91-188
=...,
~ i ~ ~
.
~ - C It
) a = ~
,"2 -,.
:~' I g
'"
S-t5 ~
~ .....
'" .. :: ...
~ ;: ~ :
'" . i :r
,... flit .. .
"-G
S ., f
~ t ! ~
i ., ~ I
& .... n n
:>> ~ : I
. ~
..-..
" :r
. ., -
o .. It
~ C 1
; ~ .
. ..... ::
If I ~
! ..
..
. c
., a ·
l .. =
-~
I'=....
i 2. ~
- 1
ENCROACHMENT PERMIT
(tor working in the
public right-ot-way)
Issued /1/ - j- 1/
Permit expires in 12 mos.
penit No. q J - I~S
X-Ref. file
CITY OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
PACIFIC BELL JOB #N4-8221S
APPLICATION - Application is hereby made for
H~nicipal Code, Section 11.04. (Application
Application Date
Application expires in 6 mos.
.1
I
I
I
I
I
I
I
I
I
t-3
o
lJj
tt:I
()
o
3:
"tl
t"
tt:I
t-3
tt:I
o
lJj
~
~
"tl
"tl
t"
H
()
~
Z
t-3
I
I
,
I
I
I
,
I
A.
a Public Works penit in accordance with Campbell
expires in 6 months if permit not p~l.d)
fe,
-. I if' "
j j- :1 40' h
___.f" W
IJII/,I' l/ 1''),,/
"e ~ v ,~ _
wries I
Attach five (5) copies of a drawing showing the location, extent and dimensions otl~~O~k
The drawing shall show the relation of the proposed work to existing surface and underq~
improvements. When approved by the City Engineer, said drawing heco"s a part of this pe~1t.
Work address or tract .
HARRISON @ SALMAR
Utility trench location
B.
Nature of work: EXCAVATE AND PLACE CONDUIT FOR POLE REMOVAL
C.
D. The General Conditions for all permits are listed on the reverse side. Special Provisions for
this penit are listed below. Failure to abide by these conditions and provisions may result
in job shut-down and/or forfeiture of Faithful Performance Bonds and cash deposits. (See
General Conditions land 2).
E. An application fee must accompany this application. This is non-refundable.
Name of Applicant PACIFIC BELL c/o SCOTT YOUNG Telephone: (408) 491-1921
Address 1531 PARKMOOR AVENUE , SAN JOSE, CALIF. 95128
Is this work being done by the property owner at their own residence? ---yes ~no
Complete and attach Workers' Compensation and Contractor Information foraa.
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 from any claim or demand for
damages resulting from the work covered by this permit.
The Applicant/Permittee hereby acknowledges that they have read and understand both the front and
back of this permit, and that the ~ wi~1 in or. theircontractor(s) of the information.
ACCEPTED 5c.o 7T \ 0 VA) ~ ~ q - 2, 7 - '11
Applica t (Permittee) print/si Date
NOTES: ALL WORK SHALL CONFORM WITH THE ATTACHED, APPROVED PLANS AND ALL APPLICABLE CAMPBELL
STANDARD DRAWINGS AND CONDITIONS.
THE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AND MUST MEET WITH THE P.W. INSPECTOR ON
THE SITE AT LEAST TWO DAYS BEFORE STARTING WORK.
I
I
.1
I
I
I
I
I
I
I
t-3
o
tr::l
tt:I
()
o
3:
"tl
t"
tt:I
t-3
tt:I
o
lJj
~
()
H
t-3
~
NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK.
SPECIAL PROVISIONS
_1.
Street shall not be open cut for underground installations. HinimUIII cuts may be allowed
for connections or exploration holes. Such cuts must be soecit1callv aooroved bv the
Inspector.
Pavement may be cut for underground installations and .ust be restored in accordance with
the Utility Trench Restoration Standard Drawing.
Work to be staked by a licensed Land Surveyor or Civil Engineer and two (2) copies of the
cut sheets sent to the Public Work Deptartment before startin9 work.
The hours of work are limited to outside the hours ot 7-9 a.a. and 3-6 p.m. work
a,ftecting a traffic lane. t--..,
'<.....J "11<- ~ t$ouL.Ji'b
'~2.
_3.
_4.
\/5.
\"i4--J':-."Fr""\ c- t>-r \t "J8'e.'-t -:'\0 t..:e:~ '\L:> <:C:a-1 ~.. n
'TO ~'t\.\-~)~ \.b~\<;.r>LJ
L9K -r:n 51(~tV OP~
/ -/8-9) (R-11 STANDARD AMOUNT RECEIPT NO.
PERMIT APPLICATION FEE
($50.0C1)
$100.00
$500.00
(100\ OF ENG. EST.)
(4\ OF BOND, $500 KIN)
$ \ e:::r;;;: . ~
$
$
$
$ \~.~ ~
\.6-\-~l
Date
~
PLAN CHECK DEPOSIT
BOND FOR FAITHFUL PERFORMANCE
CASH DEPOSIT
($200.00)
PLAN
$100,000
APPROVED FOR ISSUANCE
f, 1>1.11>O:PMT1'
~;- ...!
U
.,
~a
~
.---
= ~ t!5 (J)
'-"
~... a:: I-
-- W
=>
U CI
U co
(f)
W
0- 0
a: ,
u If)
V>
0 :z
:z 0
a:
~ I-
~ W
W
(f)
:r:
w
:z
W
cr
I-
W
~
c::>
0-
~ 0
a.. ~-,
rn
(/)
W 0
l- e.
W W
a:: a::
w
:z I....
a
:.<: u
~
~ w
:z a.. 0:
W ~ W
Cl W l-
V> I-
</J 0 =>
:z <::>
L..- a:
0 ~ ""
l- I- en
L..- L..- a::
=>
01 C!l U
(f) U>
If) 0 0
'" w
X X X
0 0 0
cr cr a::
(f) 0- a.. 0-
W a.. Ii. a.
I- ~ a:: a:
0
:z w w w
w u u
0 ~ a: a:
~ ...J -'
en 0- 0- 0-
W W W
cr cr 0:
ru M
ClYU7YS
I-
W
:::>
V> 0
W I- 0
W
I- W W
x: I-
~ W a::
w CJ ~ W
I- ro w 0 a::
:::> cr 0- >-
_J~ 0
'-" --' => 0
=> ..... C!l I- Z
:z w W
...J ~ <D I-
...J I- .... ><
a: ~ I- In W lu
:lC ~ I ...J
W a:: r 0 0 .J
I- wa:: '" 0-
a: CL w CD a:
w a.. U> :z >-
CI l... w 0
W ...J o ..J :s: Z :lC
I- ..J 0 W W
0 0 CJ) W W a:: 0 a::
:z I- ZOO If) .... l- V)
a: a: W lD
>- 00.. :r: :c ..J ....
~x: I- r.n
cr: ci (f) a: a.. u 0- co If)
:z .~w :::> :z a: I
CD u> >- Cl U> wo
::::> 01.... 00 m
(J) :::i 0-: 0 Cl a:: co
a.. ~ w W(f)
~ >- >- I-
...J ..J l- => C) 1....0
a: -' .~ co :lC a: I-
w a: u
... ""
'"
"'.
~=
1M
0) ><
lD'
000:>
</J<::t
OOOQOQQQ
u x L.) l.o u .ry" lf1 "::t
q- ~ Lr> <;;j- "7t
V) ..J
I- W
LI) <:t-
o
U a::
rn
I- -'
W
a: 0
cr U
I- _J
2 W
a I-
w
:lC
lf1
....
I
I
I
I
I
I
10
I
"'\ 0' 0J
en r..D..~
II II II
'" <l a: -'
LOx: /
x: . w I
w r'i' /
w I 3
I Wu
W u I
I _
. w~ \
o;t- I
I ' I I (f)
o;t-~ I l-
I U
M ~M =>
In - In 0
(\J ~C\J
C\J W
l-
I a:
I u
0
-'
0
I-
0 w
I -'
0
I
I-
0
u..
,
I
I
Cl
Z'
W.
I-
xw
W -'
o
oil a...
I- :z
..J w
a: :z
::r:
a.. 0
IJ) I-
a:
(f)
0- CL
r 0
LoJ cr
I- 0
x
q-
en
LD
I
x:
W
U
I
U
~,
I
I .<] eLl 0-
j ~ ~~
I _
......1-________ J ~ ~
, e;M
=r---------J
:1l ~
I ~:5 ~ f'.
o I (J)
U '"
c:>
'>- ::ro
' >< .:..
l.J
;Z <T U
C) <r
<:
(:::)
tr)
~
Q:::
Q::: ,
~ I
I
I
1
r.o , I
0 <r
I I
If) cu
ro ~I
co
If)
:z ,
I
21
~ If), _
.:::;t (Y)l.f)
ex II II II
u
o
LL
:>C
..J
a:
:z
w
o
1--,
I:.;:) 0-
15
I
I
1
I
wo
>-w
o~
:t: 0:::
W =>
a:: co
@
,-
----/
f..-.
cry
:z
a::
00
a::
(j)
(-.)
>--...,
l"-.
L.......
ct:
Q::
I---.
~
~
~
:r:::
>
G
>--...,
f--...
~
ct::
l..J
a::
w
I-
cr:
:z
Z \
Cl
0 :z
W
'-"
w ::z
-' I
u
<r
u
Q..
I
U
,
<r
I
z
o
~....
i-
()
(~
If;
~
,.~
C~,\
__I
()
C\~
(~~)
L:,_
C:i
llJ
::~
"J
c,.
n-.:
(L
Q~
<(
'"
w U
0- CL
r I I
Q..u W
. ,
:z: <:T <:T
W I I
:z ~ (\J
~ ~
..J
Q..
-'
w
~
'"
\
-~
--
~
CD
(i
-...."
()"
r-
C
(~.j
t,
'\.,'~..
o
-"';;1
,;;1-
..~.-'
;:::
,
.........--
()
(1.
~ "'I
.,'~.,...J
C')
'",.1
()
r',
'-'
::~::-jla
?
o
............
..r~_
-Q
-''\
.....
(L
(.J
u
LJ
a..
a::
u
Ul
o
2
cr:
~
l--/
~ ~ I
C\J 0
'" (f)
~ ~
I 01
~ cu
~I 0) .
~ n
~ ..
If) I
:::r: ~
(\J
M C\J ~
C\J <..:> I- 00
:z 0 "" wi
0 ~ ::> ..J
..... Ul Cl => i z
o;t- -, >-
C :z z u ~
.~~ (f) en - - I .
0 - 0 -
'to , 3 a ~ .
:; 0 5 0 .
u " 0
., .
"
,~
-
.-
! .... ~
M a 0
" <::t '" CD
CO ~I
~ tl " ci
g -' P-
o
~ -' ..
0
.; - .
" ~ ~
.. .. ~
c; .... ~ ~
::l u ...
.. ~
~----
~
i
C!~
0.
-a:
sf
'"
...c:
:~
t,
.c
.,
'-
v
W
2
0
::r:
a..
w
..J
W
U I-
a::
L..- '"
L> j:....
W X
~ 10
W
I
'..J
Z
W
a::
I-
Cl
W
(f)
'='
CL
o
0::
Q..
w
,
<r
I
C\J
I
~
- I
ct:
~
VJ
~
f--...
l7.
C
";:
ell
Cl
C
'0
c:
U,
OIl
":Jt
'-
o
$
~
.Q
::r
Q.
oj
.>
(;~;
()")
~
h....
C)
<:
-
".2!
I'.dI
U
'"
01
~..:..J
\~.,-::.
'-"
<:l
a::
I-
W
=>
o
o
C)
"-
2
:z
o
l-
e)
W
If)
:::r:
U
2
W
a::
I-
m
If)
Cl
:z
a:
U>
.
C\J