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CITY 01' ~ I; C
DZP'1'. 01' I'OBLIC.Wo'IltS
70 North Pint St::r""R
CUpbUl. CA '50~r
(401) 11__2150
hmit No. 9/-/3:>:'"
E I V E J'bCROA~ PERMYT
. .,. tor workinq in tbe
o B 1991 public r1~-of_ay) X-Ref. file
I Xa8Ued L/j 9' / '/ / Application Date ~ J,? /91
Pu'ait expu.. ill 12 _. Application ~. in " lID..
Pub/if Works/Engineering
APPLICATION - App icaticm 1. berebY _de tor a Public Wora Per1Iit in accordance with ca.pbell
Municipal COde. S~ion 11.04. (Application expirea ill , ~ if pel:ll1t not pulled)
A. Work~. or tract, 548 Hacienda Avenue, Campbell
Ut:llity 1:nncb location
IS. .ature of Wrk: Tnstilll IJtilitif'S ilS inciiriltpci on ilttM:hf'ci skf'tch. SD#G/E 00486
C. Attach five (5) copi_ of a drawinq .bovinq the location, extent and dt..naione of the work
'!'be drawinq aball abov the rel.tion of the propoaed wrk to exiatinq aurf.ce and Wld.rqrounc!
iaprav--.nte. When approved by the City Engin.... aaid dr.winq becoIIe. a part: of t:bia permit.
D. '!'b. General COnc!itiona tor .11 permite are liated on the AVera. aide. Speci.l Prov18iona for
thia penait are liated belovo r.ilure to abide by theae conditiona and proviaiona uy reault
in job abut-down and/or torf.iture of raithful hrfonaance Boncla and cuh depoaite. (S_
General conditione 1 and 2).
B. Aft .pplication f.. _t .CCOIIpUIy tbi. application. '!'bia 18 non-refunda!)l..
N... of Applicant Pacifi c Gas and E1 ectri c Company Telephone: 725-2114
Add~a 10900 N. Blaney Avenue. Cupertino. CA 95014
Ia tbia work beinq clone by the property owner at their own ~idenca? ---:t- _no
COlIplete and attach Workazw' ca.pana.tion ancl COntractor Intor.-tion tOnla.
'l'be Applicant/hnat ttH bereby aqreH by affixinq thair aiqnature to th18. persit to bold the <<:1 ty
of .
ca.pbell. ita otficera, .vente and .-ploy..a tree, aat. and baral.a. t;oa any claia Or d8a&ftd tor
daaag.. reau1t:inq traa the wrk covered by th1a penlit.
acknovledqe. that they bave read and Wld.ratand both the front and
Y 1 inf their contractorta, of the infor.-tion.
4/5/91
A~&U
Date
NOTES: AU.r MOB SIIAlrL CONPOlUI 1fI'1'B 'l'BE A'l"l'AaIED. APPROVED Pl.AIIS AlII) AU.r APPLICABLE CAllPUUr
STANDARD DRAIfIHGS AHD CONDX'n0lf8.
'l'BE CONTRAC'rOJl MUST RAVE TJIU PBRIII'r AND APPIb.IVED Pl.AIIS AlII) IID8'1' IID:'l Wl'l'II 'l'BE '... IJISPZC'1'OR ON
'I'D SI'1'B H I.EU'l' '1'110 DUB DPOIUI: 8'lAIl1'DIG 1IUU.
ROTICB IID8'1' lIB CIVD '1'0 PUBLIC WORD H LU8'1' 24 IIODRI aroa IBIIDIl'lIlIG AllY 1IOB.
sn~A.L PROnSYmnI
_1.
street aba1.l not I:MI open cut: tor undarqrcnmd inat:all.tiona. lliniJlua cute uy be allowed
for connect:iona or exploration bol_. Such cut:a Imat be a..cifieallv almroved bv th.
Inm:t~ar .
.avaent .y be cat for undtU:'lJZ'OUlld inatallat:1ona aDd -.at: be reatored iJI accordanca with
the Utility 'french RHtoration Standard Drawinq.
Work to I:MI at:aked by . licenaed Land surveyor or civil ZDq1naar and t:va (2) copi_ of the
cut: ab_te aent: to the Public Work Dept:art:aant bef~re at:artinq _rk.
'l'be boura of work an H.ited to outeide the boura of 7-9 .... and 3-. p... for any wrk
~~~f~l~U~ 911.A'Ff2\c_ ~ ')F- ltl :3 ~~~
D\tzEC.:t"\L.:;-.L) h-r ~LL '-r\\.4~"1 ~\>J.e- ~~ "'l~
SWf.::.LL- \2:-..~ p~ ~L.."Y~ ~~ ~ )~t?~
\u<l..LLJ~\.L.J~ ~--nu-:::)/. )t<::.. ~~ eb~~
~.
_3.
~4.
V;.
'.-1 ,
S'l'1NDUD
D~YPl' lID.
PLAIf CRECK , IJISPECTION PD
$100.000 - $500.000 ,t, 00.000
APPROVZD !'OR ISSUANCE
AMDDW'P
. \ ~e>.e:.<J
.
. -
$ ~
. \ t:s:O..oc. 9
4--~-~ {
PDMI'1' APPLICATION PD
PLAIf CRECK DUOSI'1'
BOND !'OR rArl'BPUIr PERI'OJIMAIICE
$100.00
$500.00
(100' or IKC. 1ST.)
(4' 01' BOND. $500 KIM)
C:f
($50.00)
CA8B DUOSI'1'
($200.00)
Date