENT RECEIPT
Effective Julv 1, 1995 9b -JJf
TO: City Clerk PUBLIC WORKS FILE NO.
PROPERTY ADDRESS II ~() ~llJ~~JF;V Ill(..
. . . . Please collect &receiptf~r the monies:<.. ......... .....
I """," .......~><... ...,. .< /.. ...
A"'" "'.,,, AO?11 Proiect Revenue (sDecify Droiectl
ENCROACHMENT PERMIT
47~ Application Fee
Non-Utility Encroachment Permit ($2251
R-l First Permit (No Fee), Subsenuent PermitlYr ($100)
Utilitv Encroachment Permit
Arterial/Collector Street ($3251
Residential Street/Other Areas ($2251
220 Plan Check DeDosit ($5001
2203 Faithful Performance Surety (FPS) (100% of ENGR.EST.I "7""]"100
220 Monumentation Surety (100% of ENGR.EST.I
220~ Cash Deoosit (4% of FPS)($500 min.)
220~ Labor and Material Suretv (100% of ENGR. EST.I
Plan Check & Insoection Fee (Non-Utility)
472. Engr.Est. < $250,000 (12% of ENGR. EST.)
.. 220 Enar.Est. > $250,000 (Denosit 15% of ENGR. EST.)"
4722 Utilitv < $100 000
Conduits/Pipelines up to 500 Feet ($1.60/ft.)
Above 500 Feet ($1.10/ft.)
Manholes/Vaults/Etc. ($105/eal
Pole Set/Removal ($105/ea)
Minimum Charge Per Location ($1201
Street Tree Plantina/Removal ( $1 05/tree)
.. 2203 Utility> $100000 (Denosit 15% of ENGR. EST.)"
476 ProTect Plans & Soecifications Proiect No.
476 Standard Soecifications & Details ($1/"" $l21Book)
476 CODies of Enaineerino MaDs & Plans 1$.50/so.ft.)
472 Penalties: Failure to restore Dublic imDrovements ($loo/Calendar Dav)
(Muni Code Section 11.34.0101
472 Penalties: Failure to correct unsafe conditions ($100/Calendar Dav)
LAND DEVELOPMENT
4722 Lot Line Adiustment ($5001
472 Parcel Map (4 Lots Dr Less) ($1 060 + $25/Lot)
472 Final Tract MaD (5 or More Lots) ($1,380 + $25/Lot)
472 Certificate of ComDliance ($4001
472 Certificate of Correction ($3001
472 Vacation of Public Streets & Easements 1$5501
472 Assessment Segregation ar Reapportionment
First Solit ($550)
Each Additional Lot ($1701
472 Storm Drainage Area Fee Per Acre (R-l, $2,000)
(Multi-Res, $2,250)
(All Other $2,5001
492C Parkland Dedication Fee (75%/25% Due Unon Cert. of Occuoancv)
496E Postaoe
TRAFFIC
472 Intersection Turn Counts (Two.Hour Count) ($601
472 Intersection Turn Counts (a.m. or o.m. neaks) 1$1251
472 Traffic Flow Mao (Dailv Traffic Volumes) ($271
472 Cari1Dhell Traffic Model (Full SCODe Assessmentll$2 250)
472 Camnbell Traffic Model (Reduced Scone AssessrrC$7401
427 Truck Permits ($35ItriDI
4721 No Parkina Sians ($lIeach or $25/100)
OTHER
TOTAL $775'.0\
-- AL/lJE
NAME OF APPLICANT ~
NAME OF PAYOR 1. AiN e . PHONE 3/7~~~74-
ADDRESS /1/9 <:::. rv /)I:.,.13lr;-/ IlR. I C.A t1 L) Vi .I ./ c,4 ZIP '7'5() 6 ~
/ J
.. Actual Cost Plus 20% Overhead (Non-Interest bearina deDosit)
*FcirPlan Clleck and Cash Deposits; send yellow copy to Finance;Ot
RECEIVED
fEB 0 5 1996
CITV CLERK'S OfFICE
roa
em CUD:
ONLY
h:\recfrm3.wk3(mp)rev.l/9/96
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CITY OF CAMPBELL
Public Works Department
March 28, 1997
Mr. I Alne
1160 Ridgeley Drive
Campbell, CA 95008
SUBJECT: PERMIT NO. 6-118 (R-l)
LOCATION: 1160 Ridgeley Drive
ONE YEAR MAINTENANCE INSPECTION - ACCEPTANCE
Dear Mr. Alne:
The City of Campbell has made the final one year maintenance inspection of subject Public
Works improvements and find that no maintenance is required.
Your warranty requirements, therefore, are hereby released.
Sincerely,
~ tt14
Randy Westfall
Public Works Inspector
MQ~
cc: Permit 96-118
Public Works/Maintenance Division
H:\ WORD\PERMITS\96118ACC(JD)
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TOD 408.866.2790
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CITY OF CAMPBELL
Public Works Department
April 16, 1996
Mr. I. Alne
1160 Ridgeley Drive
Campbell, CA 95008
RE: PERMIT NO: 96-118 (R-1)
LOCATION: 1160 Ridgeley Drive
RELEASE OF FULL FAITHFUL PERFORMANCE SECURITY
Dear Bud:
Based on our discussion last week, the remaining 25 % of your Faithful Performance Security
is now being processed and will be returned to you under separate cover. Thank you for
bringing to my attention the discrepancy between the requirements listed on the R-1
encroachment permits and our procedure of holding 25 % of the Faithful Performance Security
for the duration of the maintenance period.
If you have any further questions, please give me a call at 866-2159.
Sincerely,
Jr~41-~~
Michelle Quinney
City Engineer
cc: Permit #96-118
j:\mq\alne
70 North First Street. Campbell, California 95008.1413 . TEL 408.866.1150 . FAX 408.379.1571 . TOD 408.866.1790
NEW PW FAX #
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2/77
CITY OF CAMPBELL
Public Works Department
March 20, 1996
Mr. I. Alne
1160 Ridgeley Drive
Campbell, CA 95008
RE: PERMIT NO. 96-118 (R-1)
LOCATION: 1160 Ridgeley Drive
FINAL INSPECTION AND ACCEPTANCE
Dear Bud:
The City of Campbell has made a final inspection of subject Public Works improvements and
fmds 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 the date of this acceptance
letter. The permittee is responsible for 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.
75% of your Faithful Performance Surety (FPS) cash deposit of $775,00, plus any interest due,
is now being processed and will be sent to you under separate cover. We will continue to hold
$193.75 of your FPS cash deposit as a maintenance surety.
If you have any questions, please call Randy Westfall, Public Works Inspector, at
(408)866-2165.
Sincerely,
7tiJdJi ((JlU~7
Michelle Quinney, P.E.
City Engineer
J1-
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H:\96118FIN.LTR
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cc: Permit #96-118
70 North First Street. Campbell. Califorma 95008.1413 . TEL 408.866.:2150 . FAX 408.379.:2571 . TDD 408.866.2790
KEW ?W FAX:iF
CITY OF CAMPBELL
/106 I(Jd~ Dr.
N~ :;/vJ.
CONTRACTOR: ~4lA/N/, 8\.tJ J4/t'L-l.
PROJECT NO. 9~-IJ g-
REPORT NO:
FIELD ENGINEER' S DAILY REPORT
DATE: 3'1 q- <]~
--
WEATHER: I-a I I .
INSPECTOR: K. ~~5lfALL
ITEM
DESCRIPTION
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