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c:ITY OF CAK.P!lELL
DEI'T. OF PDBLIC WOJUtS
70 Horth First St.
~~bell, CA "008
(408) 1"-21'0
!NC'ROA~ P!:RMIT
(tor vork1nq in the
public d_t-ot_aYJ X-~ .. fUe
laneel ;:L/;:J~/ 91 ._..caUon Da~e #..:ls;/5'/
'--i~ upiru 111 12 _. ApplicaUOII expires 111 6 ...
APPLICA"l'ION - Appl1caUon ia baraby ude for a I'Wllic Wora '--it in aCCOrdance v1t1l CGIpbe1l
llunicipal Code, hct.ion U.N. (ApplicaUon expires in 6 Ilontba if pemit DOt P'llleel)
Pemit Ho.
9/-/ 32
.
&. Work addrau or b'ac:t' 38" IV G.6iVia.At- 4V~
VUl1q. tnncb locaUon
a. .atun of workr 5/LG' ;::/ /]~(/ /2 7I.ry
. / f
c. Attacb fbe (I) copi.. of a dnv1ng uowinv tile locaUon, atent and cUaensicma of tile work
'l'be dnvinv aball uow tile nlaUon of tile propo.ed work = ai.ting aurtaca and andervround
iaprovaenu. When .PPZ"CWed by tile C1q. Bnllineer, ..id clr.viftv becmIu . part ot ~ pem1t.
D. 'l'be General COndJ,Ucma for all pemJ.u an lia~ed on tile nveru aide. Special PrDviaiona for
tIlia pemit an lined below. '.llure = abide by tIle.e concl1Uons and Proviaicma uy neult
122 jOb uut-dovn and/or forteitun ot 'aithful Perfomance Ionda and CUb depoaiu. (S..
General ConIUUou 1 Ud 2).
E. An .pplicaU. f.. ~ UI:: 4l&IIY tbia .pplicaUon. !'Ilia ia DOn-ntundable.
.... ot App11cant j(.;.f3VIA..J -:Nv/?.S, \"'b~ 'I'alapbanet ~op,:.~~.~. '/y;N:
Addru. ~."'?~ " IV ?c7V:;'1?..A t- ;q vc
la tbi. work beinv done by tile properqr owner .t tIle1r own ru1denc:a? .::::::;:..
_DO
CoIIplet. and atuCb WorUn' CoIIpenaaU. and COntra=or Infoma~1. tozu.
'l'b. Applican~/Puaitt:ee benby .9ftU by .ftLxinv tIle1r ailJDature = tIli. -pemit = bold tile City
ot
Campbell, it.. ottican. .llenu and -.ploy... tna, a.ta end baral... fJ:'tlla any claill or daand tor
.....9.. n.w tinv troll tile work c::averwS by tIlia puai~.
'l'ba Appl1cant/Pemi~e bereby acknowledqe. that they b.ve read and underaund both tile front and
back of thia pemit, and tbat they w111 in.~ tom~~ 1r ntra=orc.) of the intoma~OD.
A~J;U ~t;-Vnv 711v/,?~,...I ~ ~ l!: -22--<;' /
Applicant (Pera1U"J . pr1nt/a1lJD Dau
NOTES: ALL WOIUt 8BALL CONPOJtJI1II'1'B 'l'JIZ U'1'ACBED, APPROVED PLUS UD ALL APPLICULI C&IIPULL
8'l'ANIWtD DltAWDlC:S AIID COND1'1'1CII8.
'l'JIZ COIl'1'RAC'l'OR 1ID8'l' RAft 2IIU PBRIa'r AIID APPJu"Yc.&I Pr.&III AIID IIDS'1' IID'1' Wl'l'II '1'111 .... DlSPJ:CTOIt CIIf
'l'JIZ SI'1'Z Nt LEU'1' ftO laYS Bl'O.D SDII:rDG ~.
1IO'1'IC:Z lIDS': D GnD '1'0 PDBLIC WDUI Nt LZU'l' 24 JIl:IOItS urou IIZft&IrnJrG AllY 1IaU.
SPEeIAL PROVYSYORII
_1.
8treet aball DR be open GIlt for undar;round 1n81:allaUcma. lUniaua cut.a uy be allowed
tor conne=ions or uplomUon bol... lucb cut.a lII1.t be .!Hlcifical1v almrmr.d bv the
In."'~er .
Pav_ent uy be GIlt for UdU'lJZ'OUDd 1nfta1latioD8 and .at: be na=nd 122 acc:ordanoa witll
tIla Vt1l1q. 'l'rancb "'=ration St.andard orawiftv.
Work to be ataked by . lioenaed Land Sun.yor or C1v11 Znq1neer and be (2) oopi_ ot tile
cut aheeu HIlt to tile Public Work Daptan:.ent beton ~ work.
'l'b. boure ot work an l1ai~ = outaide tile bDUrII ot 7-' .... Ud 3-1 p... for allY WOJ:Jt
attectin; a tzaff1c laDe.
_2.
_3.
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BeETPI' 110.
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PZRKIT APPLICA'l'ICIIf n:z
PUJf CB!c:Jt DUOS%'!'
(150.00)
Sloo.oo
"00.00
.
.
.
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.
BOND FOR FAITB7tJL PDJ'OJaWrc:z (1001 or BNG. ZIT.)
CASH DEPOS%'!' ('200.00) (<It or IDJI'D, '100 IIIK)
PUJf CBEc:Jt , INSPECTION n:z (10 - Sloo,ooo 101,
1100,000 - 1500,000 '1, I'OO,JOO and ~e 7', 1100 KIN)
APPROVED FOR ISSUANC:Z / PO?~ /C;;~<-f
r-~ c.t.ty arlq1nHr
c-.z C7DIat mE)
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2- S- 6's-.r
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Date
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TO:
City Clerk
Please collect & receipt
for the following monies:
3372
3521
3521
R-1:
($50)
3521
Other Cash Deposit (specify)
($200)
3372
3373
3373
3373
3373
3373
3372
3372
3372
3372
3372
3395
3370
3380
3510
TOTAL
PUBLIC WORKS FILE NO.
9/-/2-L
Other:
:$100)
$500)
(100% of)
(ENGR EST)
(4 % of FPB)
($500 min.)
Cf.'
aC} 2.S-~~-
$
-2 \CJ c.:'5!--
NAME OF APPLICANT
ADDRESS -'~8 C /v.
FOR
CITY CLERK
ONLY
/,{t;UIIV
77~lhf!.>70;'~
C.CA./'/7Z-4L
,4Jl.:
c,,? /"?/'..-3c'2 l-
<::4
(';1'/ i"'r '-;'V';'). Qi-:FiCF'
\..r ~ at.... ;..,.,., \ l." '. J , , .
~:-Z+'1J
RECEIVED BY
DATE
r'",,) ;:'".,
PHONE '7'0'8 3 70 f)~?.c
ZIP '7 .$-0('>8 ~ C ~-' 2fo
(
Department: Public Works
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CITY OF CAMPBELL
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
October 9, 1992
Kevin Thurston
386 N. Central Avenue
Campbell, CA 95008
SUBJECT: EXPIRATION OF ENCROACHMENT PERMIT # 91-122
Dear Mr. Thurston:
On February 26, 1991, an encroachment permit was issued to you
for construction of a new driveway approach and sidewalk for your
residence at 386 N. Central Avenue. A copy of the issued permit
is attached for your reference. Encroachment permits expire 12
months after issuance. Your permit expired on February 26, 1992.
The City will therefore be returning the $200.00 cash deposit
that you had posted in connection with this permit.
Please be advised that if you intend to install these
improvements in the future, you will need to apply for a new
permit at that time.
If you have any questions, please give me a call at 866-2162.
Sincerely,
1tlukJiL rv~
Michelle Quinney
Senior Civil Engineer
Attachment:
Permit #91-122
cc: Hank Imokawa, Public Works Inspector
File 91-122
MQ:mq
REFUNDABLE DEPOSIT
CHECK REQUEST
TO: SANDY TERPKO
ACCOUNTS RECEIVABLE
Please issue check payable to:
Kevin Thurston
Address:
Line 1:
386 N. Central Ave
Line 2:
City :
Campbell
State:CA
Zip: 95008
Description: Ref Deposit/Permit No: 91-122
INTEREST EARNED
Exact Amount Payable:
$200.00
Account Number: 001.00.905.4662
001.05.540.4448
LOCATION:
386 N. Central Avenue
DATE AND NO. OF RECEIPT:
2-26-91 #25855
PURPOSE:
Permit expired - deposit refunded
Requested by: M.Quinney f.I.JJ... Title: Sr.Civil Enqr Date: 10- 8-92
Approved by: J .Bo11ier~A Title: City Enqr Date: ~
1/
Verified by: Title: Date:
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Ma il as is
xx
Mail in attached envelope
Return to:
(Department)
(Name)
Other:
Rev 11/21/91
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