ENC2000-00184
CITY OF CA.\fPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working within the
public right-of-way
Issued
Permit expires in
P-:rmit No~tJ'C. 2l11JO- 00 J S t}
.Ref. file
~ IOJ5J00
Application Date 1 ~ ! G. - 00
Application expires in 6 months
: 1 Cf
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A?PUCA TION - Application is herdly made (or a Public Worn Permit in =rd.ance with Campbell Municipal Code. Section ll.(}.l. (Application apircs in 6 molllh.s
if tbo: permit is DO( is.sued. Application Fo:: is non-refundable.)
A. Wor!: add~s nr!Tact I I F D Y Cl ,"{ "I _
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Util ily tmlCh locaLion
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B. N= of won:
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C. AtI3Ch foor (4) copics of an c:ngino::red plans showing the location and extcnL of the won:, and (our (4) copic:s of the preliminary Engineer's EstimaLc o( won:. The
pl:u:s shall show the relation o( the proposed won: to existing surf""" and underground improvements. When approved by the Cicy Engineer, said plan becomes a pan o(
r.h is permit.
D. All wor!: shall alnform to the Cicy o( Campbell Standard Spa:iticatior..s and Dcuils (or Public Worl:s ConstrUction; the General Permit Conditions listo:l on the revme
side: and the Special Provisions (or this permit. listo:l below. Failure to abide by these conditions and provisions may result in job shut~own UldJor (orfeiwre o( Faithful
Pcrfornuocc Surctic:s and cash deposits. (So:: General Permit Conditions 1 and 2.)
E. THE CONTRACTOR MUST HAVE THIS PER.\lIT AND APPROVED Pl.ANS AT THE SITE AND MUST I'OTIFY THE PUBLIC WOR.I(S DEPARTMENT AT
l...EA.ST TWO DA YS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBLIC WORKS AT l.EAST 24 HOURS BEFORE RESTARTING ANY WORK.
Name o( Applicant Pacific Gas & Electric Comoanv
(print rume)
Ad~s10900 N. Blanev. Cupertino 95014
Telephone 408 725-) 70S
24 HOUR EMERGENCY TELEPHONE NO. {- ~ DC> - ;:;6 E -':..000
The Applic:antIPermiuo: hC'l'cby agrees by affuing their signawre to this permil to hold the Cicy o( Campbell. its ameen. agents and employees (ro::, safe and harmJt.>s (rom
any cWm or demand (or damagcs resulting (rom the wor!: covered by this permit. . I:) ~
The Applic:wlPermiw:c herdly ac!:nowledgcs that they luve read and undcrsWld Ixxh lhe (ront and bac!: of lhis permil. and they will inform their ~sc E'. VE 0
infornution.
. OCT 0 5 2000
P W9IIiU
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Is this wort being done by the property owner at their own residence?
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SPECIAl. PROVISIONS. . . .
_1. Str=t shall not be open C1lt (or underground iiutall.ltions.Muiimum C1lts m2v'bC.:ilJ~~ (or'comeaions or exploration holes.
aoproved bv lhe ll1S'QCCtor prior to cultin\? :..:.,.,::>,,::::0:,.::.:. ..... ". ... ..... . ... ...... .
_2. Pavement. =y be cut for underground insullations arid.must be rcstored in aa.ordarcc withtheUtilicy Trench Rcstor:aUon Sundard D=ils. Method' A. Baci:fiI(
unlcssothcrwiseapproved by' [nspcaor:-:':,.:', :., .' ..... . .. ',.. . . .
....::..).... WOr!: IG be staiccd by a li=ed Land Swv~yor' or LlVil Engineer and two (2) copi.c:s of the cut shccu Sent to the Public Works D:p= be(ore st3rtmg work.
4. Per Scaioo 421So(.!he Govemmau Code this pcrinit is not valid for C1ci~o.s uritiJ Und<:rvound Scrvic::Alen (USA) has been notified and the inquiry
~S.' ~.r~nnumba- has bcCn~ed~~n~:Y;^ Pbon.. 1~~.2'~-??OO"'."....~SATlC~.~o.' . . . .... .
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SEE PUBLIC WORKS FEE SCHEDULE FOR 'CURRENr FEES:':',':"
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. PLAN CHECK DEPOSIT . .
SECURITY FOR FAITHFUL PERFOR.\{ANCElLABOR&MATERlALS
CONSTRUCTION C~H DEPOSIT '.' . . ...
Pl.AN CHECK &. INSPECTION FEE ,. .....
APPROVED FOR ISSUANCE
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