96-121
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APPUCAnON - AppI~""" illIIIrcbJ ..... tar . MIic VI.. PaIIIiI .. ..
iD 6 aauIII if die permit iI DOl iIIuIld).
100 North 3rd Street
"'_ willa r..."... ......... CadI. SIaiaD 11.0&. (AI'P'w..... apins
It.. VlOIt.scsraa or met #
(x-st Civic Center Drive)
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Utility uadI Jacatiaa
B. Nature r:I wmt
EMERGENCY Service Repair -.4'x4' cut in the concrete
C. AIIaCII four (4) alIpics r:I u apccnd dmriq IIaoIriq _1ac:IIIaI. __ ud * '.. ollila wad. n. cInnriac 11IIII__ - ..... ol tile
I""~ wmt to cziII:iDc IUJ'facc ... 1IDIIc.~......d ~o-- .. 'MIa "'W"..:Rd by" a, P~, IIid dnIwiD&.bIalaII:a. pan ol tIIiI pcrmiL
D. .All wart sAaII calfcnm to me aty'I Gcaaai r~~ S&IDdud G...a..aaa l'i_Lii- ud SIadaad CcMInaaio6 DaaiII tar PlIbIic WOIb
~ &be GcacraI Permit r.-l~ ..... c-. &be nwaa 8M; ad _ ..1'1..... . ~." ,. ddI plllllit.1iIIId bebr. PIiianllO abide br
dIac CDlditioa& ad ~ ..,. raub iD jab ...... ud/M fClllfcian r:I PaidafuI hdGl ..- SunDe& ud ... dcpaIi1L (See GaaaI
Pamit Qladitioa& 1 ud 2.)
R. A ~Ic qplic:aIiaa fee m_ - 1-"" tIIiI ~. _Ii ...
Name r:I AppIicaDt San Jose Water Company
~ 1221 South Bascom Avenue, San Jose, CA 95128
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CoaIpletf aDd.nadl warUn' ~ aDd ~ lafq--..... fam&.
The AppIic:aDt!paminee hcnbr -.r- by dbiq tMiI'...... 10 daiI ~ 10 baid .. asr ol""""""" ita caIcaa. .... ad ~ooof I 1-- tr.. sale
... humicII from att'f claim M dcaIaDd fM daIIIapI...aaiD& fftlID .. wart CIMNlI by dIiI paIIIiL
The AppIicaDt!pemlinee beftby~ dill tIIey !law tad ... ad .~..Ad baCIa Iba baalud b-* r:I tIIiI penai&. ad tIIey.uJ WOl'tll tbeir
CIlIImccoz(l) 01 tile iDfarmatiaa.
2/7/96
0-
Jane Leinberqer (EMERGENCY VERBAL)
(AppUc:at (Pei~) plillt/lip
Aa:lol~
Nares: -AU. WORK SHALL CONfORM Wl'l1I1'Hl!A1TAamD. AI'I'IlOVED PlANS AND ALL APPLtCABU! CAMPBEU. srANDARD
DRAWINGS AND CONDmON5.
1'Hl! CONTRACI'OR MUsr HAVE nus PERMlT AND APPROVED PLANS ATnIE srre AND MUSI' NO"llP'Y"mE PUBUC WORKS
DEPARThIENf ATLEASI'TWO DAYS BEFOREsrAImNG WOK
NanC! MUST BE GIVEN TO PUBUC WORKS AT IJ!ASI' 2C HOURS BEfORE Rl!STAKI'ING ANY WOR&:.
SPECIAL PROVISIONS
_1.
SIRct sbal1 DOC be apeD ad fM ....~......d __II........ ~1t""UI aatlIlUf be aIIaMld far n ...~ or apanac. bok:L SudI CIJtI must -;::
~ merifil2llv ~ bY tbe I!IsIleemr 17rior to t:UttiM.. C
hvaDent may be: ClIlIM 1IDdcqrDuad iamJl.fW- ad IIUII& be nsnd .. _.:IaI:e wida ... Udlity Tzada ~..... 5aaDdaJd Dftwiac. Ct
wcn* to be IIabd by . IicaIIed UDd s.aw,ar M CMI PitS;- ad t'WD (2) ~ ol &be all ...... - 10 tba ~ Wora DepuuDat rr:
before aaniq -.art. C":
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PERMIT APPUCAnON PEE mOJlJ
PlAN aIECIC DEPOSIT SSDD.OO
Sll'REIY POR pArI'HFtJL PERfORMANCE (1~ OP PoNG. EST.)
CASH DEPOSIT (4.0P SUREI'Y. S500 MIN)
PlAN amcK a. INSPECIlON PEE (JIIRST >>S3D.ooo 14~
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APPROVEDPORISSUANCE ~_tJ.J!f_
(01' City
h:PW pERMIT/R.ev.4/94 (.. cdleuide)
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