96-132
CITY OF C~~L...... V E ~
DEPT. OF PuI[I~ I "",.
70 North First St.
Campbell, CA 9500&~AR 151996
(408) 866-2150 1m.' "
Fax (408) 376-0958 ,_'
A.DMINISTRA TIO,..
APPUCATION - Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04.
expires in 6 months if the permit is not issued Application Fee is non-refundable).
~NCROACHMENT PERMIT
Jr working within the
public right-of-way)
Issued 4/9/70
Permit expire~ in 12 mos.
*,: 1:;:'tr Per '. Nor q C - 13~ ~ ADI') ,
X File
Application Date 3/13/1,
Application expires in 6 mos.
(Application
A. Work address or tract #
Utility trench location /I.
B. Natureofwork/NJ'T-fLL 6"!/YOA.-w,..r .r'/l& r;Jll/ir~ :1-I'/~v J..!-.2." fJ.VIC6 IlJ,srcvA4cr
. I
c. Anach four (4) copies of engineered plans showing the location and extent of the work, and four (4) copies of the preliminary Engineer's
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by
the CIty Engineer, said plans become a part of this permit.
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D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit Conditions
listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and provisions may result in
job shut-down and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions I and 2.)
E. THE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS
DEPARTMENT AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS
BEFORE RESTARTING ANY WORK.
Name of Applicant/Permittee J;;AJ J.re t1JArFP.. OOJAPA~,(
Telephone 271'-7847
Address orE
Is this work being done by the property owner at their own reSidence?
q 5""1 z.8
Yes
No
The Apphcant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell, its officers, agents and employees free,
safe and hannJess from any claim or demand for damages resulting from the work covered by this permit.
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an' OF CAMPBELL
DEPT. OF PUBUC WORKS
10 North FU5t St.
Campbell, CA 9:S<nl
(0) ~2lSO
ENCROAOINENT PERMIT
(for wottiD& withiJl tbc
piblic ri&bt4..ay)
Jgued 3/SJC) (j). C)
Pamit apircs in 1i IDOL ?
Permit No.
X-Rd. file
Applicatioll Detc~
Applicatioll apircs in 6 IDOL
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APPUCATION _ Applicatioll is hereby made for a Public Worb Permit in 8CCOI'daDce with CampbcU NUDicipU Code, Soc:tioIll1.04. (Applicatioa apira
in 6 IIIOIItbs if tbc permit iI DOt iIIucd).
A. Won: acSdreaor tnct# HarvlIlton Avenue, 'BC' Elf;. April Way
Utilitytrcoeh Iocatioll eross,n9 Han\llton Ave.nue
B. Natureofwort ~ater Main ,,,staUot,on. Est. Cost "219,400' ~
C Att.adI four (4) copies of aD eqjDceted d.rwwiDc Ibowiq the IocatioD, atcIlt aDd diIM.,. of the wort. Dc cbwiD&.un Ibow tbc rcIatioIl of the
J'I'OPC*d wort to cDtiD& lUJ'facc aDd uderpouDd improvaDcDts. Wbca apprtMd by the aty EIIpaccr, aid 4nwiD& bccamcI . part of tbiI permiL
D. AU wort shaD COIlform to tbc aty'1 GcDeraJ CoDditioaI, StaDdud CoaItnK:tioG I'rcNiIioaI aDd StaDdud CoaItnK:tioG DctaiII for Public Worb
Coaatructioc; tbc GcDeral Permit CoDctitioalli5ted OD tbc ~ aide; aDd tbc SpecialI'rcNilioal f<< tbia permit. Ii5ted below, Pduft to abide by
tbece cooditioal aDd proviIioaa may reault in job lhut-doMl aDd/or forfeituR of Faithful PafOl'lDUlCC 5uJeties aDd caIh deposits. (See Geoeral
Permit Cooditioal1 aDd 2.)
E. A DOIU'efuDdable applic:atioa fee mUll lIClCClIDpUI1 thia appIicatioa.
Name of Applicant
. Addte$S ,z. '2. f
SAN JCSE WATER c..DMPANY
SD. f>ascorn Ave., 5an JDse
,
CA
Tdepbooe '2-19 -784-1
9.5' 2.8 tl..E....C...E. I)
MPJ< 51996
II this wort beiDg doae by tbe property OWDCr at their own raideDoc? Yes
./No
Complete and attach Workers' Compensatioll and Contractor Informatioa f~
t"l..n,.;L.I(. \iv 'v I"~'\.';
Dc Applic:ant/permittee hereby ~ by afIUiD& their lipature 10 tbiI permit to bold the aty of c-..".....u. ita oftioers, apltl aDd1lll'fM1,f"'~~OI\l
aDd harmless from allY claim or delDllDd for damages JUUlting from tbc wort ~ted by thiI permit.
The Applicant/permittee bereby ackDowledge:s that they ~ read and UDdcratand both tbe front aDd beet of this permit, aDd they will inform tbeir
COCltractOr(S) of the information. ~
Accepted Edwin L Mello I p, E. I rvJlrR.. ~ 9{'
(Applic:ant (permittee) print/sign
NOTES: ALL WORK. SHAll CONFORM wrm TIlE ATTAOIED, APPROVED PLANS AND ALL APPUCABLB CAMPBELL SIANDARD
DRAWINGS AND CONDmONS.
1HE CONTRACTOR MUSI HAVE nns PERMIT AND APPROVED PlANS AT 1HE srre AND MUSI NOTIFY TIlE PUBUC WORKS
DEPARTMENT AT LEAST"IWO DAYS BEPORE SIARTING WORK.
NOTICE MUSI BE GIVEN TO'PUBUC WORKS AT LEAST 24 HOURS BEPORE RESTARTING ANY WORK.
rJdfE:.: WD,4J(. rJ /0 ...e:.~/AN with ~qlJ../~ If /ANt, C f.,IJ swtl; /,.}
SPECIAL PROVISIONS 1"1<#. CIN If 5i4111 J<i$E. 12,0. W.
_1. Street shall DOt be opeD cut for WldergrouDd iDstalIatioaL Minimum CUll may be ~ for COIlDeCtioII6 or espIoratiOD boles. Such CUtl.!!!!!a
be soecifica1lv aooIOYed by the Insoector >>"or to cuttin2.
_2. PavemeDt may be cut for WldeqrouDd instaUatioal aDd mUll be rc:st.ored in aa::ordaDcc with tbc Utility TreDCb RatoratiOD Stao4ard DrawiDg.
_3. Won: to be staked by a 1ioeD&ed Land ~ or Civil BDgiDecr aDd two (2) copies of tbc cut lbectl leDt to tbc Public Worts DcpartmeDt
before atarting 'WOrt.
_4. ~ I L....G(> IF
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RFrFl1"I" NO.
0.
PERMIT APPUCA110N PEE $210.00
PLAN OIECK DEPOSIT SSOO.OO
stJRIITY FOR FAInIFUL PERFORMANCE (100% OF ENG. FSr.)
CASH DEPOSIT (4% OF SUREI'Y, SSOO MIN)
PLAN CHECK &. INSPECI10Nfu (FIRSI' $().$30,OOO 14%;
Next $30,000-$80,000 10%; Amount r ~$8O' 0 rr miD)
APPROVED FOR ISSUANCE v _f.L
for City . eer
h:PW PERMIT/Rev.4/94 (5Ce other side)
USA phone (800) 642-2444 TICKET NO.
ex.
"* "*
CITY OF CAMPBELL - Public Works, l'I\ay 1995
LANE CLOSURE CHART
-
MAIN STREET: Hamilton LOCATION: elo Bascom
DIRECTION: EB STATIONS:
6)
MAIN STREET: Hamilton LOCATION; elo Bascom
DIRECTION: WB STATIONS:
LANE REQUIREMENTS AND HOURS OF WORK
MID NOON
NITEAM AM AM PM PM PM
Beoin Hour 1 2 1 2 3 4 5 6 7 8 9 1 0 1 1 1 2 1 2 3 4 5 6 7 8 9 1 0 1 1
Mondays - Thursdays ~\\\\\ii\\ \\\\~\\!~ \\:\\\\\\\\\\\\\\1: :::!:;:;:::::
.............
:.:.:.;.:.;.;.;.;.;.:.: Illt
Fridays and days before ~:::::::::::: mt;~~1@;~;~$ ............'
Desionated Leoal Holidavs :~1~~\~;~;1~ \~t\t~~ r\?~~jjt~~~. Il~lll~l~i
Saturdays ~ ;\:\\\\\\::\\\\~\\\\\\\\\ ;:::i:;:f.f.:
.:.:.;.:.:.;.
......'...... :::~:::~:::
;:;:;:::::::; ,:,:,;,:,;,:,:,:,:"';'" .:.:.:.;.;.:-
Sundays and Designated
Leoal Holidavs
LANE REQUIREMENTS AND HOURS OF WORK
MID
NITEAM AM
Be in Hour 12 1 2 3 4 5 6 7 8 9
Mondays - Thursdays
At least one lane open in direction
of travel
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At least two adjacent lanes open
in direction of travel
All lanes open
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At least one lane open in direction
of travel
At least two adjacent lanes open
in direction of travel
All lanes open
e
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PM
8 9 1011
REMARKS:
1. For mid-blocks only.
2. Based on latest traffic counts.
3. Based on max. service flow 1.200 vphpl
with sufficient merging taper.
REMARKS:
1. For mid-blocks only.
2. Based on latest traffic counts.
3. Based on max. service flow 1,200 vphpl
with sufficient merging taper.
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