91-156
r
EHCROA~ PIBllUT
(for work ng in the
public rigbt-of-way)
Issued '7( - Z. - Cj 1
Permit expires in " 12
Permit Ro.
9/ - /J"'cO ~
1"
I
IIOS.
X-Ref. file
Application Date ;::J - /6 - '/ /
Application expires in 6 IIOS.
APPLICATION - Application is bereby..de for a Public Worb Perait: in accordance with CUpbell
Municipal COde, section 11.04. (Application expires in 6 IIOnths if permit not pulled)
8 0 B "E .. M.e... c..l ~ ~ LA->-4. E
A.
Work address or tract: .
--
Is this work being done by the property owner at their own residence? ---yes
~no
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B.
utility trench location
S~\-
Nature of work:
t......q.) rI...tI:N e~ -r S
C.
Attacb five (5) copies of . drawinq sbowinq the location, extent end dblendons of the work
The drawing sb.ll sbow the relation of the proposed work to existing surface and underqround
improv_ents. When approved by the City Engineer, s.id drawing beco.es a part of this permit.
D.
'!'be General Conditions for all permits are listed on the reverae side. special Provisions for
this permit are listed below. Failure to abide ~y these conditions and provisions ..y result
in job shut-down and/or forfeiture of Faithful Perforaance Bonde and caab deposit.. (See
General Conditions 1 and 2).
B.
An application
fee .ust .cco.pany this .pplication. '!'bis
Pr\....lc. 'f.... R. .. l- \. ~ \Jc---rL
B~\",- A~ ~tL\ '-l~ LcS
i. non-refundable.
35" /$.. '2. (.. B 3
950 '3 '-
Telephone:
5A-TbS / ~..
NlUIIe of Applicant
Address I Co l..O 0
..
..
>
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>c .c en
II .. ::I
complete and attacb Workers' Compensation and COntract:or Inforaation foras.
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the city of
Campbell, its officers, agents and employees free, safe and harmless fro. any claim or deaand for
damages reSUlting from the work covered by this permit.
The Applicant/Permittee
back of this permit,
ACCEPTED
Applicant
they have read and understand botb the front and
eir contractor(s) of the information.
>"/rc- /9 I
Date
NOTES: ALL WORK SHALL CONFORM WI'l'H '1'HE ATTACHED, APPROVED PlANS AND ALL APPLICABLE CAMPBELL
STANDARD DRAWINGS AND CONDITIONS.
'1'HE CONTRACTOR MUST HAVE 'l'HIS PERMIT AND APPROVED PlANS AND MUST IIBft WI'l'H '1'HE P.W. INSPBCTOR ON
'l'HE SITE AT LEAST TWO DAYS BEFORE STARTING WORK.
NOTICE MUST BE GIVEN TO PUBLIC WOIUCS AT LEAST 24 HOURS BBFORE RESTARTING ANY WORK.
--
RECEIVID
MAY 1 G 1991
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SPECIAL PROVYSIORS
_2.
Street sball not be open cut for underqround in.tallations. Miniaua cuts aay be allowed
for connect:ions or exploration bole.. Such cuts must be saecificallv aDDroved bv the
Inenector.
Pavement may be cut for underqround in.tallation. and must be re.tored in accordance with
the utility Trench Re.toration Standard Drawing.
Work to be staked by a licen.ed Land Surveyor or civil Engineer and two (2) copi.. of the
cut sheet. .ent to the Public Work Deptartaent before .tarting work.
The hour. of work are liaited to out. ide the hour. of 7-9 .... and 3-6 p... for any work
.ffecting a traffic lane.
_1.
_3.
_4.
_5.
Public Woru/EnQin08rin"
STANDARD
PBIDII'1' APPLICATION I'D
tloo.oo
AMOUNT
. jt)o ~~
RECEIPT NO.
PIB CIIBCK DEPOSIT
BOND FOR FAI'l'IIFUL PBRFORllAlfCB
$500.00
(lOOt OF DG. EST.)
(4t OF BOIfD, $500 IIIR)
t,...v.
. 5"tro -'
. G'Lco 0'"
J
.
$
.2-rr-909
~r9 /0
CABH DBPOSIT
i:' C',(}
.:.700 ,-
. <.
ezc --
PLAN CBBCK , INSPBCTION FBI . ($0-$100,000 lOt,
$100,000 - $500,000 ~~,$5".0~~0,0~. and, ' above ", $100 1IDf)
APPROVED FOR ISSUANCE L - _
for City Engine r
........-: '-. ,~)
-1-_'-1-/' (
Date>
f: PNPERMIT
Revised 4/91
(
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
Department:
Public Works
February 25, 1992
Mr. Alex R. Ziegler
16200 Brooke Acres Drive
Los Gatos, CA 95032
SUBJECT: FINAL INSPECTION AND ACCEPTANCE
PERMIT NO. 91-156
LOCATION: 808 E. MC GLINCEY LANE
Dear Mr. Ziegler:
We have made a final inspection of subject Public Works
construction and find it acceptable and in conformance with
City standards. Accordingly, we will recommend the
acceptance of the work to the City Engineer.
You are responsible for the maintenance, repair and/or
replacement of all work done should any failures occur
within one (1) year of this date.
We will inspect the work in one (1) year and advise you
whether or not maintenance is needed.
We have received your maintenance bond (certificate of
deposit) in the amount of $2,050.00 and have released your
faithful performance bond (certificate of deposit).
Please feel free to call me if you have any questions.
~:~Jb-
Senior Civil)i;n<1ine~r
SDL/HI:djr
cc: Don King
Maintenance Division
Suspense - 1 year
f:91-156
REFUNDABLE DEPOSIT
CHECK REQUEST
TO: SANDY TERPKO
ACCOUNTS RECEIVABLE
Please issue check payable to:
Address:
Line 1:
Alex R. Zieqler
16200 Brooke Acres Drive
Line 2:
City :
Los Gatos State: ~ Zip: 95032
Description: Ref Deposit/Permit No:
INTEREST EARNED
Exact Amount Payable:
$500.00
Account Number: 001.00.905.4662
001.05.540.4448
LOCATION: 808 E. McGlincev Lane
DATE AND NO. OF RECEIPT:
5-17-91
#28910
PURPOSE:
Refund of cash deposit - Permit # 91-156
Requested by:
Approved by:
Verified by:
H. TmQ~J. Titl.: P.W.Inspector
Sal Duckworth-Lan~~tle: Sr. civil Engr
Date:2/25/92
Date: 2/25/92
Title:
Date:
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Ma il as is
Mail in attached envelope
Return to:
Pltblic Works
Department)
Sal
(Name)
please put permit number on check
Other:
Rev 11/21/91
CITY OF CAMPBEll
PUBLIC WORKS ENCROACHMENT PERMIT/PROJECT
INSPECTION REPORT
DATE: 2- -25 - 92
PERMIT/PROJECT NO.: 91 -IS0
TRACT NO.
ADDRESS: B08 E. /VIC(:7LIN c.GY I.--4Nt:
TYPE OF WORK: STREET:
STORM:
SANITARY:
SIGNALS
LIGHTING:
SIGNING:
STRIPING: IRRIGATION: PLANTING:
P.C.C.:~PARKWAY: ~ OTHER:
PRELIMINARY INSPECTION WITH DEFICIENCY LIST:
(Date)
v'" FINAL INSPECTION AND ACCEPTANCE: 2-- Z. $- ~ ? 2-
(Date)
SIGNED PLANS?
COUNCIL ACTION?
C E ACTION?
FILE NOC?
YES_
YES_
YES_
YES_
NO~
NO ---
NO l.--'"
NO ,........-
CHARGES AGAINST DEPOSIT? YES_
NO V
OVERTIME:
HRS. @ $
PER HOUR - $
EQUIPMENT RENTAL: TYPE:
AMOUNT: $
DATE:
REASON:
TOTAL CHARGES:$
ONE YEAR MAINTENANCE WITH DEFICIENCY LIST
ONE YEAR MAINTENANCE ACCEPTANCE
II. i III O/<.fj W,1
..
INSPECTOR
2-2-~~9 L
DATE
f:pw insp
9/91
) j:.- .(:~
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CITY OF CAMPBEll
70 NORTH FIRST STREET
CAMPBELL. CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
February 26, 1993
Alex R. Ziegler
16200 Brooke Acres Drive
Los Gatos, CA 95032
SUBJECT: ONE YEAR MAINTENANCE INSPECTION, ACCEPTANCE
PERMIT NO. 91-156
LOCATION: 808 E. MC GLlNCEY LANE
MAINTENANCE SURETY: ACCT #01422-00653, BANK OF AMERICA, LOS
GATOS
Dear Mr. Ziegler:
We have made the final one (1) year maintenance inspection of subject Public Works
improvements and find that no maintenance is required.
Your maintenance requirements and any surety, therefore are hereby released. Your time
deposit receipt and assignment form are ready to be picked up at our Public Works
office. If you have any questions, please do not hesitate to call me at 866-2158.
Sincerely,
~~
Mike Fuller
Assistant Engineer
MF:djr
cc: File (Encroachment Permit #91-156)
f:91-156
ASSIGNMENT AND RECEIPT OF INV~STMENT CERTIFICATE
TO CITY OF CAMPBELL, 70 N. I :T STREET
CAMPBELL, CALIFORNIA 95008 (408) 866-2150
P.W. Pp-wuit No. 91-156
TR or
Loc. ~o~ MCGLlncey Lane
I am/We are the owner(s) of a sayi~~ccount at
at its .ertnch office at Los GAtos
-€'e~gfii~ie No.01422-00653 in the names of Alex
and having a present balance of $
Bank of America
, California, investment
Zlegler
2,O~O.OO
I hereby grant, transfer and assign said account, said investment certificate, said
balance (including interest which accrues thereon), and all other rights in connection
therewith to the CITY OF CAMPBELL, assignee, for a good and valuable consideration,
receipt of which is hereby acknowledged, for the purpose of insuring construction
described as follows:
I have physically delivered verification of said investment certificate and duplicate of
this Assignment and Receipt to said assignee.
I understand that assignee can withdraw from said account any time on his signature alone
upon presentation of a written order to the issuer. I also understand that I may not
withdraw from said account unless I present a signed release from the assignee. The
issuer of the certificate assumes no responsibility for the conduct of the assignee and
may act on the signature of the assignee without further inquiry.
Executed on
Februarv 25 , 19 92 at said office of the issuer.
sign
print
ALE)(, (L. 'L\.E~~ Assignor
~ fL. :;doc .
~ Assignor
sign
print
ACKNOWLEDGEMENT BY ISSUER
Issuer affirms that there are no other holds on subject account, that subject monies are
available, and that the above described has been noted on the Records of said
issuer.
Date
t-;J~f2-
By
i
,
Authorized
Title:
ATTACH
NOTARY
ACKNOWLEDGEMENT
INSTRUCTIONS TO ASSIGNEE
Please sign below for signature identification and as acknowledgement of your notice of
Assignment. Return this Assignment and Receipt to the issuer at its address above.
Retain one copy of this Assignment and Rece'pt for your files.
Date: J- J.~f?Z-
City
By
RELEASE BY ASSIGNEE
Said assignee hereby releases and relinquishes all his right, title and interest in and
to said account, said investment certificate, said balance and all other rights in
connection therewith.
~)l\\t1~
City ~ C~
By () 7M!.." !Y.
1/~
,
i'\JjleJc.
Date:
m Bank of America
Time Deposit Receipt
*
*
*
*
*"
DATE
RATE
$ AMOUNT
TERM
ACCOUNT #
2/25/92
5.00% YIELD. 5.13%
$2.050.00*
365 d~s
01422 00653
BRANCH TO~ r.ATO~
PURCHASED BY *AU::X: '11:1?GT FR*
, *
*
*
No.
*
'42
*"
*
The publication(s) you receive contai the terms a conditions of this account. This time deposit will be reinvested automatically for the
same term upon maturity or on the effectIve date of a deposit or withdrawal made during the grace period.. (The grace period is two business
days for terms of 89 days or less; ten calendar days for terms of 90 days or more beginning on the maturity date.) The new interest rate will
be the interest rate in effect on the date your funds are reinvested.
· Interest compounded daily. Yield assumes deposit and interest remain in the account for a year at the same interest rate.
IMPORTANT INFORMATION
If you withdraw all or part of your deposit before it matures a substantial interest penalty will be imposed. A personal time deposit evidenced
by this receipt is NOT TRANSFERABLE EXCEPT IN ACCORDANCE WITH THE RULES AND REGULATIONS OFTHE FEDERAL RESERVE
BOARD"
R-162 5-89 (Reprint 10-90)
NOT NEGOTIABLE
Bank of America NT&SA . Member FDIC
B Donald E. Banta & Associates
.. Consulting Geotechnical Engineers
415 Meridian Avenue · San Jose, California 95126
408/287-7800
February 10, 1992
469-1A, C5397
Mr. Alex Ziegler
16200 Brook Acres Drive
Los Gatos, California 95032
RE: REPORT NO. 2
EARTHWORK OBSERVATION AND
TESTING SERVICES FOR
INDUSTRIAL BUILDING
808 EAST McGLINCEY LANE
CAMPBELL, CALIFORNIA
Dear Mr. Ziegler:
As requested by you, we have provided earthwork observation
and testing services for the above project. A foundation
investigation was performed by our firm for the project and
the results presented in our report titled "Foundation Inves-
tigation, Industrial Building, 808 East McGlincey Lane, Camp-
bell, California," dated October 10, 1989. In addition,
Report No. 1 for earthwork observation and testing services
was issued on August 26, 1991. The scope of our services was
primarily directed toward intermittent part-time observation
and testing during the earthwork operations. This report
includes the preparation of subgrade for the future city
sidewalk only.
During the above earthwork operations, we observed the grad-
ing operations and performed field density tests. The results
of the laboratory compaction test, as well as the field den-
sity tests, are presented on the attached Tables A and B.
Locations of the field density tests are shown on the site
Plan, Figure 1.
Based on our field observations and the attached test re-
sults, it is our opinion that the subject area was prepared
in general accordance with the City of campbell's recommenda-
tions. We must note that to date our services at this site
have not included construction observation or testing during:
(1) the placement of the gravel, membrane, and sand under the
building slab, (2) utility trench backfill, (3) the removal
of approximately two feet of soil over the proposed pavement
area, or (4) subgrade preparation, fill, and base course
placement in parking and driveway pavement areas.
We have employed accepted engineering and testing procedures,
and our professional opinions and conclusions are made in
Mr. Alex Ziegler
February 10, 1992
469-1A, Page 2
accordance with generally accepted soil and foundation engi-
neering principles and practices. However, we do not under-
take the guarantee of the construction, nor do we relieve the
contractor of his primary responsibility to produce a com-
pleted project conforming to the project plans and specifica-
tions. No warranty is either expressed or implied.
If you have any questions concerning our observations or test
results, please call.
Very truly yours,
DEB/EP:ml
copies: Addressee (4)
Attachments: 1) site Plan, Figure 1
2) Tables A and B
INC.
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CITY OF CAMPBELL
PUBLIC WORKS ENCROACHMENT PERMIT/PROJECT
INSPECTION REPORT
DATE: .2..-2.S-~L
PERMIT/PROJECT NO.: ') / - J ?b
TRACT NO.
ADDRESS: 808 B. f/J C (~U AL6€V
TYPE OF WORK: STREET:
STORM:
SANITARY:
SIGNALS
LIGHTING:
SIGNING:_
STRIPING: IRRIGATION:
P.C.C.: ~ PARKWAY:
PLANTING:
OTHER :
PRELIMINARY INSPECTION WITH DEFICIENCY LIST:
(Date)
/ FINAL INSPECTION AND ACCEPTANCE: 2 - 2..5'"" - ;>? .
(Date)
SIGNED PLANS?
COUNCIL ACTION?
C E ACTION?
FILE NOC?
YES_
YES_
YES_
YES_
NO
NO v
NO ~
NO ~
CHARGES AGAINST DEPOSIT? YES_
NO ~/
OVERTIME:
HRS. @ $
PER HOUR - $
EQUIPMENT RENTAL: TYPE:-
AMOUNT: $
DATE:
REASON:
TOTAL CHARGES:$
ONE YEAR MAINTENANCE WITH DEFICIENCY LIST
ONE YEAR MAINTENANCE ACCEPTANCE
II. IMO~ALIJ
INSPECTOR
3- 2 ~ - 5 Z-
DATE
ORle, INAL Lo~n.
f:pw insp
9/91
VACUUM
BARRIER
SYSTEMS
~---~
VACUUM BARRIER SYSTEMS CORPORATION, 16200 BROOKE ACRES DRIVE, LOS GATOS, CA 95032 (408) 358-2683 . FAX (408) 358-3247
January 20, 1992
.5C;.,~_U;
JAN 22 1992
Jut.Uc Worh/r
5n""..,inl
City of Campbell
Dept. of Public Works
70 North First Street
Campbell, CA.. 95008
Attn: Mr. Don King
Subject: 808 East McGlincey Lane - Oak Tree Interference
Reference: Permit No. 91-156
Dear Mr. King,
I would like to confirm our meeting at the counter today and our
discussion concerning the oak tree and the sidewalk interference.
To avoid cutting any further into the root structure of this important
tree on my property in the sidewalk area, we will be starting the
grade back a few feet further than planned and have a gentle rise in
the curving sidewalk around the base of the tree.
I appreciate your approval of this small change as we all agree that
all trees on McGlincey Lane in Campbell should be preserved
wherever possible.
Thanking you agam..
Very truly yours,
~
Alex R. Ziegl
Owner
SPECIALISTS IN LIQUID NITROGEN PIPING SYSTEMS
VACUUM
BARRIER
SYSTEMS
VACUUM BARRIER SYSTEMS CORPORATION, 16200 BROOKE ACRES DRIVE, LOS GATOS, CA 95032 (408) 358-2683 . FAX (408) 358-3247
December 12, 1991
City of Campbell
Dept. of Public Works
70 North First Street
Campbell, CA. 95008
a'(;I'''IO
DEe 1 c 7991
eublic 'NorhlE .
n911leering
Subject: 808 & 786 McGlincey Lane
Dear Sir,
I am building a new building at 808 E. McGlincey Lane and have permit
no. 91-156 for the public improvements. The adjacent property to me is
786 East McGlincey.
It has come to my attention the sidewalk at the adjacent edge of our
two properties has a small crack about fifteen inches long at one
corner of the concrete. I also understand the Public Works
Department is holding up the release of the $6,000.00 Bond put up
by my neighbor Mr. Paisley until this work is done.
As I have contracted for my sidewalk improvements at 808 and will
be doing this work over the next few weeks I would like to propose
to your department that the cracked section of concrete will be
replaced with new concrete at the same time as I do my work.
Hopefully, this should allow you to release the Bond monies to Mr.
Paisley.
Please feel free to contact me for any questions you may have.
SPECIALISTS IN LIQUID NITROGEN PIPING SYSTEMS
"'.
TO:
'Gity Clerk
Please collect & receipt
for the following monies:
PUBLIC WORKS FILE NO.
"
~......... ~
'....J
35-3396
3372
3521
3521
3521
3372
3373
3373
3373
3373
3373
3372
3372
3372
3372
3372
3395
3370
3380
3510
Project Revenues (specify project)
Public Works Excavation Permit Fees:
Application Fee
Plan Check Deposit
Faithful Performance (Cash) Deposit
R-1:
($50)
Other Cash Deposit (specify)
($200)
Plan Check & Inspection Fee ($0 - $100,000 10%;
$100,000 - $500,0009%; $500,000 and above 7%; $100 min.)
Project Plans & Specifications ($10)
General Conditions, Standard Provisions & Details ($10 or $1Ipage)
"No Parking" signs ($1Iea. or $25/100)
Work Area Traffic Control Handbook ($5)
Copies of Engineering Maps & Plans ($.50/sq.ft.)
Final Parcel Map Filing Fee ($450 + $20 per lot)
Final Tract Map Filing Fee ($500 + $20 per lot)
Lot line Adjustment Fee/Certificate of Compliance ($400)
Vacation of Public Streets and Easements ($500)
Assessment Segregation or Reapportionment
First Split ($500)
Each Additional Lot ($150)
Park Dedication In-lieu Fee per Unit ($4,548)
storm Drainaqe Area Fee
Public Works Special Projects
Postage
TOTAL
$
Other:
($100)
($500)
(100% of)
(ENGR. EST)
(4% of FPB)
($500 min.)
/f~c".~3 \537
(.-c
$ ;')Zc --
NAME OF APPLICANT
ADDRESS
FOR
CITY CLERK
ONLY
PHONE
ZIP
I RECEIVED sf ~i~ ~t (1..~
DATE g/~~\ )
CITY OF CAMPBELL
PUBLIC WORKS ENCROACHMENT PERMIT/PROJECT
INSPECTION REPORT
DATE: 2. -8.-93
PERMIT/PROJECT NO.: ':) J -15G TRACT NO.
ADDRESS: 8 0 fj & Me,;;, 1-1 Ai LeY LA--'Ai I-='
TYPE OF WORK: STREET:
STORM:
SANITARY:
SIGNALS
LIGHTING:
SIGNING:
STRIPING:
IRRIGATION:
PLANTING:
P. C . C.: /' PARKWAY: V""""
OTHER:
PRELIMINARY INSPECTION WITH DEFICIENCY LIST:
(Date)
FINAL INSPECTION AND ACCEPTANCE:
(Date)
NO I./"
NO L.-
NO L--
NO (/"
NO t./
PER HOUR - $
SIGNED PLANS?
COUNCIL ACTION?
C E ACTION?
FILE NOC?
YES_
YES_
YES_
YES
CHARGES AGAINST DEPOSIT? YES_
OVERTIME:
HRS. @ $
EQUIPMENT RENTAL: TYPE;.
AMOUNT: $
DATE:
REASON:
TOTAL CHARGES:$
ONE YEAR MAINTENANCE WITH DEFICIENCY LIST
V ONE YEAR MAINTENANCE ACCEPTANCE
J-! / /VI /J J(,q wA
. INSPECTOR
2 -6)..J) 3
DATE
f:pw insp
9/91
VACUUM
BARRIER
SYSTEMS
z. - t. S - 'C) '2...
~ fD~ -fD/t.-
A- (/o~ v~
f' tV ~
VACUUM BARRIER SYSTEMS CORPORATION, 16200 BROOKE ACRES DRIVE, LOS GATOS, CA 95032 (408) 358-2683 . FAX (408) 358-3247
~J;'I~I 20, 1992
City of Campbell
Dept. of Public Works
70 North First Street
Campbell, CA. 95008
Attn: Mr. Sal Duckworth-Lanvo
Subject:
Final Acceptance/Bond Release of Cash Deposits
808 East McGlincey Lane
Reference: Permit No. 91-156'"
,,'
Dear Sal,
The street improvements a have been completed for this project and
I would like to request final inspection and release of my $8,200.00
Certificate of Deposit (held as Bond).
Please find attached the twenty five percent (250/0) CD of the
original sum which is $2,050.00 representing the one year
maintainence deposit.
I am awaiting your letter of final acceptance to allow me to proceed
with the building department for my occupancy certificate.
Very truly yours,
~t.
Alex R. Ziegler
Owner
v
V
VACUUM
BARRIER
SYSTEMS
Penoyer
Quinnev
Duckworth
Bollier
Kruaer
Gomez
Kina
/-I~ I.L
Return to
v
VACUUM BARRIER SYSTEMS CORPORATION. 16200 BROOKE
v
C-S 6r
\ -<."'L -"'\
~
J./"J:-
(-2,3-'10
Kina
January 20, 1992
.lc;l'~_~;
JAN 22 1992
'''10 Worq
, En8/nlffiiii
City of Campbell
Dept. of Public Works
70 North First Street
Campbell, CA.. 95008
Attn: Mr. Don King
Subject: 808 East McGlincey Lane - Oak Tree Interference
Reference: Permit No. 91-156
Dear Mr. King,
I would like to confirm our meeting at the counter today and our
discussion concerning the oak tree and the sidewalk interference.
To avoid cutting any further into the root structure of this important
tree on my property in the sidewalk area, we will be starting the
grade back a few feet further than planned and have a gentle rise in
the curving sidewalk around the base of the tree.
I appreciate your approval of this small change as we all agree that
all trees on McGlincey Lane in Campbell should be preserved
wherever possible.
Thanking you agam.
Very truly yours,
~
Alex R. Ziegl
Owner
SPECIALISTS IN LIQUID NITROGEN PIPING SYSTEMS
Jo~
-\1-\-/~ <.:>
l'"::>
\In
~c~<o.-L
ASSIGNMENT AND RECEIPT OF INVES'l'HENT CDTIFlCATE
TO CITY OF CAMPBELL, 70 N. FIRST STREET
C~l!PnELL, CALIFORNIA 95008 (408) 866-2150
P.V. Penit No. 91-156
TR or DEV
Loc.
CD
I am/We are the owner(s) of a-.a.tA&a-aecount at Bank of America
at its branch office at Los Gatos , California, Investment Certificate
No. 142 in the name. of ~lpx R 7.ipgl~l'"
and having a present balance of $ Q ? () () Q Q
.
I hereby grant, transfer and assign said account, .aid Investment Certificate, said
balance (includinR interest which accrues thereon), and all other rights in connection
therewith to the CITY OF CAMPBELL, assignee, for a good and valuable consideration,
receipt of which is hereby acknowledged, for the purpose of insuring construction
described as follows:
I have physically delivered said Investment Certificate and duplicate of this Assignmenc
and Receipt to said assignee.
I understand that assignee can withdraw from said account any time on his signature alone
upon presentation of the Investment Certificate to the i8suer. I also understand that I
may not withdraw from said account unless I present said Investment Certificate and the
8ignature of assignee approving said withdrawal. The iS8uer of the certificate assumes
no responsibility for the conduct of the assignee and may act on the signature of the
assignee without further inquiry.
Executed on
~/z.
, 19 ~I at said office
of the i....r~
Q.L,.l. ~
Assign
Assignor
ACKNOWLEDGEMENT BY ISSUER
Issuer affirms that
available, and that
issuer. ~
Date ~ t If!
/ /
there are
the above
,
no other bolds on s ject account, that subject monies are
d...r1bed ".1~ ~. beeo DO~j~ Record. of ..id
By ~.
Signature
INSTRUCTIONS TO ASSIGNEE
Please sign below for signature identification and as acknowledgement of your notice of
Assignment and as receipt of said Investment Certificate. Return tbis Assignment and
Receipt to the i8suer at its address above. Retain one copy of this Assignment and
Receipt for your 11es.
Date f I,/;
RELEASE BY ASS IGNEE
Said assignee hereby releases and
to said account, said Investment
connection therewith.
Date
~~~)-:fZ--
relinquishes all his right, title and interest in and
Certificate, said balance and all other rights in
~tYo~;~~~A
I A.~.tlll...
CERTIFlCI-. ~E OF INSURANCE
'" ,- -~-------,
ISSUE DATE (MM/DD/YY) I
8/2/91 !
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
PRODUCER
Harbert Agency
P.O. Box 631
Santa Cruz, CA
95061-0631
COMPANIES AFFORDING COVERAGE
f~~~~NY A
Fireman's Fund
408-427-2378
INSURED
f~T~~~NY B
JU 1 ied Group
Alex Ziegler
Vacuum Barrier Systems, Inc.
16200 Brook Acres Dr.
Los Gatos, CA 95032
f~T~~NY C
RECEIVID
(\U G ;) t991
f~T~~~NY D
f~T~~NY E
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO
TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
A X X COMMERCIAL GENERAL LIABILITY
CLAIMSMADEXXXOCCUR MXX 80496579
OWNER'S & CONTRACTOR'S PROT,
7115/91
7115/92
GENERAL AGGREGATE $ 2 , 000 , 000
PRODUCTS-COM PlOP AGG, $ 2 , 000 , 00 0
PERSONAL & ADV, INJURY $ 1 , 0 00 , 0 0 0
EACH OCCURRENCE $1 , 000 , 000
FIRE DAMAGE (Anyone fire) $ 5 0 , 0 0 0
MED, EXPENSE (Anyone person) $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
B X X SCHEDULED AUTOS
HIRED AUTOS
X X NON-OWNED AUTOS
GARAGE LIABILITY
ACP 7840049831
COMBINED SINGLE $
LIMIT 1,000,000
BODILY INJURY $
(Per person)
BODILY INJURY $
7115/91 7115/92 (Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGATE $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
OTHER
ADDITIONAL INSURED: liThe City of Campbell and its respective officers, agents
and employees are named as additional insureds from and against any claims,
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS 0 S S 1 all y, co s 0 rex pen s r 1
or in anyway connected with the construction of the project. This coverage
shall be primary and any coverage carried by additional insured shall be
excess insurance only."
CERTIFICATE HOL R CANCELLATI08
City of Campbell
70 No. First Street
Campbell, CA 95008
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
E TION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
IL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
FT, B T FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
~ABILlT OF ANY KIND UP E CO A ITS AGENTS OR R SENTATIVES,
ACORD 25-S (7/90)
@ACORD CORPORATION 1990
:""'.-1
U;J Bank of America
Time Deposit Receipt
BRANCH Ln~ Ga1:n~
PURCHASED BY * * *A 1 P-X R 7.1 egl p-r*
*
No. 142
*
DATE
RATE
$ AMOUNT
TERM
ACCOUNT #
08/01/9]
').00% YIELD" ') / 13%
$8,200.00*
10 days
01422 00668
,
\
* *C11:y of Campbell*
*
*
*
PAYABLE TO
The publication(s) you receive contains e terms and conditions of this account. This time deposit will be reinvested automatically for the
same term upon maturity or on the effective date of a deposit or withdrawal made during the grace period. (The grace period is two business
days for terms of 89 days or less; ten calendar days for terms of 90 days or more beginning on the maturity date.) The new interest rate will
be the interest rate in effect on the date your funds are reinvested.
" Interest compounded daily. Yield assumes deposit and interest remain in the account for a year at the same interest rate"
IMPORTANT INFORMATION
If you withdraw all or part of your deposit before it matures a substantial interest penalty will be imposed. A personal time deposit evidenced
by this receipt is NOT TRANSFERABLE EXCEPT IN ACCORDANCE WITH THE RULES AND REGULATIONS OF THE FEDERAL RESERVE
BOARD.
~
J
~
,
t
\
~
R-162 5-89 (Reprint 9-90)
NOT NEGOTIABLE
Bank of America NT&SA . Member FDIC
,C- /.":<~
Addr.........;.....:.. " /
"/ /;
CITY OF CAKPBEU., CITY ENCINEER' S CONSTRUCTION COST ESTIKATE
(>
Surface Con.~ructiDn
Claarina . Crubbina
Sa.cut Concrate
Concrete ae.oval
Curb . Cutter aa.oval
InIot Drain with Pip.
CUrb 6 Cutter
Side.alk
Drive.ay Approach
Handicap a-p
latnaded Cu%b
larricade
Str.et lacavation
At 'ave..nt
Adjuat llanhole to Crade
Adjuat IIandhole to Crade
Ilon~nt lox _/K_nt
Str.at Tr.e (15-..11on)
'.--nt St'd,ina ($100 ain)
'..,..nt Le,enda ($100 ain)
Ito" Street .... or Other Sian
'av...nt "run
'av_nt ley CUt
LIIap SIIa btiute
le/ Lf@ $ 4.00
SF @ 3.00
Lf@ 5.00
IA@ 600.00
Lf@ 14.00
Lj- ,- SF' 4.00
:> r-'-." SF @ 5.50
lA' 400.00
Lf' 1.50
Lf' 50.00
... ,. ,-/ ,~ \ SF)x($O.lO)xC :~.)
I / I ~
SF)x($O.30)xL----.)
lA' 375.00
lA, 275.00
lA' 600.00
lA' 300.00
Lf' 0.65
lA' 40.00
lA' 120.00
lA' 15.00
Lf' 10.00
\" ,~
Peni t No.
by:-A: date
- $
- $
- $
- $
- $
$
$
$
- $
- $
- $
$
- $
- $
- $
- $
- $
- $
- $
- $
- $
- $
- $
- $
/'
- $
5/'>/1 . /1"
s~(
,t,s. . I
,. ---) '.
~ ;:.~ , (-
~ / /'" ~. ,
,I / <0 ,. /': '
Surfaca lubtotal .S.
Adjuat for abe: .S"<$30,OOO add 20\, .S.>$100,ooo nbtract 10' (+ or -) $'1 I,- .I'
I~..~ U.l\'ttnlr
llectrolbr
Condul t
Conductor, ,air
Pull lox
I~Dr. nr.f~...
12- or 15. lCP
11. Dr 21" lCP
Itraat IDlat
lIaIlhole
Iruk . Inter IIaMole
'",
/
,it. )
"".- ,
rfti...d 'III
f/co..-co.~-..~
lA' 2,000.00
U , 10.00
u, 2.00
..,
200.00
/. U, 60.00
U, 70.00
lA' 1.600.00
lA' 2,400.00
! lA' 650.00
totAL UTIJlATl $
lIS! rea IOIUl $
'"..-..,
- ,
- $
- $
- $
- ,
- ,
.
- .
- $
- .
- $
(/' ~ /'
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, ....
/
CITY OF CAMPBELL
MEMORANDUM
To:
Bill Helms
Date:
HElMS
JOCSIJN
KP.U~ER
PENOYER
......L
From:
Ted Thoeny
Subject: McGlincey storm Drain
--
----------------------------------------------------------
The City of San Jose has calculated the design Q of 600 cfs
(see enclosure) for the Union Ave. storm drain.
Unfortunately the design capacity of the existing 54" storm
drain is approximately 75 cfs considering roughness
coefficient, slope and pipe size. Fortunately, the pipe is
deep enough so that it is able to flow underhead .
utilizing San Jose's calculations, at least a 10' diameter
RCP should be installed to carry the additional flows from
Union Ave. west to Los Gatos Creek in the MCGlincey area.
A smaller pipe could be used if buried sufficiently deep so
as to also flow under head.
As for the existing system, the pipe and ground slope is
flatter than critical slope, making it necessary to start
the design at the upstream end of the system in San Jose,
not the downstream end in Campbell.
I will continue to work on a solu~ion.
TT:cc
f:mcgstmdrn
TO:
City Clerk
PUBLIC WORKS FILE NO.
'7/- LS-G
Please collect & receipt
for the following monies:
3372
3521
3521
Project Revenues (specify proJect)
Public Works Excavation Permit Fees:
Application Fee
Plan Check Deposit
Faithful Performance (Cash) Deposit
R.1:
($50)
Other:
($100)
($500)
(100% of)
(ENGR. EST)
(4 % of FPB)
($500 min.)
3521
Other Cash Deposit (specify)
($200)
3372 Plan Check & Inspection Fee ($0 - $100,000 10%;
$100,000 - $500,0009%; $500,000 and above 7%; $100 min.)
3373 Project Plans & Specifications ($10)
3373 General Conditions, Standard Provisions & Details ($10 or $1/page)
3373 "No Parking" signs ($1/ea. or $25/100)
3373 Work Area Traffic Control Handbook ($5)
3373 Copies of Engineering Maps & Plans ($.50/sq.ft.)
3372 Final Parcel Map Filing Fee ($450 + $20 per lot)
3372 Final Tract Map Filing Fee ($500 + $20 per lot)
3372 Lot Line Adjustment Fee/Certificate of Compliance ($400)
3372 Vacation of Public Streets and Easements ($500)
3372 Assessment Segregation or Reapp'ortionment
First Split ($500)
Each Additional Lot ($150)
3395 Park Dedication In-lieu Fee per Unit ($4,548)
3370 storm Drainaqe Area Fee
3380 Public Works Special Projects
3510 Postage
TOTAL
NAME OF APPLICANT /J / ex R. z,. ef}/ er PHONE
ADDRESS 10~OO Rrot:Jk Ary.e5 en"". ) 1-.05:. Ga-foc.,) C A
I . riJ
$ 1?6o ,....-'
FOR
CITY CLERK
ONLY
3S? -:2- t:,g.3
ZIP 95tJ 3 ;;...
RECEIVED BY ;;I
DA TE ~ / ) 1/ 9/
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~<
ENCROACHMENT PERMIT ISSUANCE ,LECK LIST
;:. -/S-~
City of Campbell Encroachment Permit No.
Department of Public Works
~ Applicant section complete
~APPlicant signature and date
~ Permit Application fee $100.00 paid
Receipt number -;;2-5-tj(j cy
/
* ~lan check depos it, $500.00 paid
?eceipt number :2- &- q /0
/ ,., 3 OL<:~O. l~
_____?tve sets of improve~t plans submitted
- - -- - -- - ------- - - -------- - - ---- ----- - - - -- - --- -- - - - - - - - - - - - - - - - - - - - - - - - - - - --
~Bond for faithful performance, 100% of City Engineer's
estimate, supplied or paid , I. D. # j// ~7,_
Amount $ 2' 'ZC' c ~ Form G- D _ y- -
~ ~Cash Deposit: 4% _of FP bond, $500 min. paid
Amount $ ~~OC) '":"':::'" Receipt No. 2- t.~ c; l 0
~Plan Check & Inspection fee of 10% of F.P. Bond for
amounts of $0 - $100,000; 9% for $100,000 - $500,000;
7% for $500,000 an~ above; $100 min. paid
6 t.)V
Amount $ C:;'Zl~~)- Receipt No. ~ ~ ~ .-.,.
~ Workers' compensation information received for Applicant
(see Information Sheet for Encroachment Permits)
_____All other Public Works requirements listed in the
Conditions of Approval of the development.
-- - - - - - -- - -- - - - - -- - - - - - - - - -- - - - - - --- - - - - - - -- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - --
,\ l/
~Workers' comp and Contractor's Information received for
. Contractor (see Information Sheet for Encroachment Permits)
.
~(L- Certificate of Insurance with Additional Insured's
Endorsement received from Contractor (see General Summary of
Insurance Requirements for Encroachment Permits)
.~ ~ Three sets of off-site plans, stamped APPROVED (Tract or
Development and Public Works Permit number and property
address on plans)
_____Permit signed for City Engineer
WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE, PERMIT MAY BE ISSUED
Issuer: Initial and date and file with permit
UPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
f:pmtcklst (Mise forms)
Revised 4/91
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