91-164
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ern or CAIIl'BEU.
DZPl'. or PUBLIC 1I01UtS
70 North F~~ st:.
ca.pbell, CA '5001
(401) 111-2150
Perait Bo. '7 I ~ 16,);/
X-R.f. fil. 9\- l4-~
Application Date b - \"1- -Cot L
App1.1cation upiz'u 1ft 6 _s.
EHCROA~ ~
(for work1llq 1n tn.
pulIlic ri~-of_.y)
I.ned ~ - \'~-<=4, \
Per1Ii~ expu.. 1ft 12 _.
APPLICA'l'ION - Application is bereby _de for a Pllblic Works Per1Iit 1ft accordance with CUlpbell
Municipal COd., Section 11.04. (Application upu.. 1ft 6 _ntbs if ~t no~ pulled)
A. Work addru. or tract: t
1800 Whiteoaks Avenue
B.
ut:llUy trench location
.atare of works new gas service as per attached sketch
SDG00886
C. A~tacb five (5) copi_ of a dravin9 sbov1n9 the loca~ion, extent: and dia.nsions of the work
'l'b. dravincJ sball &bow th. relation of th. proposed work to existincJ surface and uncl.rc;rrouncS
!aprav-.nta. 1Iban appraved by t:be City Enq1fteer, said dnvincJ beccmes a part of tbiJI pumt.
D. 'l'b. Gen.ral ConcSitians tor all peraita an listed on tha nvena sicSa. Speci.l Provisions tor
this pe~t an liS~ed alov. r.ilure to abide by thes. conditians and provisions _y result
1ft job &but:-ctown and/or forfeiture of Faithful Pertonaance Banda and c:asb deposita. (&_
General Conditions 1 and 2).
z. An application f.. 1lUSt: .ccoapany this .pplication.
Pacific Gas and Electric
'l'bis is Don-refundable.
Tal~n.s408/725~2229
H... of Applicant
AdcSraa. 10900 N. Blaney Ave., Cupertino
I. tbi. work beinCJ clon. by th. property owner a~ their own raaicl8nce? ---:t- -!.,no
CoIIpl.t. and .ttach Morken' ccmpen..tian and Contractor Infonaatian taE1lS.
'l'ba Applicant/PU'llittH bereby aqnu by .ffixing thair siCJll8tur& to this'pe~t to bold tha City
of
campall, its ofticara, .gants and .-ploy... tre., ..fa and baral... t~ any claia or d.-and tor
cta.Aq_ raault1ftV trail t:be work CGYared by this perait.
'l'be Appiicam/P.ra ay have read .nd undaratand both the front: and
beck of this ntract:or(.) ot tha 1ftfonaat:ion.
AC~JtI)
Date
6/11/91
HO'l'ZS: ALL MOB SBALL CDHPOJUI wrrB 'l'BE AT'l'AamD, APPROVED PLYS AlII) ALL APPLICARl..! cupuu.
STANDARD DRAWIIIGS AHD COlfDrrIOIIS.
'1'D COICTRAC'l'Oll !lUsT HAVE '1'II1S PDIIIT AHD APnuvlD PLlUI8 AHD IIUS'l' IIDT wrrfI."wI ~ 011
'l'BB SI'l'Z H LZAft '1'110 laYS DI'OD S'l'AR'lDIG IIOIIK.
NO'l'ICI: IIOST .. GIVD '1'D POBLIC WORD H LUS'1' 24 BOURS auoa RBI'l'AlmJIG ~J :; 199 J
sn~AL PROVISYONS ~ublic Worb/Engineering
.~ Straet uall not a open ~ for undarqrcnmd 1ftatallationa. llinillua cuta MY a allowacl
- far COJIIlact:ions or ezplaration bal... SUcb cuts lm.~ be ..,.ei~il!'!Jl.llv amtrmre bv Mia
tn.D~ar.
_2. pavaant MY a cat for andU1JrOUnd inst:allaUona and -.at be rutorad 1D ac:cordance with
tha Utility 'french Restoration Standard DnwincJ.
_3. Work to .. staked by a licansed Land sw:veyar or Civil ZllcJ1ftaar aad two (2) copt_ of the
cut &b_ta sant to t:be Pllblic Work Deptart:mant befl:ln startin9 work.
_4. 'l'b. boura of work are 11a1ted to outside t:be boura af 7-9 .... and 3-6 p... for any work
aff.ct:1nCJ . traffic lane.
_5.
'.-1 ,
S'l'1HD1RD
Im~Pr MO.
AMOmI'l'
les:c> . CC)
<f
PDHIT APPLIc:a.'fIOII I'D ($!l0.00)
PLUf CBJ:CZ DUOSI':
BOND POR FAI'1'BI'01. PI1U'OJUCAIICI:
CUB DUOSI': (UOO.OO)
PLUf CBZCZ , IJISPECTIOH 1'D
'100,000 - '500,000 ",
APPROVZD FOR ISSOANCI:
$100.00
$!l00.00
(100' OF ERG. 1ST.)
(4' or BORD, '!l00 KIK)
.
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Dat:e
(SEE ODD SItE)
CITY
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APPROVED FOR CONSTRUCTION.
City of Campbell
Public Works Permit No. 9/-/(,;/
/
C """"eto, mllSt hove these pions
(\. rl,~ jf'"oh site during construction,
LAMPI3t.LL
P [R-fV\ I (
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RECEIVID
JUN 1:; 1991
cs:)
lrJ
Public Worb/EnQino.rinA
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