91-135
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ern or CAIIJ>UU,
DZP'l'. or POBLIC 1fORU
70 Noreb r!zwt st.
ca.pbell, CA '5001
(401) 116-2150
qt-/~Fj
PeJ:1ait No.
~c:ROA~ PERMYT
(for worJc1nq in the
public ri9ilt_f_y) X-Ref. file
la_eel .I//?3/tfj Appl1caUon Data 3/29/91
PeDL1t upu.. in 12 _. AppllcaUon upiru in 6 lIOa.
APPLICA'1'%OH - Application b bereby _de for a Public Worb Penlit in aClClOrdance with c:a.pbell
Municipal COde, Section 11.04. (Appl1caUon upu.. in 6 1IOn~ if. peJ:1ait not pulleel)
A. Work addr8aa or tract:, 2365 Wi nches ter Blvd., Camp be 11
Utility trencb locaUon install util Hies indicated
II. lI.tun of varks Gas Service, Remove Meters per attached sketch SD#G00698
C. Attach five (5) copi_ of a drawinq abovinq the location, extent and diaeuiOM of the work
Tbe drawinq aball ahov the nlaUon of the propoaeel work to exiatinq .urface and uncserqround
iaprov-.sta. When appnwecl by the City Enqineer, ..ieS dr.winq becmIea a part of tbb permit.
D. Tbe General Conditiou for all permita an liateel on the reverae .ide. Special Pravbiona tor
thia peJ:llit an liateel belovo r.ilure to abieSe by the.e concUtiou and proviaiona MY n.ult
in job ahut-down and/or forfeitun of raithful Performance BoncS8 and ca8h eSepodta. (S_
General COfteSiUou 1 and 2).
Z. An .pplication f_ auat ac:eaJIP&ftY this application.
N... of Applicant Pacific Gas i& Electric
AcSeS~s 10900 N. Blaney, Cupertino
Is thia work beinq done by the property owner at their own ~icSenca? ---y- Lno
Tbi. is non-nfundable.
'1'elepbones
725-2229
COIIplete aneS attach Morken' CGapenII.tion and Contractor Infor.ation foalS.
Tbe Applicant/Pemitt_ bereby .qreu by affixinq thair d9ftatun to this-per1lit to bold the City
of
campbell, i~ officera, aqenta and -.ployee. free, ..fe and barale.. f~ any claia or deaand for
claJIaq.. raaultinq froa the work covered by this permit.
Tbe Appiicant/Pemi ttee bereby acltnov~. tLat th
back of thia perait, and that they w thei
A~~ Michael S. Blodgett
Applicant (Penaitt_) print/aiqn
rataneS both the front and
for.ation.
3/29/91
---
NO'l'ZS: ALL WORK SIIALL CDHPOJIII WI'l'B TIlE ATTACHED, APPROVZD PLAlfS AlII) ALL APPLICABLE ~JEl.L .
STANDARD DRA1fI1IGS AND CONDrrIOD. R I {; I I V ID
TIlE COIfTRAcroR MUST HAft 'l'II18 PDIIIT AND APftUVZD PLAIIS AlII) IIOS'1' IID'r 1Il'l'JI TIll: P.W. ~~~l.c
TIll: SITZ H LDI'l' '1'10 laY. IID'OD SDRrDIG tIOU. At"K U 1 l~~
HO'l'ICE MUST .. arva '1'0 PUBt.IC WORD H LZU'l' 24 HOURS uraa RB8'l'AIl'nJIQ AllY 1IOU. .
"ublic Works/Engineering
SPECYAL PROVl:SYOHS
t...-- 1.
Sb:ee~ aball not be 0I*l ~ for uncSerqrouDd inatallaUou. lI1niaua cuts _y be alloveel
for connec:t:iOM or eDloraUon bol... SUCh cuts ~c1fteallv II.DDrmrtld bv ~.
tnmt.et:ar. -
pavaent _y be cat for anderqrouncS inatall.tiou UIcl -.at be natorecl ill accordanc:e with
the Utility 'l'nncb Raatoration Stanc1arcS Drawinq.
WOrk to be .taJtecl by . licen.eel LaneS surveyor or Civil Enqineer UIcl two (2) copi_ of the
cut abaets .ent to the Public Work DepurtJlen~ bef~n ~ work.
Tbe boura of work an l1a1tecl to ouuieSe the boura of 7-' .... and 3-. p... for any work
affec:tinrJ . traffic lana.
_2.
_3.
_4.
-,.
'.-1 ,
S'!'MIDAJU)
AMDmft'
Jm~rptt MO..
PZIUa'1' APPLICA'l'ION I'D
PLAN CBZCJt DUOSIT
BOND lOR FArl'BI'Cl. PZRI'OJlIfAIICI
$100.00
$!IOO.OO
(100' or ERG. 1ST.)
(4' or BORD, $500 KIN)
$ \ C!;:O. 0:0
S
.
$
. l cs.c.. <.c;.
Cf
G='
(SSO.OO)
CASH DEPOSIT
($200.00)
PLAN c::B!:CJt , INSPECTION PEl!:
$100,000 - $500,000 ", 00,000
APPROVZD FOR ISSUANCE
4- -~,~ l
Date
APPROVE
City of Campbell
......*~ Public Works Permit No. t'?l -/...! <.- /
.J ....
PLAT: 3412-J4 Controctor must ltG'Ie ,helle plan.
on the ;ob ,ite during con<tructlon. /
NEW SAFEWAY STORE #1293 /
#2365 WINCHESTER BLVD.
/ / / / / / / / / / / / / /
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'-\:..l 2- STL. H.P. GRS "RIN I-}-~
t t
/
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CD c
(0
'3' X 3' TRP HOLE IN GRRSS PARK '3' X 3' TRP HOLE IN GRRSS PRRK
STRIP.
STRIP. =<: . INSERT 1-1/4- STL. SERVICE WITH
. RBRNOON GRS SERVICE RT "RIN. t- PL. ACROSS STREET.
. RE"OVE OLD VALVE LOCRTED BEHIND C:::l . INSTRLL NEW 1- PL. VALVE IN
EXISTING R.C. CURB. . FRA"E I COVER IN SIDEWALK RRER.
a.. . REPLACE 1 FLAG Of' CONC. SWLK.
h... . (3' 2- X 2' 3- FLAGI
::I: . REMOVE OLD VALVE LOCATED BEHIND
-..j EXISTING A. C. CURB.
.
RICEIVID ~ ..J ~
~ Cl:::
~ CJ)
APR 0 1 1991 ~ (::J
(\J
Public Workt/Engineering - ~8'
- 1--80'
~PPROVED BV
REV, DATE DESCRIPTION GM IWN. CHKD, ~UPV . APVO.
IN PERMIT SKETCH
sUPV. MSB LIST
DSGN. MAH UPSDS
OWN. MAH #2365 WINCHESTER BLVD. UPSD BY
CHKD. GER SAFEWAY STORE REMODEL HEH NO.1 OF lSHEETS
O. K. CAMPBELL REV.
DATE I SCALE. PACIFIC GAS AND ELECTRIC COMPANY 41G00698
3/'91 1"=30' SAN FRANC I SCO. CALIFORNIA
o FOR CONSTRUCTION
363