91-109
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ern or CUIPBZLL
DZP'l' . or PUBLIC NORD
70 Hortb rir8t st.
~.~ll. C& '500.
(401) ..6-2150
9/-/0 C/
nfCROACHImHT PmniIT'I'
(far work1nq in tbe
public ri~kaY)
lawed ~ 'Z /
Penlit in 12 _.
Penlit 110.
X-Raf. fil.
Appl1caUon Dat. I/..? 3/9)
App1icaUon expu.. 111 6 _a.
APPLICATIOIf - Appl1caticm ia baraby _d. far a Public Wora Parait in aeeordulea with ea.pball
Hwlic::ipal COde, S~ion 11.04. (Application exp1re8 111 6 ~ U ~t not pul.lad)
A. Work ad.dr8aa or Uilet t Winchester &. Camden, Campbell S.D. 1I0541E80206
V1:ili~ 1:nncb location Install utilities as indicated on the attached sketch
B. ..tar. of works
C. Attacb five (!l) copi_ of a drawinCJ abovinCJ the location. extant and eU..n.iema of the work
'1'be drawinq ahall abov the nlation of the prapaaad work to axi.tinq aurt.ce and lUId.r;raund
1IIprav-.nta. When .pproved by the City EnCJineer, Aid dr.winCJ becaMa a part of tb.ia pu1Iit.
D. '1'be Ganaral Conditione far all peralta an li.tad on the ravana aide. Spacial Pravtaiana for
thia pea,1t an Uatad belovo Failura to abide by th... conditiona and prov18iana MY n.ult
in job uut-down and/or forteiture of Faithful Performance Banda and caab depoaita. (8_
Ganaral Conditiema 1 and 2).
z.
All .pplicaUon f.. ..t acca.pany thi. application.
Pacific Gas and Electric
'1'b18 18 ftOn-ntunclabl..
'l'alapbon.: 72,5.-2.186
-'-':CElva:D
N... of Applicant
Add~a 10900 North Blaney Avenue. Cupertino, CA 95014
I. thia work be1nCJ done by the property owner at thair own ~id8nca?
----:1-
I (i ~ I ()" ~j Q (1)
_ftOul-\ii t..,l " ..,:)
CoIIpl.ta and .ttacb WorJcan' CoIIpena.tion and COntractor Inforutlon foru.
Public Works/Engineering
'1'b. Applicant/Perm1ttH banby aqra_ by affixinq their ailJllature to thiaopenit to bold the City
of
Campbell. ita oftic.re, aCJante and -.play.ea tree, .at. and barala.a f~ any cla1a or d..and far
dauCJ" ruult1nCJ fZ'Oll the work cavancl by thl. penit.
'1'b. Appii that thay have nad and lUIderetand })atb the front and
l)acJt ot thair contractor(.) of tha intarutian.
A
Data
L S. BLODGETT
1-18-91
HO'1'ZS: ALL waB 8BALL COIfPOlUI WI'1'B 'l'BZ A'l'TACBZD, APPIWVZD PLAIIS AlII) ALL APPLICABLE CAllPULI.
STANDARD DRAWIHGS AND COIfDrrIOXS.
'l'BZ ~ MUST RAft '1'Bl8 PZRlII'l' AND APPlluVZD PLAIIS AND IIU8'l' IID"l' WI'1'B 'l'D P... DrSPZC'1'OJt ON
'1'D SID Nt LJ:Aft 'l'WO laY. IID'OD SDRfIIIG WOB.
IfO'l'ICZ IIDST a GIVZIf '1'0 PUBLIC WORD Nt LIWJ'1' 24 BODRS uroa RB8DIl'1'IlIG AllY WORlt.
SP!:t!YAL PROV!:SYD1ItI
_1.
,treat 8ha11 not be open cat for ~ inatallaUona. llint.. cuta MY be alloved
for ccmnac:tiona or exploration bol_. Sucb cute IBUft ba .a.cifical1v aDDravad bv t:he
Ift~.ct:cr .
P.vaant MY be cat for undarqrauncl inatall.Uona and -.at be natond ill .ccordanca with
the ot111ty 'l'rencb RaatoraUon Standard Drawinq.
Work to be a'taJced by . lican.ad Land sun.yor or Civil l:ncJinaer and two (2) capi.. of the
cut abaete aant to the Pu})l1c WorJe Daptartaant betgn atarti.n9 _n.
'1'b. boura of work an liaitad to aut:aida the boura of 7-9 .... and 3-. p... for any _rJe
.ff.c:tinrJ . traffic lane. . I. , .
~/h1.t1/Nn1I;U S41='E 77.,./0 wA/~ .t>c/)F;S-neIAAlj l/Et-I,cuL~A!.. -r,t(..4'&rlc-' ~r ALL 7)/I'?€...S
4) Loc.A-Tl'O;J-QS ~ Do /Jcy,pUJLtE ~UY//)()LES61€. CAt3LE:..S.5o 7H7?/77-IEY
od5,IC.-l<...c. T -n-IfE ~N i> / LA;/) )(4 h1 ..cJ /
c.) L.ocATl'oJ"4 - Pi\oVt"Dt:=:. fo;( A- ~/fI//~,N"/ o~ 4 Ct..c4tVtN~ {O(L ~'.AN-5.
_2.
_3.
_4.
...- !l.
'.-1 ,
S'l'1NDARD
HeElPI' NO.
AMOmft'
PZRKl'1' APPLICATION rzz ($!l0.00)
PI.uf alZa DBPOSIT
BOND l"OR rAI'l'BI'OI. PZRI'OJIIfAIrCZ
CASH DEPOSIT (S200.00)
PI.uf alZa , DrSPECTIOX rzz
'100,000 - '500,000 ", '50
APPROVZD !'OR ISSUANCZ
'100.00
$500.00
(loot OF IRe. 1ST.)
(4' OF BORD, $500 KII)
$ /OD.OD
$
S
S
Q
~
$ /00 .00
-Q
p~1
(S!Z amm SItE)