96-128
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I PERMn' APPUCA'nON PEE mOJXJ
;: PUN CHECK DPPOSrr SDIJXJ
..: stnmrY fOR PAl'llIPUL PERFORMANCE (tClJllt OP ENG. ESI'.)
I -' CASH DEPOSIT (.... OP stJREIY. ssm MIN)
: ~ PUN CHECK .A INSPECI10N~~r1 (fIRST >>S3OJXX) 141lJ1&;
:.::. Ncu S3O,lXlO-SBO.OOO 109&; AmouDt dIaa~ mm)
I t: APPROVED fOR ISSUANCE __
III for City
< h:PW pERMIT/R.evA/94 (MC other side)
* USA ohene (800) 642-2444 nCKET NO.
APPIJC\'nON - Appwrioa iI buebr'" far. MIic WClIb J'amilm ~ willa r....".-. )I...' 'J"'I Code. SIaiaD I1JM. (AJIP......... apireI
ia , tDDDdII if tbc p:nait iI .. iIIued).
A. Wort -'draa or aw:r #
120 Kennedy Avenue (x-street Industrinl Strp-etl
UIiIity aadllocatica
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B. Nature d wort
EMERGENCY Main Repair - 4'x5' r.llr in ric::phrilr
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C. Astadllour (4) c:opia 01.. eqiDccftd drniac.... tbclal:laaa. CIIIlIII.... <lIT ',. 01 tile 1IIlft. 11la dmwiq Ibaa .. _ ndmaa 01 t2lc
...~ wort to c:siIriq IIII'fMz .... ""'~ ........ f-t..-. .... WIIIII "ftM~ by tbc 0lJ p~ IIid dIniac~. pm 01 t!IiI permiL
D. AD MIIrt &ball c::calorm to me Cty'1 GIaaat r..-~ SIudud ea.r-oaa ~ 'I' .. ad SIadud ~ DetaiII far PabIic Worb
Coaamaiaa: me GeaaaI Permit r~itVw ..... c-. eM meaa aide; ad eM ~ FftlIW~ far... pamil.1iaIed..... PIibn to abide br
tbae caaditioal aDd prcMliaallIIaJ' raIUt ill jab IIuat-4aMI _lor {ClIIfeiaIm d PaithfuI hJ... - SuIeti. ad ~ depaIiu. (See 0cacraJ
ramit Qladitioall .... 2.)
P. A acmcfuDdablc 8ppiicatiaa lee 1II11II Ad 1-&' 'tIIiI-nJ. at... .
NameolApplicer San Jose Water Company Tdepbaae 279-7979
II t!IiI MIIrt beiq daae by tbe t'"~ 0MICr It tbIir ClIft ftIiIIcDc:e'!
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Addrea
1221 South Bascom Avenue. Snn ~nc::o, ~n P5'2i
Complete ucI anadl Worten' CaaapetIuaaa ad Ccatncrar IIIfanutiaa (ClIIDI,
The Appticut/perminec hereby -.re- by.ab:iq rMir........ to dill pamir to boW dIa aty d.r.. ........1&.. ita cdIcca, apDtI ad J o4f I 114M lnc.lllfc
IDd hanDJcg fIOIII uy claim or dcIIIaad for damapI..utiq fraaI tbe wart CIIMftld by tIIiI paIIiL
The AppIicaDI/Fermincc bcn:by actDoIriedp:I tbII tiler... lad aDd ,,~ bodl tile fraaI aDd bact 01 dliI pamit, IIId tJaerwiD Ust'0ftIl their
caaaxtoJ(l) d tile iDformatiaa.
Jane Leinberger (EMERGENCY VERBAL)
(AppUcat (Pamiaea) Jllillt/lip
2/26/96
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Nams: -ALL WORK SHAU. mNPORM wrm 11D!A1TAaIED. APPROVED PlANS AND AU. APPUCABI.E CAMPBEU. STANDARD
DRAWINGS AND CONDmON5.
1HE mNI'RACI'OR MUST HA VI! nus PmUdIT AND APPROVED I'IANS AT'IHE srm AND MUST NOTtPY 11IE PUBIlC WORKS
DEPARThIENl" AT LEASI'TWO DAYS BEPORE S1'AKI1NO WORK.
NanCE MUST BE GIVEN TO PUBUC WOJUCS AT LEASI' 24 HOURS BEfORE RESTAlmNG ANY WOK
SPECIAL PROVISIONS
SIrccl &ball DOC be apeD CDt lor ada....-d flll""l...... Miaimlllll CIJtI may be lIIIoRd for........... - or apkndaa baic:L Sudl ClltI mUll -;::
be merifil21Jy .YIJ~ ~ bY the 1MbermP!!rim!t) rartiM'.. C
hvaDear may be: au for ~ i_U.Po- .... __ be I'CIIDftd izl aa::mdIIIce wida die UdIity TftIIdI D 1Mb. 5audad DnwiDc- ==
Wort to be aWed by. Iicaaed Lud s.w,or or 0viI P.IIP- ad two (2) cap. d die CIII ..... - 10 die Public Wons DeputmcAr ~
Wcm: staniq wart. ("':
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