96-145
3-28-1996 8:36AM
FROM CAMPBELL PUBLIC WKS 408 3760958
P.2
ENCROACllMENf..d I c: Pam;l No. ~~ii..
(for ~or~& within !he Ii , '.I-If. Pile -
pub'.. "ghl-o(....,.) ~ " .,~ ,Ii';
Issued 4)5 A Ca .... 8 1.996,^pplication Date 3 - 2q - 9 c..
Permit c::xpim in 12 m '; ....,. . . ' Application expil'e$ in 6 mos.
'"';"';/!/"\i (
APPLICA nON - Application is hereby made for a Public Works Permit in aocor~;,ylth Campbell Municipal Code, Seetioo 11.04.
expires in 6 months if rbe permit is not issued Application Fcc is non-refundable).
CJTY OF CAMPBELL
DEPT. OP PUBLIC WORKS
70 Nonb First St.
Campbell. CA 95008
(408) 866-2150
Fax (408) 376-0958
(Application
A. Work addreu or tract #
Utility trench location
.5'35 lI~mIL1bAJ AvE. T CAIllPE3cL~
AS /JJl:JICA TEL:::, oJJ S KETci-l.
:LA)Srnll lJ 1(.;, f'A{') / l17g ro t:.'""JRVE JJ[Uj Cu.s7?Jmht"'"
,
(~D# I/Go4b4-z ')
B. Nature of work I{)
C. Atrach four (4) copies of engineered plans showing the location and extent of the worle, and four (4) copies of the preliminary Engineer's
Estimate of work. The plans shall show the relation of the proposed worle to existing surface and underground impl'OYemenlS. When approved by
the City Engineer. said plans become a part of this permit.
D. All worle shall conform to the: City of Campbell Standard SpeciflCations 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 shUl-down aradJor forfeiture of Faithful Performance Sureties and cash c!epo$its. (See General Pcnnjt Conditions 1 and 2.)
B. THE CONTRACTOR MUST HA VB THIS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBLIC WORKS
DEPARlMENT AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 2A HOURS
BEPORE RESTARTING ANY WORK.
Name of Applic.anrJPennittce g,..,g KEmP A G,. .f ~. Telephone 2QQ-J05B
Address ~ S:r6CJ<IbAJ AvE.. ~A.l JOSE
Is this worle being done by the property owner at their own _idl..? ~ Yes No
,gU!./AJc~
The ApplicantIPermiace hereby agrees by affixing their signature: to this permit to hold !he City of Campbell, its officers, agentS and employees free,
safe and harmless from any claim or demand for damages resulting froni the work covered by this pcnnil.
The Applican1lPermittee hereby acknowledges thai they have read and understand both the frOnt and baclc of this permit, and they will inform their
COntraClOr(s) of the information:
&hKanp(PQjEJ
(ApplicantIPcnnittce)
Z:!,;;:'p
3/Z9/th
I>.ne
-
I
CU:: /;;/1 LC/.' I
- I
&t:t:MIa aft (S) aapu. ~ a dl'aviDI ~ _ ~.., ........h rt_. _ ~ ~'
~ dnviD9 IIIIa11 __ _ nlat:t. . _ _ . I .d ~ ~-=.-t.. _~ ... -...0 _--A
.......... ,~. ... apA..... .., _ ~ ~r I',..u __ "a a paft . au ,..-.tt.
D. 'IblI ~ CDad1u.. ~ all ..uta .. u..e.I _ _ _.. u. dda. .. hi ~ .. .
tIWI pead~ .. 1J..fted ba1oIr. hilan to Mtde .., tMM ...au.. ... ~ ~ ~~ .
Sa ,-~...... WII4/- r.faibln of hitllflll ~...- ~... __ ~ta. (..
---.J. CDad1u.. 1 ... I). . B
s. All ~ ~__ Ill" .11'" tIt.1a ..'._f~.. !Ida'" 18 _ --~ ~ ~.. .
:-..: "'"~o;, &; ;:~ 7'0.</ 1/ U L ,-,' /, \..xr.J j, i 2"l'1 - 1 0'&1 I
Ia tIWI WDl'k beblg __ bf tM pr:opuq .... a& t:Miz' _ ~.'-I~j/Jifl A:t- ___ ~ t:.QfY\p
ca.pleU lIIId at:Qala ~. n .,MINt:t. lIIId CD.A;..~ DatI ,..~ flIIaa.
',;~,1
~'... q(P-IYs
-(~ .....:... ~- q -;). 9
pIIaIJ&:J ~ -'lJ .HIIC. ..,- , - 0
In II~ ,~t--1~ ~~ 3- / / - q (p
'JI8ai~ --.na ia U... ~"'t-.1l_ ~ ia'",
, ,
~~?Dd._u~.. 111......,....... allllWo.~~t~.~~, wltIl,. ~ _T U
L. -..1_ , r.-e.. u....._U_f- .....,... .. . _ 66 .. INa
~ g &. 1IDn ~ _ taac I '5.36/j';'M iL ro"u A"tlE... 0/1/.-1"t//3E L.. L
-<t '~
~ ~ aullt:r tnMIl 11 - '.. 1/ S / tJ /) / C ~ r e 1) (),I.../ .:5 /::.' Sf.-: C.,L./ \
, ;12 ~!O II / < -r'/l I' I / ',/ 1'--" 1 _.,./"'.). .-,;!' /'.:' /..:, ,)
; Z L "CIIZ'a of ~ "-I CO' i 11....... '- . I ; ..... ,. / . '::'.'/ C ;.... '_.' j
~
;; 1;; C.
Clft ,. --"
~. ,. IIr8LIC _
" IMdIl .... ..
,.". - .11. ca .....
(fOl) ....USO -
'.0
en
en
..--.
a:-
~
(",'1'.
r.::i;
~$?
...
Be Appl~~ ......, -.n- .., aft1xiD9 t:Miz' ~. to ala ...~ to IIDld _ Cl_ .
ca~l1, ita otr1aen, ..... lIIId -.lop. fne, ~. lIIId "'_1... CIa .., alaia _..... ..
....,.. nea1Uzat CIa Uaa WDl'k oannd .., t:Ia1II peadt:. ,
'IDe Appl1caR1hn1~ benbr 8Clbavl...... t:ba~ t:Mf .... ned lIIId -- r.taDlIlIDtIa t:ba ez.t ...
back oft:la1ll ptmIi~, lIIId t:ba~ tiler rill ~om tIIeU UDUMtu(.) of _ h1r -u.a.
~...,
, Appllc:un: CPua1ttee) ~ai9D
Date
~I ALL tIDRK SIIAL". ClDIII'UMB WI'1'B 'DIE AftACBED. AJIIIIDVED ".... AD AU. AJ'PLYt!Il1lY~ CIDRr.L
ftAIfDUtD DlAllDlGI AD =-~naa.
'. caftIIICIaa ..., aft 'lWD -..rr an UJ_.._ 1I.aIIa.. h:." -..r .. .. _ ....
DUBCtaa .. 'IU U'ft U IAn no laD ..-aa .ft'AIlftIiII -.L ~ ~. ~ ,_ .VWII Ir
.. AD__ nsua --......
.'.... .
IID'ftC& ..., . G9III 'lD IDBLIC ... U rAft It __ ..... .~..., .... .
. .,," ~:.. , ~::'.... ,,..--..-........ "","" ..... .
peTAL PIlaVrnmm ,. ..~, . .
_1.
ftnft 8baU ~ ... opeD ~ t= 1IDlIeqnaIId~. ...4... GIIt:a .., lie alllll"
~ 4'" ,"'-1_ _ -.1on~1aa bolee. 8IIaIa CIIIt:a ~ .. _t'hmlh, aD.. ~_...... hlr ~
b~ Brft!tP 'bI ~t....
Pavaeac -7 be c:ac t= ~ ~ lIIId __ be ~... 1a ........ 1d.t:Ia
Uae UU1i~ 'I'nDab ~ ftaIIdu'4 ~.
1IDft to be Rabd by a lie." ell I.ulI ........._ -- QTU' ~... __ (I) GIIp1IIe of _
~ .....u ~ to Uaa JiaIa11a IIDft ~ baton ~ -.L
!'JIa boan of Wdt an Uaited to ~ _ --.n of ,., .... ... J-. .... file.., ~
aneaUJlt . tnff1c ~. pAl JJ-4M/L r(j-v /Wf:j.
_2.
-J'
-L..
-"
ISIKl'Z' U'lP't!Il..-- ra
--- -
..... I .3J5J 00
.....- .
(lOOt ,. _. ...) .
(f' ,.~. .... IIDIJ .
ClO-flOO,OOO 181, . ;)/O.<J<l
..... n, S100 II1II)
~
4- ~9~
Dace
... -...... _..
a
:--'
11M c:ImICZ ..,..... rr
8IIIIBft POll P&rl'IIrUI. JII!UI. 4uloUICZ
C&SII ~D'
PI.AII aIBCIt . D8J.~~,*
S100,OOO - "00,0 0 , ,
ARIlwnD roa IUUUCI:
f: PIf I'ERIIn'
Revised lOIn
,
:;
=
C
L!
I
I
I
I
I
I
I
-
-
I
I
I
I
I
I
I
I
I
~
.
j
I
..,
tIC
n
...
It
tIC
I
I
I
I
I
I
I
I
-
.
, -
. ~ ... - .-
966ll Z tlti~J
APPROVED FOF~ C()NSTRLJCTION.
~ity F~)f cct,n:Pbel!96_/q'5
Public Works errru !'JO,,_,_._..~___
I~ :a J\ ~ ;;Ii J ~ ~
C Or-Hoctor must hove these pI"""
')r7 -;-he iob c;it~? dlJr;n~~ ~(1P.~".J("ti",
. eo C C C. C 0 COO 00 0 Q () ~ J J ') J"), J~J~:) J e 0
.. 'f: 'C OCC G 8'000000 J JJ.JJ ,...O....}.J )e )
eac-..,:c ctco ~oo 0 0 0 aJ .)~J'J...J. .3_) ) e 0
.....,A:CCCCOOQOOOOOJ'J,)) ..JiJ-,) ).
. "CJI(:.,C.C C C'O 0 0.0000 ::J ~)'ta) ). ()f~) ) e ()
. "'_J{=~,c C"() 0 0 ~ 0 0 0 C)~) )J~) J' _Of::) ) ).
.erc:~..-c~.c.~c'cnCO~OOQ..J )1_) ) ).'.C)):Jeo
. .' C C (:' c c ~-G (~ eGO 0 :J.J .J ~ -). : t )(JlJQ ? ~ .
"',-- .""_.~-~,.,., '~"-."~> -'..~ .....
LB
LOC. WIRE
CPA NO ~41.) -.20 (I"ro- I:l )
}~/(AI'''€#Q RISER ~
BONDED TO: IYI
~MAIN ~
'ilALVE
CATHODIC PROTECTION:
INSTALL CATHODIC PROTECTION:
ANODE: NONE MAG 0
YES 0 NO ~
ZINC 0 SIZE
ANODE 0
AMP FITTINGS INSTALLED AT: 0 NONE
o RISER
OTEE
o OTHER (MUST SHOW ON SKETCH)
;::;,e.eJ.1~U~ ~-ra
SKETCH
"-
~
:t-~
lQ,
. P. t:.,.A!:!.!' e "'-o,() 0 A 4'
~...,.s 7AUEA../t: H /,L/d.r
3At:Jc;.,;r I ~ 4- , .../ '?
.
· ~J..i~-r 'L ~7' or:h
...:J (~ (..0' -r# $/+' N' C
R/~~
· p., ~ G. 7"0 Co ,
oFF- .sl rG E LEe..
-- .
I~Eut!.H nUt::- e..
734(!ILF/~/.u~
· 02-""T~ ,LfA.u,~oL./..
p,eafl D ;-Iou.s~L
A I Pt!oP'o ~
If,$cit
.II- _ __
-
v:t: ~_~; r.:f.1 ~~,!S{~.t~.rED
Ff~ I:; ,~ ~ ~: C.:.\8
~_.. "..~.:.~~,.",_-J.:3 :-fV
~5'
~~~
.
f:! .__.<- 7- ~
L----- ',. .'---' ..,.~
P04C 70 0
~IEP'-4Ce:IJ
I!M P'~e.
at<l.s t/~.e tt J.It:&.sE.Ln.l~
LC1I!.: LJ Dt=TAtL. ~ 4-
I-'
CITY OF CAMPBELL
5?5' ~. (f<r",
Gtfr f'H d^- Y>'U(;cL. 11\), ~'Ijrv
PROJECT NO. q6--- /
REPORT NO:
DATE: '.5/; r
WEATHER: r:AI R.
INSPECTOR: K. ~G:.-5-rrA.LL
FIELD ENGINEER'S DAILY REPORT
-< ^-' 0 j} H", / f) le ~c.I 01.- .
CONTRACTOR: "'-'>r~' (j I raN: CJ .
d.'5~-&
ITEM DESCRIPTION
5 ~
i.>~
CC:
PAGE: I
OF I