96-151
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DEPT. OF PUBLIC WORKS
70 North First St.
Campbell. CA 95008
(408) 866-2150
Fax (408) 376-0958
(for working within th,
public right-of-way)
,/ 0/
Issued 9-/ k: .' f/~
Permit expires in 12 mos. ~-11
X-Ref. fill:
Application Da/-~ -516
Application expires in 6 mos.
APPLICATION. Applic:alion is bercby IIIIlIe for. Public Worb Pamit ill acconIaace wilh CaIIIpbdI MuaicipaI Code. SectioD IUM. (ApplicadoD aplrel i116111111Mbs
if lbe permit is IIOl issued. Applicalioa Fee is Zle.)
A. Workaddras orlrlll:t' /;t,~~ ~ '/C't #'~ 1 rntc-/ A~.t:5'c9./6
./
Utility lI'alCb IocIlion .
B. Nllureofwork ^ >k/ /~b' /'2?t-em~J7~'
C. AIIICh four (4) copies of au qineered plaos Ibowilla lbe IocIIiaa aDd CllIaIl of lbe wmt. aDd four (4) copica of lbe pnIim1n1ry EaaiDeer'I I!ItimIIe of wort. The
pIaos IbaI1Ibow lbe relation of lbe propoaed work to exiItiDa III1'face aDd \IIIdqrouDd ~. Wbeo IppI'OYed by lbe CIly EaaiIIecr, laid pIaa IIec:oa8 . part of
1hiI permit.
D. All work Iball confonn to Ihe City of ~ SlandanI Specmc:.ioas aDd DecaiIs for Public Worts Conslruaioo; lbe GeaInI Permit r_m..." lilted OIIlbe _
lide; and the Special Provisions for lhis permit, listed below. Failure to Ibide by lheIe COIIdiIioaI aDd provisiool may rauIt ill job 1but-doWD lI1tdIor farfeilure of FaiIhfuJ
PafOl1lllllCe Sureties IIId cash depoao. (See GeaenI Permit CoIIdiUons llIId 2.)
E. THE CONTRACTOR MUST HAVE TIDS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS DEPARTMENT AT
LEAST TWO DAYS BEFO G WORK. NOTlCEMUST.BE.GIYEliIO ~JJC WO~ AT ~ ~ H01}RS BEFORE RESTARTING ANY WORK.
~ofAPPlicanl' . L./17~c7VA/ ;~c ) (J!,'/1/2,./I/L;'kZ,j 1~;.::?tb~~:J7#d
(print DaIIle) 24 K>UR EMERGJH:Y
// ,,/
TELEPHONE NO.
Address
Is Ibis worlt beiDa done by the property owner at tbeir own residence? Yea
The ApplicantlPermittee hereby aarees by aff'Wna tbeir lipaaure to lhis permit to bold die City of CaqlbeU, ill ofticen, IpID IIId employees !Re, safe IIIlI barmleu from
any c1aim or demand for dama&ea resulq from lbe work co by lhis .
lbe froal aDd ba of 1hiI permit, IIIlIlbey wW iDform tbeir ClIIIIJ'It:lDJ'I) of lbe
'Hr//7er5 _? .2 "? L
Accepted
""
CITY OF CAMPBELL
:)EPT. OF PUBUC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working wi1hin the
public right-of-way)
"ennit No.
(-Ref. File
9~ -/5/
Issued
Permit expires in 12 mos.
Application Date
Application expires in 6 mos.
4/sJq(p
APPUCATION - Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application
expires in 6 months if the permit is not issued Appli~" Fee is ~refundable).
A.Workaddressortract# /R~ d:12r/./~# ~~, Trtlet ~~~4~,
Utility trench location
B. Natureofwork ~/~~ /~~~~,
C. Attach four (4) copies of engineered plans showing the location and extent of the work, and four (4) copies of the preliminary Engineer's
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by
the City Engineer, said plans become a pan of this permit.
D. All work shall conform to the City ofCampbcll Standard Specifications and Details for Public Works Construction; the General Permit Conditions
listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and provisions may result in
job shut-down and/or forfeiture of Faithful Performance Sureties and cash deposilS. (See General Permit Conditions 1 and 2.)
E. THE CONTRACTOR MUST HAVE TInS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS
DEPARTMENT AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS
BEFORE RESTARTING ANY WORK.
Name of APPlicant/Permittee,X \~ '" l k-:: \ ~ ~ eo '----
Address
Is this work being done by the propeny owner at their own residence'?
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell, ilS officers, agenlS and employees free,
safe and harmless from any claim or demand for damages resulting from the work covered by this permit.
have read and understand both the front and back of this permit, and they will inform their
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ENt ......JACHMENT PERMIT ISSUANCE Cl&Lo~K LIST
City-of Campbell Encroachment Permit No. ~.- \ 'S: \
Department of Public Works \"l.- ~L- \.~""" l~\-cT
~'2.. . ~~4- 6
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Applicant section complete
Applicant signature and date (front and back)
Permit Application Fee $225.00 paid - Receipt Number<q:"'LLq'l
Plan Check Deposit, $500.00 paid - Receipt Number ~.;"(....-L. C1,.~~,
Five sets of improvement plans submitted
I.--L-'"\._C-_ Engineer's Estimate of Construction Cost <i:. \. -:24 ~""2:'\-\
~-~-9'-
,..(S~,-
'''"'\.-i 'B. - 9.,,-
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(J!J{
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Security for Faithful Performance and Labor and Materials, 100% each of
Engineer's Estimate, supplied or paid.
Amount $\"1A. ~ Form I.D. # cz>b4~'2b<:~
'F"r.::I\:?: ~'\N~)~e.er a.~
Construction Emergency Cash Deposit: 4% of Engineer's Estimate, $500
minimum paid. Amount $.dAltx:), Lr:.C Receipt No.ct4~<-
Plan Check & Inspection Fee or Deposit Paid
Citv Engineer's Estimate < $250.000
12 % of Engineer's Estimate
Amount $ \.4, ~..<t'c,D , c-,c Receipt No. <3t4. ~C:>-t
OR
Engineer's Estimate > $250.000
Actual Cost plus 20 % administrative overhead
15 % deposit required
Amount $ Receipt No.
Wo.rke(~ compens. ~~n w)!r~ce lnfOrtnation, Sheet ~ece.l'ved f9r ~p. plicant
ti~C-'0L-,#/e..- ". //c.:lL:~. ~~"~j-?-nr/'..J ~,~/I?~
~'y~J'm .,/ " ... .eXe,m. /.;. '::f'~r.:. /.
t6ther app~e ~~U1rement Ist6d'i'rthe ~ondltlons of Approval of the
development.
Worker's Compensation Insurance~d Contractor's Licensing Information
Sheets received from Contractor C-~{~DlI'r-
Certificate of Insurance with Additional Insured's Endorsement received from
Contractor
C!J::{ Three sets of off-site plans, stamped APPROVED (Tract or Development and
~ '~~~'~~~;~~~"~J~OP~~d96 o~ plans) /1.
eX Pennit signed by City. Engineer or representative j:J ~j/ #.
WHEN ALL OF TH~ ~?'7 ITEMS ARE COMPLETE, ~E~ MAYBE ISSUED
Issuer: Initial ~ aod dale ~;,./"9 t and file with pennil.
~ UPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK
DEPOSIT REFUND
j:\forms\pmtcklst rev.3/96 and 6/96
Approved by: Michelle Quinney
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount Payable:
Account Number:
Date and Receipt No:
Permit No:
Purpose:
Requested by:
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is:
Return To:
Cit: of Gampbell- Chel ..~ Re~uest
Littleton place Partners
54 N. CEntral Avenue
Campbell
State: CA
Zip:
95008
REFUNDABLE DEPOSIT
Finance Only:
INTEREST EARNED
$4,430.08 *
101.2203 101.540.7448
7/15/96 Rec. #94806
*Deduction from original deposit
of $4,960 for overtime inspection.
$4,960 - $529.92 = $4,430.08
$529.92 should be transferred to
account
#435.535.472
96-151
Final inspection - improvements accepted.
Maintenance
Period begins.
Robert Phillips ~~ ~
PW Inspector
Title:
Date: 8/29/97
,ttW
-
Title: City Engineer
Date: 8/29/97
0_1
I
Title:
Title:
Date:
Special Instructions For Handling Check
Mail in Attached Envelope:
(Department)
Other:
(NAME)
rev: 3/25/95
-,
Actual Plan Check and Inspection Charg..
/
1
!
!
Name
Invoice/or
PPE
Date
Invoice/or
Hourly
Rate
om.
Received
06116/96 39.22 55.20 1.00 66.24 10109196
11/03/96 39,22 55.20 7.00 463.68 11/06196 I
I
8.00 529.92 )
2.00
Littleton Place (96-151)
Westfall. Randy
Westfall. Randy
Grand Total
Subdiv
OT
Hourly
Rate
Staffl
Invoices
Incl 20% OH
Regular
Hours
Overtime
Hours
/
/,~
190.962.65
// -
I' 0.00
6/11/973:12AM
15
To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line 1:
Line 2:
City:
Description:
Amount-Payable:
Account Number.
Ioate and Receipt No:
Permit No:
Purpose:
Requested by:
Approved by:
FINANCE ONLY:
Verified by:
Approved by:
Mail As Is:
Return To:
Other:
I
rev: 3/25/95
City of CampbeIl- Check Request
.:::& .'~.' ,.,'
....:.~:.~'~...
LITTLETON PLACE PARTNERS
54 North Central Avenue
Campbell
State: CA
Zip: 95008
REFUNDABLE DEPOSIT
Finance Only:
INTEREST EARNED
$ ~~~ 2,000.00
101.2203 101.540.7448
7/15/96 #94805
96-151
Monumentation has been set. Engineer/Surveyor has been paid.
Okay to release monumentation security.
Harold Housle
Title: Land Dev. Engineer
- Date: 8/4/97
Michelle Quinney
Title: City Engineer
Date: 8/4/97
Title:
Date:
Title: Date: I
Special Instructions For Handling Chec~
Mail in Attached Envelope: I
MARLENE POMEROY
(NAME)
PUBLIC WORKS
(Dep:u:ment)
CARROll
. E:~~~~rveyon
Tel: 408-265-4770
Fax: 408-265-4772
E-mail: becarroll@aol.com
3150 Almaden Expressway Suite 103, San Jose, CA 95118
July 7, 1997
RECEIVED
JOr 08 au
Mr. Chuck Gomez
City of Campbell
70 North First Street
Campbell, CA 95008
I-'UJi..i( VvVj~t...~
ADMINISTRA T!O~
RE: 1222 Harriet (Littleton Place) - Tract 8846
Dear Mr. Gomez:
Per your telephone request, this letter is written to advise you that the monumentation for
Littleton Place has been set. We have been paid in full for the project.
If you need any further documentation, please advise me.
Sincerely,
CARROLLENGTINEERING
a~~
BEC/Im
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Dollars $
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{JUtN CU6CIL -.::. 506 .00
- $ "0'7 (.Ot>
AMT. PAID
CHECK
BALANCE
DUE
MONEY
ORDER
By
i
CASH<:
RECBPT
Date
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19 a /~ .", ; i ; '; :~.) )-, i
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Received
Address
For i::S -
AMT. PAID
CHECK
BAlANCE
DUE
MONEY
ORDER
By
i
PUBLIC WORKS DEPARTMENT RECEIPT
EffecIive July I. 1996
0: City Cleo!< PUBUC WORKS FILE NO. "r<7- 9.~ -V /
~:?~ 7. ~;:1 _ 7;7//
PROPERTY ADDRESS
Please collect &;receipt for the followinamonies:..
ACCT. I . ITEM ..AMOUNT
435.535.4921 Proiect Revenue 'ect) S
ENCROACHMENT PERMIT
4122 AppliC8lion Fee
Non-Utility EncroIIchment Permit ($225)
R-I First Permil (No Fee). Su........... PermitlYr (SIOO\
Utility Encroachment Permil
ArteriallCollector Street S32S\
Residential StteetIOlher Arus S22S
2203 Plan Check ~it- 2".4 ofENOR. EST. SSOO miRl .
2203 Faithful Performance Securitv lFPS) 1000ofENOR.EST.) .
2203 Labor IIId Materials Security 100'.4 ofENOR. EST.)
2203 Monumentation Security 100% ofENOR.EST.) .
2203 Cash Deoosit 4% ofENOR.EST.lISS00 minlSlO 000 max) .
2203 Labor and Material Security 100% ofENOR. ESTJ .
Plan Check &; Inspection Fee (Non-Utility)
4122 Engr.Esl. < $250.000 (12% ofENOR. EST.)
.. 2203 Enw.Est.>S25O 000 ffienooit8% ofENOR. EST.1S30 000 min.)" .
4122 Utili'" < S 100 000 (B".4)
Minimum ChIrae Per Locolion (S120)
ConduitslPipelines up to 500 Feet (S1.60Ift)
Above 500 Feet (S1.101ft.)
ManholesIV IUltslElC. (S 1 OS/ea)
Pole Set/Removal (S I OS/ea)
Street Tree PlllltinRiRemoval is I OS/tree)
.. 2203 Uti~>SIOOOOO Actual Cost + 20% .. .
4160 Pro'ee1 Plllls &; SpecifiC8lions Pro' eel No.
4160 Standard SoecifiC8lion. &; Detail. (SI/PR Sl2/Book)
4160 Cooies of EnRineerinR MlDs &; PIIII. (S.SO/so.ft.)
4122 Penalties: Failure to restore public improvements (S I OO/Calendar Dav)
IMuni Code Section 11.34.010)
4122 Penalties: Failure to conect unsafe conditions IS I OO/Calendar n;;;)
LAND DEVELOPMENT
4122 Lot Line Adiustment SSOO) ~
4122 Parcel MID (4 Lots Dr Less) SI 060 + S2SILoI) / ..";'/! I. ~
4122 Final Tract Man (5 or More Lots) SI,380 + $2SlLot) -
4122 Certificate of Complilllce SSW
4122 Certificate of Correction S3(0)
4122 Vacation of Public Streets &; Euements SSSOl
4122 Assessment Segregation or Reapportionment
First Split (SSSO)
Each Additional Lot (SI10)
4121 Stonn Drainage AJea Fee Per Acre (R-I, S2.(00)
(Multi-Res, S2.2S0)
(All Oth.... S2 500)
4920 Parklllld DediC8lion Fee
4965 Po......e
TRAmC
4128 Intenection Turn Counts (Two-Hour Count) $60)
4128 Intenection Turn Counts (am. or p.m. neaIcs) S125\
4128 Traffic Flow M~ m.ilv Traffic Volumes) 521)
4128 Comnbell Traffic Model (Full Scone Assessment 52,250\
4128 Comobell Traffic ModellReduced Scone Auessment) S14O)
4211 Truck Pennits 53Sltrin\
4128 No ParkinR Sion. S lleach or S2S/1 00)
OTHER
- -A
TOTAL S /6/.'?~ tJ
~ nf </7 /;:r~//!- ,-~// ~Y:C1 t/i &~~
NAME OF APPLICANT
.~ " /)L;"1// ~.y'7Y?:7~ /77 ..:z:-,l/7C "
NAME OF PAYOR / ....,- /'/7/7C PHONE
'7 h4;7 rY L/.--~ 'Z .::, -; / --' ~ ...s/~ c:7
ADDRESS ZIP
,-
.. Actual Cost Plus 2()1.4 Overbead lNon,Interest bearinR denositl
#t' -
>,/;4/ A?,,4/r/~y
FOR
CITY CLERK
ONLY
I.~.
,---_..... . ... ---. .,., ."." " '" ,..""'.-------...".....
.---..--, ,.... - .,.., '" ",.- ., .", .,.-""",.
lUlClllVE[lJ:l'.1 .......... ........ . .... ..... ......... ....... d.... .......dd.
"'/ii/-/.:~CjjQi
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RECEIVED
JUl 2 3 1996
CITY CLERK'S OFFICE
I"For Plan Cbeck and Caih Deposits, .aid yellow coPY to FilllllCC.
~)lIill"s
h:\recfnn4 .wlc3(mp )rev1 11/96
"'-. ,
/; ~';;
.....
'.'
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..
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I
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'",,:t:
F~EC~.T BY; LI.SAB
CITY
Ur
r-L!.iNir; i _
~'::.:: ""......-..
t'i,'vTif:': Wi1C:TT i.~.~~ T;rU;i ;~C:~:tJ
TODAY:' S"DATE;'.07/Z3/96 /'
REG1STEF~ DATE:
[!ES~RI PTIori
& ~JfDi~ FILING F
A MOUNT
CHECK PAII!:
CHECK
.!:....
f~l...; ..
7Ci.jnL~'CTi.
I i..i~i.~ :...?\ :"1: I:
CHANGE =
:.\.,.
,Vi ':1)1 ir&.(
Vi; ~'J; /'.J
CA
01000094990
Ti~r.
i.i,ii;..C
1i .;:ry .'....Ci
..u.,; CY-i
c; c::r,:: fill
".L :> ..J\i....~ . V.....
TOTAL DUE:
- --------------
$1,505:00
."it'\r'lof
"..'71
t; .. =.i\;:; (1:1
'T.. ....... '10:'....1: 'II V
e; =:/\;:: t)t;
or.. :"'\o.'.,,'w. ;"\.)
t fir,
~ c "0 \:
. 0 .'0,
,.".,' .'.
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...
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(,
10: uty Clerk
Please l'('i'- -. and receipt
for the : iIlg monies.
^ ./.c...:) 9' - -- -(.....f
~HJeN"'1 . ~
IV. Q1W&
~~ ~
General Plan Text IS.oo
Zoning Ordinance 22
Copies (per page) 1
Refundable Deposit - Account 2203
Fire Department Review - Account 01.303.3322
Architectural Approval S>
Project Plan Review 15)
Subdivision 100+ 10 per lot/unit
Park Impact Fee - Account 295.535.4920 .' A 3 ., , ? C7 0 0
! 7" ~;;y- 0- ~LI,J ,S-d V}/ '
For Oty Oerk Only: Rea!ptl'Jo.:~~ R E C E IVED
AlmuntPaid: _ a an
Rm!iwdby, U~~ JUl 1 8 1996
I'\tp
CITY CLERK'S OFFICE
Excepti!)n for Major Projects: It is anticipated that the application processing costs of
selected major projects will significantly exceed the above fees. In these cases, the
Community Development Director may collect a deposit and charge actual time spent to
process the application based upon current hourly rates.
Note Adopted by Resolution No. 8841 by aty Council, aty of Campbell, 6/20/95.
ITEM
I. Miiac
A. 1+ acres - General Plan Amendment
Zone Olange
Planned Development Permit
EIRReview
AMOUNT
S4,425
4,425
4,425
4,425
3,225
3,225
3,225
3,225
B. 0-1 acre General Plan Amendment
Zone Owtge
Planned Development Permit
EIRReview
II. MiDar&
A. Subdivision Map (5+ lots)
Site and ArchitecturaI 10+ K S.F.
Tentative Parcel ~p (4<Lots)
B. Site and Architectural 0-10 K S.F.
Variance <Non-residential)UText Amendments
Use Permit
3,225
2,150
2,150
1,550
1,550
1,sso
1,550
III. Miscellaneous:
A. Variance <Residential)
Modifications of Approval
Modification PD Permit
Reinstatements
Revised Development Schedule
Extensions of Time
960
960
960
960
960
960
B. Lot Une Adjustments SD
Site and Architectural (Res.) (Each House) 120
Signs (Each Sign) 120
Fence Exc:eption 120
Promotional Events 120
C. Appeals 0
Downtown Development Permit 0
Historic Preservation Zone, Use Permit, HP Permit 0
PUBLIC WORKS DEPARTMENT RECEIPT
EfI'eclive July I, 1996
TO: City Clerk PUBLI,C WORKS FILE NO. ~ ,- l ~ 1
\""'"2..'"2 "2- \:.~\-eT 'Tn.... ~
PROPERTY ADDRESS \ .
Please collect & receipt for the followins monies;
ACCT. f rt:EM ............... ............ ........... .. ......... AMOUNT.
43S.S35.4921 Pro' ect Revenue (snecifv DrOiect) S
ENCROACHMENT PERMIT
4122 Applicalion Fee
Non,Utility Eneroachmcnl Permit (S22S)
R-I First Pennil (No Fee), Su_uent PermitlYr (S I (0)
Utilitv Encroachment Permit
ArteriallCollector Street S32S)
Residential StreetIOIher Areas S22S)
2203 Plan Check Deoosit- 2'~ ofENGR. EST. SSOO min) .
2203 Faithful Performance Securitv IFPS) 100% ofENGR.EST.) .
2203 Labor and Mmaial. Securitv lOO"~ ofENGR ESV
2203 Monumentation Securitv 100% ofENGR.EST.) ....,. .~ 0';;:;;
2203 Cosh Deoosit 4% ofENOREST.lI5S00 min/$IO 000 max) .4 ;q 4>0.<-:"':'"
2203 L8b0r and Material Securitv 100% ofENGR EST.) .
Plan Check & lnapection Fee (Non,Utility) \4-. ~- ..
4122 Engr.Est. < S2S0,OOO (12% ofENGR. EST.)
.. 2203 Enw.EII.>S2S0 000 meM.;18% ofENGR. EST.1S30 000 min.)" .
4122 Utilitv < SI00,OOO (8%)
Minimum ChlIrIIe Per Locotion (SI20)
ConduiulPipelinea up to SOO Feet (SI.6O/ft)
Above SOO Feet (S1.1 0Ift.)
ManholeaIV 8UltsIEtc. (SIOS/ea)
Pole SetlRemovaJ (SIOS/ea)
Street Tree PlantinlliRemoval SIOSItree)
.. 2203 Utilitv > SI00 000 Actual ColI + 2()o~ .. .
4160 Proiect Piano" Soecificaliono Proiect No.
4160 Standard Soecificalions & Details (SI/Po 5121Book
4160 Conies of Enoineenno Mans & Plans (S.SO/"".ft.1
4122 Penalties: Failure to restore oublic imorovemenlS (SIOO/CaIendar Dav)
(Muni Code Section 11.34.010)
4122 Penalties: Failure to correct unSlfe conditions 5 I OOlCalendar Dav)
LAND DEVELOPMENT
4122 Lot Line Adiusunent SSOO)
4122 Parcel Man 14 Lots or Less) 51 060 + S2SlLot
4122 Final Tract Man (S or More Lots) 51,380 + 52SILotl
4122 Certificate of Compliance SSOO)
4122 Certificate of Correction S3(0)
4122 Vacalion of Public Streets & Easements 5SS0)
4122 Assessment Segregation or Reapportionment
First Split (SSSO)
Each Additional Lot 151101
4121 Stonn Drainage Area Fee Per Acre (R-I, S2.(00)
(Multi-Res, 52,2S0)
(All Other, S2 SOO)
4920 Parkland Dedicalion Fee
4965 Postaae
TRAFFIC
4128 Intersection Turn Counts (Two-Hour Countl $60)
4128 Intersection Turn Counts Ia.m. or o.m. oeaks) 5125)
4128 TrUlic Flow Mao (Dailv TrUlic Volumes) S21)
4128 Camobell TrUlic Model Full Scone Assessmentl S2 2Sm
4128 Camobell TrUlic ModellReduced Scone Assessmentl S14O)
4271 Truck Permits S3Sltrio)
4128 No Parlcino SilinS SI/each or S2S1I(0)
OTHER
TOTAL S"2..\ '~ri>ltb
NAME OF APPUCANT L. \. --r-r<..JE::? PI..~c..E-~~~->
.
NAMEOFPAYOR l L-rt"'l k--l ~ ~c...e- R~ '~\2-'S.. PHONE
ADDRESS c:-...a- w. e:-=- ",,'~ ~'~F- ZIP 9S:CJ~
"Actual COli Plus 2()o~ Ovem-l CNon,lnteresl bearina deoositl
.For Plan Cbeckand Cash Deposits, Send yellllw copytO FilUlllCe.
Q4YJr
FOR
CITY CLERK
ONLY
RECEIVED
jUl 1 5 1996
CITY CLERK'S OFFICE
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CITY OF CAMPBtLL~ CA
RECVD BY: LISAB 01000094807
PAYOR: LITTlETON PL. PARTN
TODAY'S DATE: 07/15i96
REGISTER DATE: 07/15i96 TIME: 16:18:18
DESCRIPHON
ENGR & SU~DI~ FILING F
AMQUNT
$14,880.00
CHECK PAl!!:
CHECK NO: 102
TENDERED:
CHliW......
11 nlUt I
TOTAL DUE:
$14 ~ 8&) :00
$14 ,880.00
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CITY OF CAMPBELL, CA
RECVD BY: lISAB 01000094805
PAYOR: LITTLETON PLACE PAR
TODAY'S DATE: 07/i5/96
REGISTER DATE: 07/15/96 TIME: 16:16:20
. [!ESCP1PTI(j~ AMuUNT
REF DEPOSITS FUND 101 $2,000.00
Tii/pi ilUE:
'2~OQij .00
CHECK PAID:
CHECK NO: 102
TENDERED:
CHANGE :
$2,000.00
$2~OOO.OO
$.00
~
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CITY OF CAMPBELl~ ,CA
. \ ~
RECVD BY: LISAB 0100')094806
PAYOR: LITiLETON r. PARTNE
lODAY'S DATE: 07i15i96
REGISTER DATE: 07Ji5i96 TInE: 16:17=20
DESCRIPTION AMOUNT
REF DEPOSITS FUND 10i $4,9Mi.OO
----------------
TOTAL DUE:
$4,960.00
CHECK PAID:
CHECK HO: 102
TEHUERED:
CHANGt:
$4,960.00
$4,%0.00
$.00
~
"
". .
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To: Accounts Receivable
Please Issue Check
Payable to:
Address - Line I:
Line 2:
CiQ jf Campbell - Chec~_ ReJl-uest
B & C Properties
c/o Littleton place Partners
54 N. Central Avenue, Suite 2
City:
Campbell
State: CA
Zip:
95008
Description:
Amount Payable:
Account Number:
REFUNDABLE DEPOSIT
Finance Onl)'1
INTEREST EARNED
$ 500.00
101.2203 101.540.7448
ate and Receipt No:
Permit No:
4/5/96 #92298
96-151
Purpose:
Permit issued, refund plan check deposit.
Requested by:
Harold Housle'-
Title: Land Dev. Engineer
FINANCE ONLY:
Verified by:
Date: 9/17/96
D 9/17/96 I
ate:
Dm:~
Date: I
Approved by: Michelle Quinney fUJ< ~
Title: City Engineer
Title:
Approved by:
Title:
Mail As Is:
Special Instructions For Handlillg Check
x
Mail in Attached Envelope:
Return To:
(NAME)
(Department)
Other:
~v: 3/25/95
PUBUC WORKS DEPARTMENT RECBPT
Effective July " 1995
PUBlIC WORKS FILE NO, 9~ - /~~/
PROPERlY ADDRESS ~ Ai;;; ~.... -/ e, ~ Ae.
=:~ig:~~~~E~~i;E~~~:1!r~I~~I;"'.:~~':.. . .... . .. ". ..... .:"':':::~::::::}}}}}}}}:~:::{:))""".'... ::.~..::>.
ENCROACHMENT PERMIT
472. ADDliclltion Fee
Non-UtIIity Encroachment Pennit ( t2251
R.1 F'nt PennitINo Feel. Sub.eouent Pennit/Yr $1001
Utilitv Encro8Ctvnent Pennit
ArtIIriellCollector Street
Rnidentl.1 StIHtTOther A.....
P1.n 0MIck Deaalit
F.ithful PerfonMnce S- CFPSI
Monumentation s.--..-
Caah De.....it
Labor .nd M.teriaI S-'
P1.n Check &. InaDectlon Fee CNon-UtllitY)
Enar.&t. < *250.000 112" of ENGR, EST.I
EMr.EIt..> *250,000 IDe.....it 15" of ENGR. ESTJ"
UtIlItY < $100.000
Conduit./PIDelIne. UD to 500 Feet 1$1 .60/ft,1
Abo_ 600 Feet 1$1.10/ft.1
M8nhoInNlIUItI/Etc. 1$105/e.1
Pule Set/RemovaC ( $1 05/e.1
Minimum 01_. Per Loc.tIon ($1 201
Street T.... P1_/RemovaC '$105-1
UtilItY> $100 000 DeDO.it 15" of ENGR. EST. ..
Proiec:t Plana &. S~.n. Proillet No.
St.ndard S-ation. &. Det.il. $1/Po $1218ookl
Cooie. of E Man. &. Plan. It, 50/.0. ft.)
PenaCtle.: F.... to I'8lItDN nubile ImIllO_ment. '$100 Calendar 0...1
IMwll Code SecltIon 11.34.0101
472 PenaCtle.: F..... to con.ct unllf. condition. Cl100/Calendar DPI
LAND DEVELOPMENT
4722 Lot l.lne AdlUltment
472 Pan:el MID 14 Loti or La.1f
472 final Tract l.iiD15 or Men LotII
472 Certificate of ,..-&1_
472 Certificate of eorr.ction
472 Vacation of PubIIo StrMtI &. Eanmentl
472 A.__ Seareaatlon or Re_rtIonment
Am SpIlt
Each Additlonel Lot
472 Stonn Dr.un- A..a Fee Per Ac..
TO: City Clerk
496
TRAFFIC
472
472
472
472
472
427
472
OTHER
~~A
220
220
220
220
220
1$3251
$225
$6001
(100" of ENGR.ESTJ
100" of ENGR,EST.
14" of FPSU$600 min.1
100" of EN GR. EST.!
,., /JT~
...
472
220
472
220
47Rl
47&
47&
472
$5001
$1 060 + U5/Lot
$1 380 + US/lotI
$400
$3001
$550
1$6501
'$170
1R-1.U.0001
lMultJ..Re.. U.2501
IAI Other U 5001
Pult-e
Intenactlon Tum Count. ITwo-Hour Countl $601
Inte....ec:tIon Tum CountI1a.m. or n.m. -aka $1251
Traffic Flow M... /D.1Iv Tr.ffIc Volume. I U1l
CamDbell Traffic ModellFull Seo- A.....ment) $2 2501
c.mDbeII Tr.ffIc Model/Reduced Sea.... A.....'" $7401
Truck PennItI $351tria1
No P.rk..... ~. $1 alCh Dr *25T100'
g.
TOTAL
$ '7~h
r
~~-
. . --
NAME OF APPliCANT -' 'LF A
I'-
NAME OF PAVOR / / //
ad./.'1Z ;?- - / .- / V~I/T.
~k/~~ ~,# J P";.- ..04 ~ ~J/
-.-
.For Plan Check end CiiIh o.polihl, ... yellOW llOPY tll fttiIirIc:e,..,.f.
....ActU.1 COlt fkl8. 20" 0 .::~ NOfto.IntihHtbliiOriMd......IltJ. 'l'Jate al~>1
ADDRESS
-
c:rI'fCUU
-.w
._f?
~ - ~- .-AI ..../
PHONE ~ /.K~
ZIP 9..
77:)
li~c:~
1\'1'0
APR u 5 ~
CITY .. rsS6
CLft:;fS OFFiCe
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J:
City Clerk
PUBLIC WORKS FILE NO.
Ufv-.
,
(f . )
~ /
Please coiled & receipt
for the following monies:
.5-3396
CCT, ITEM AMOUNT RECEIPT NO.
$
3372
3521
3521
3521
3372
3373
3373
3373
3373
3372
3372
3372
3372
3372
/337Q /
;338Q
/33~
~10
Project Revenue (specify project)
Public Works Encroachment Permit Fees:
Application Fee
Regular ($210)
R.1 ($58)
Plan Check Deposit
Faithful Performance Surety (FPS)
Other Cash Deposit
Plan Check & Inspection Fee (First $0-$30,000 14%; Next $30,000-
$80,000 10%; Amount Greater Than $80,000 7%; $200 min.)
Project Plans & Specifications
General Conditions, Standard Provisions & Details ($12 or $1/page)
"No Parking" signs ($1/ea, or $25/100)
Copies of Engineering Maps & Plans ($.50/sq. fl.)
Final Parcel Map Filing Fee ($1,000 + $21/per lot)
Final Tract Map Filing Fee ($1 ,300 + $21/per lot)
Lot Line Adjustment Fee/Certificate of Compliance ($500)
Vacation of Public Streets and Easements ($525)
Assessment Segregation or Reapportionment
First Split ($525)
Each Additional Lot ($160)
Storm Drainage Area Fee per Acre (R-1, $1,875;
Multi-Res., $2,060; all other, $2.250)
Public Works Special Projects
Park Dedication In-lieu Fee
Postage
($500)
(100% of ENGR. EST)
(4% of FPS) ($500 min.)
~ ~2S<;E ~;,J.&
~: "'-12 , >~ -~ 2. (.;
~
$ \ L 1~7..5rJ
I
TOTAL
'\103dac\l
Ec{, Vlui:'iOi"l,.;(l~
I.ME OF APPLICANT ~eorj~ 1\1 ,
)DRESS qt.S- VI, L.,nde/1
=OR
:::ITY CLERK
JNLY
PHONE
eft
'7~"" 07 b
ZIP
RECEIVED BY . ~~
DATE f/~--- / 9 -1
I
BOND FOR FAITHI<'UL PERFORMANCE OF MAINTENANCE l'ERlOD c.~
ULU-;o}j~/t;
We, the undersigned Li ttleton Place Partners. (hereinafter "Principal") and 7
FAR WEST INSURANCE COMPANY . a corporation organized under the laws of the Stare of
NEBRASKA . and authorized to transact business in the State of California, as Surety. are
obligated to the City ofCampbeU (hereinafter .City"), a municipal corporation under the laws of the State ofCaliforma,
in the sum of Thi Try ()n~ Thon!=:i'I nn Dollars ($l1 n n non) for the paymem of which sum
we obligate ourselves and our SUccessors and assigns, jointly and severally by the following provisions:
The condition of this obligation is that the Principal entered, or is about to enter, into a certain written Contract
with the City dated ,19 and entitled PERMIT g6-151. TRACT 1:l846
a one year maintenance period of the work described in said Contract, a true and correct copy of which is presently on
file in the office of thc City Clerk of the City of Campbell, which said agrecment is hereby referred to and made a pan
hereof. And, the City requires a guarantee from the Principal against defective materials and worlcmllm:hip in connection
with that maintenance.
Now, therefore, the Principal agrees that it shaH make all repairs or replacements necessary during the period
of one-year from the date of acceptance of the contract work, by reason of defective materials or worlcmllnsbip in
connection with the Contract. If those defective materials or workmanship occur within that period, the City shaH give
the Principal and Surcty written notice of that defect within 60 days after discovery. When each replacement is made
:u u';.;; 5atisfc.cti~il of tho; Cii.y, we obiigation of the Principal and Surety shall be discharged as to that replacement,
othr.rwise to remain in full force and effecL
of it.
Any repairs or replacements made under this bond shall in like manner be subject to the terms and conditions
No prepayment or delay in payment and no changes. extensions, addition or alteration of any provision of said
Contract or in any plans and specifications referred to herein, and no forbearance on the pan of the City shall operate
to release the Surety from liability on this bond, and consent to make such alterations without further notice to or consent
by the Surety is hereby given, and the Surety hereby waives the provisions of Section 2819 of the Civil Code of the State
of California.
In wimess, t,he parties have executed this agreement as of J UL Y 22.
,19 97
~~
Hastings Development,
Title /)~,
(Principal~
Inc.~ome. --c.-
TI~~.
~urety) FAR WEST INSURANCE COMPANY
~
THIRD ST.,#550
SAN JOSE, CA 95112
(Attach Acknowledgements)
Surety's Bond Number OObOOl:1025
(Both Principal's and
Surety's Attorney in Fact)
(h: \forms\bonds.frm)(mp)
(Accompany this bond with Attorney-in-fact's
authority from Surety to execute the bond
certified to include the date of the bond.)
NO TAli Y ACKNOWLEDGMENT
.
State of
CALIFORNIA
County of
SANTA CLARA
On
7-22-97
before me, VERONICA RAMIREZ
(here lilsert ilame)
Notary Public, personally appeared JOHN J. DALEY
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me all that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature ~ /JJI/fr
(Seal)
.................................................................,
VERONICA RAMREZ
J . Commission' lorM210 ;;
~ ... Notay Pubic - CaIfomIa !
~" Santa Clara CoultY 1
i _ _ _ _~co.:':~r:~l~~
CAPACITY CLAIMED BY SIGNER SIGNER REPRESENTING
NAME OF PERSON(S) OR ENTITY(IESl
-- - -
_ INDIVIDUAL(S) __ PARTNERIS) _ GUARDIAN/CONSERVATOR
_ CORPORATE -X ATTORNEY IN FACT _ OTHER FAR WEST INSURANCE
OFFICERS _ TRUSTEE{S) COMPANY
-
SUBSCRIBING WITNESS
ATTENTION NOTARY: Although the information requested below is OPTIONAL. it could prevent fraudulent attachment of this certificate.
THIS CERTIFICATE MUST Document Tille or Type: MAINTENANCE BOND
BE ATTACHED TO THE
DOCUMENT DESCRIBED Number of Pages: ONE Document Date: 7 -22-97
HEREIN:
Signer(s) other lhan named above:
A 'IN.A9016 iRev. 6 g..l ~l
State of &.-v, ~ / A
County of 0fh\.JY A- (!L-PreA
On UEPf'/'lY1P.;fJ? 7~ Iqfie;ore me
DATE ~ '
personally appeared 70 (Y1 f? f5U~
NAMES(S) OF SIGNER(S)
( ) personally known to me - OR 1\1_
- ~roved to me on the basis of sa~factory evid~nce to be the person~hose name1w<'
lS~ subscnbed to the WI'thin . ~
kn lDStnunent and
ac o~ledged to me that he/<!ft(e/'~' executed th
same mhis~' ,~~ e
that b hi . I: u~~_~ed capacity~, and
y s IgnaLlU~) on the instrument the
person~ or the entity upon behalf of which the
person~acted, executed the instrument.
r. SHANA GARO .~-
_ . Comm, # 1141349
lJ) ~ -. NOT ARY PUBLIC. CALIFORNIA ~
t Sanll Clara County ...
. . : . MV Comm: Exp~rtl June 7,2001 )
CRIPTION OF ATTACHED DOCUMENT
DESCRIPTION OF DOCUMENT (OPTIONAL)
s~
County of ,-~M.t.. C\ v-
an ~ 2(0 \l\C{'l before me, ~ ca. ~i,\\"-
Notary Public, personally appeared ~Do.... ~'-.Q.~
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscnoed to the within instrument and acknowledged to me that helshelthey executed the
same in hislherltheir authorized capacity(ies), and that by hislher/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
t 55,
CD... . . ~
Title or Type ofl)ocumel\t ~
State of California
Nwnber of Pages
Oau. oCl)ocumeI\t
Signer(s) Other than named below
(Seal)
'\ A. -.. .A.... A.. .-... _ -.. -.. .A.. -. .A.. ....... ---1
0... ,~""". A. S. MILLER ~
. . Comm #1024093 Gl
Cl : NOTARY PUBLIC CALIFORNIAn
~ SANTA CLARA COUNTY ,
J.~C:;F .: '~ ~c~: ':P~M~ ~" ::9~ t
WITNESS my hand and official seal.
S. ~
19nature .
FD-1 (Revised 1/93)
D DOCUMENT
BOND FOR LABOR AND MATE' \L
We. the undersignedLITTLETON PLACE PARTNERS. (hereinafter "Principal") andFAFi WEST INSURAHCE
COMP AN X a corporation organized under the laws of the State of MF.R R A .~J( A . and authorized
to transact business in the State of California, as Surety, are obligated to the City of Campbell (hereinafter "City"), a
municipal corporation under the laws of the State of California. in the sum of One Hundred Twenty-Four Thousand
Dollars ($ 124,000,00 ) for the payment of which sum we obligate ourselves and our successors and assigns,
jointly and severally by the following provisions:
The condition of this obligation is that the Principal entered. or is about to enter, into a certain written Contract
with the City dated 1-J\J~L':.r L., ,19 qf:; . and entitled Permit 96-151, Trac,t
a true and correct copy of' hich is presently on file in the office of the City Clerk of the City of Campbell, which said
Contract is hereby referred to and made a part hereof.
8846
Because Principal is required to furnish a bond in connection with the contract, providing that if Principal, or
any of its subcontractors, shall fail to pay for any materials, or other supplies, or for any work or labor on the contracted
work of any kind, or for amounts due under the unemployment insurance act with respect to any work or labor on this
project, the Surety on this bond will pay for the debt. in an amount not exceeding the sum specified in this bond, and
also, in case suit is brought upon the bond, a reasonable attorney's fee to be fixed by the coun,
Now, therefore. we,LITTLETON PLACE PARTNE~~ Principal, AND FAR WEST INSURANCE COMPANY
_' as Surety, are obligated to the City of Campbell, in the sum of $ 124,000.00
lawful money of the United States, for the payment of which sums will and truly to be made, we the said Principal and
Surety bind ourselves, successors and assigns, jointly and severally, by these provisions.
The condition of this obligation is that if Principal, its successors or assigns, or its subcontractor, or
subcontractors, shall fail to pay for any labor, materials, or other supplies, used in the performance of the work
contracted to be done, or for amounts due under the unemployment insurance act with respect to this work or labor, then
the Surety on this bond will pay for them, in an amount not exceeding the sum specified in this bond, and in case suit
is brought upon this bond will also pay a reasonable attorney's fee, to be fixed by the court.
No prepayment or delay in payment and no changes, extensions, addition or alteration of any provision of said
Contract or in any plans and specifications referred to herein, and no forbearance on the part of the City shall operate
to release the Surety from liability on this bond, and consent to make such alterations without further notice to or consent
by the Surety is hereby given, and the Surety hereby waives the provisions of Section 2819 of the Civil Code of the State
of California.
In wimess, the parties have executed this agreement as of AUGUST 5
, 19.2L.
~2
r- ,- en, President
B&C Homes, Inc.
(principal)
By LI~~~-=1~4ce ~~~S
c:::--:r- -u-~ - hAs''' \ ""'7~ ~
--- )
Tffie---- , - \. I "/
. ,~ / ',/\..- I
(Surety)
Address of Surety: 2105 SO. BASCOM AVE., #370
CAMPBELL, CA 95008
-
(Attach Acknowledgements)
(Both Principal's and
Surety's Anorney in Fact)
(h: \forms\bonds. frm)(mp)
Surety's Bond Number 00600(3025
(Accompany this bond with Attorney-in-fact's
authority from Surety to execute the bond,
certified to include the date of the bond.)
,
\-L'
V
NOTARY ACKNOWLEDGMENT
Slate of
CALIFORNIA
County of
SANTA CLARA
On AUGUST 5, 1996
before me.
VERONICA RAMIREZ
ROY G. FLETCHER
(here insert name)
Notary Public, personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me all that he/she/they executed the same in hislherltheir
authorized capacity(ies). and that by hislherltheir signature(s) on the instrument the person(s), or the entity upon behalf at
which the person(s) acted. executed the instrument.
WITNESS my hand and official seal.
Signature
(Seal)
J......-............................................
=< fi' c~=~~o f
f -.. Notary Pubic - CaItomIa I
" . Santa CIaIa Cotnty -
j _ _...M:~~~I:~l
, CAPACITY CLAIMED BY SIGNER SIGNER REPRESENTING
NAME OF PERSONISI OR ENTTTY(lESl
- L- PARTNER(S) -
_ INDIVIDUAL(S) ~ GUARDIANlCONSERV A TOR
_ CORPORATE :x ATTORNEY IN FACT ~OTHER FAR WEST INSURANCE
. COMPANY
OFFICERS '"""'; TRUSTEEiS)
CJ SUBSCRIBING WITNESS
I ATTENTlON NOTARY: A1lnouQn Ine Information reauested belOW IS OPTlONAL It could Dravent fraUdulent anacnment Dt this cemticatl.
THIS CERTIFICATE MUST Document TiUe or Type: PAYMENT BOND
BE ATTACHED TO THE
DOCUMENT DESCRIBED Numoer of Pages: ONE (1) Documenl Date: AUGUST 5, 1996
HEREIN:
Signercs) other than named aoove:
READ CAREFULLY
This document is printed on white paper containing lhe artificial watermarlted logo (A ) of Amwest Surety Insurance Company, the parent co. of Far West
Insurance Company (lhe "Company"), on the fronl and brown security paper on the back. Only unaltered originals of the POA are valid. This POA may nol be
used in conjunction with any olher POA. No representalions or warranlies regarding this POA may be made by any person. This POA is governed by the laws of
lhe State of CaIifornia and is only valid until the expiration date. The Company shall not be liable on any limited POA which is fraudulently produced, forged or
otherwise distributed without the permission of the Company. Any party concerned aboul the validity of this POA or an accompanying Company bond should
call your local branch office at (4OlO 559-6988
KNOW ALL BY THESE PRESENT, that Far West Insurance <;ompany, a Nebraska corporalion (the "Company"), does hereby make,
constitute and appoint:
ROY G. FLETCHER
AS AN EMPLOYEE OF FAR WEST BOND SERVICES
~
its true and lawful Attorney-in-fact, with limited power and authority for and on behalf of the Company ... ~'execute i
thereto if a seal is required on bonds, undertakings, recognizances, reinsurance agreement for a MiI1ero~ perfo~ce
lhe nature lhereofas follow: ~
All Other Bonds $**5.000,000.00
Federal Contract (perfonnance Ie Payment) $****479,000.00 A "II ./ ~
...................-............... B........ ...U......... ~ " &-<1. ~1
""'" """ "",,,,,,,,,,,,,,,th=by. Th. __.""'" ~"'''''' by ~~~4. ~ - m full f=.... "'O<!
I, the undersigned secretaty of Far West Insurance Company, a Nebrask . on, DO R Y at this Power of Attorney remains in full force and
effect and has not been revoked and furthermore, that the resolutions ~~ O/D~ s foith ~wer of Attorney, and thallhe relevant provisions of
lhe By-Laws of the Company, are now in full force and effect. ~~ ~ ~
BondNo.006008025 Signed&Sealed~th. H 0 GU T ~~ P ~
Karen G. Cohen, Secretaty
. . . . . . . . . . . IONS~ O~ F DIRECTORS . . . . . . . . . . .
Anic1e II, Seclion 7 oflhe By-Laws of Far West ace com~' is sign d sealed by facsimile under and by the authority oflhe following
resolulions adopted by the Board of Directors 0 estInsu e om ya~ee' gdulyheldonJuly28, 1983:
RESOLVED, lhat lhe President or any IC sent, in n cti . the ltcretary or any Assistant Secretary, may appoint attorneys-in-fact or agents with
aulhority as defined or limited in lhe ins t den~in ~ en~ case, for and on be, half of the Company, to execute and deliver and affix the seal
of the Company to bonds, undenakin ces, ~~p o~ons of all kinds; and said officers may remove any such attorney-in-fact or agent and
revoke any POA previously granted to c personi!] ~y
RESOLVED FURTHER, that any bo ,unde 'ng, gn' suretyship obligalion shall be valid and bind upon the Company:
(i) when signed by the President or any Vi s t ~I~ and sealed (if a seal be required) by any Secretaty or Assistanl Secretaty; or
(ii) when signed by the President or any s' ent taty or Assistant Secretaty, and countersigned and sealed (ifa seal be required) by a duly
aulhorized attorney-in-fact or age I; or
(iii) when duly executed and sealed (i required) ne or more attorneys-in-fact or agents pursuant to and within the limits oflhe authority evidenced
by the power of attorney issued by e ompany to such person or persons.
RESOLVED FURTHER, lhat lhe signa re of any aulhorized officer and lhe seal of the Company may be affixed by facsimile to any POA or cenification
lhereofaulhorizing the execution and delivery of any bond, undenaking, recognizance, or other suretyship obligalions oflhe Company; and such signature and seal
when so used shall have the same force and effect as lhough manually affixed.
IN WITNESS WHEREOF, Far West Insurance Company has caused these presents 10 be signed by its proper officers, and its corporate seal 10 be hereunto affixed
this 14th day of December, 1995. , ./ 1,/ ~
~~ -'"?C3V~-L ~~ ~
John E. Savage, Pre aenl Karen G. Cohen, Secretaty
State of California
County of Los Angeles
On December 14, 1995 before me, Peggy B. Lofton Notaty Public, personally appeared John E. Savage and Karen G. Cohen, personally known to me (or
proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me all that
helshc:'they executed lhe same in hislher~eir aulhorized capacity(ies), and that by hislher/lheir signature(s) t :;:. nen1.l.he.Jl.C~n~ o..u..he....nt~ U.lll1n ~hl
of which lhe ~rnon(s) acted. executed the Instrument.
",,\\,\\~I~ R '~"""", WITNESS hand and official seal. . PEC:OYI.IDFRW
", S v " A I 'I, ""_ ....
"" ~ ..................~v0"", $ ~_af'l*l...,. iI
l "....... ~p 0 -9 ....... \<' '-.:. !! NDIaIr "'* - CalbI'lIII ~
f J..../..CP -i ~\ 0\ . (Seal)j I.CIIAnatI_CcuwIy 1-
:: f/)! C?' 0 \ 0 = Mv Comm. __Aug6. ""
:: W : - DEe 14 : =
l~\ ~ 1995'~ JtJ Far West - - - - - - - - - - - -
\ rS,~"'..f!eR ,,~*::.......~ I
.;P' .... f"\ .... ~ ,,'
"""'.::1 ....*..... ~~""
"'I""",lIlIn,,""\\\\\
Insurance Company
2
. :::=o::..~=~~. ~2;'2:;:::' -Z2::::::',::::, :'.:=~::-=::::_:..
CALIFORNIA ALL. lRPOSE ACKNOWLEDGMENT
State of
County of
On
C!.,4[,,) mILA} J ~
5 AAlI 4- r t-Fht-1'1
~ - ;J..-- qc.
DATE
.. '-'. --.-- '... . -'. -'._ .0 .' '.'. _'_ . _. __"."_ _"..'.... '_._... ~_"_'_ ._
.. .0 " ", . . """ . _ .. .. _ _ ". _ . . ._ .. ." _ " ,. _. _ ,_. _.
- ..... ------ - ----- ------.------ -------- --.. -.. --.
No.5!
;a
before me,
personally appeared '\--40111 J4-) ~ fA ~.t-.-
NAME(S) OF SIGNER(S)
o personally known to me - OR - ~d to me on the basis of satisfactory evidence
to be the person(s) whose name(s) is/are
subscribed to the within instrument and ac-
knOwledged to me that he/she/they executed
the same in his/her/their authorized
capacitY(ies), and that by his/her/their
signature(s) on the instrument the person(s),
or the entity upon behalf of which the
per s) a ted, executed the instrument.
Though the data below Is not 'equi..d by law, it may peove valuable to pe'sons 'elying on the document and could p,event
fraudulent reattachment of this form.
~.... ..... - - ...... ..................... .... J
i e.... .~.,~.. .~ BRffiMCOI.ET1I
-. . Commission #1039510
~ :-:... .~. Notary PlbIIc - CaDfomIa ~
z ~ . Santa Clara COU'lly
, . " My Camm. expIres Oct 5. 1998
CAPACITY CLAIMED BY SIGNER
o INDIVIDUAL
o CORPORATE OFFICER
TITlE(S)
o PARTNER(S)
o LIMITED
o GENERAL
o ATTORNEY-IN-FACT
o TRUSTEE(S)
o GUARDIAN/CONSERVATOR
o OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(lES)
"
,
OPTIONAL
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DA TE OF DOCUMENT
S/GNER(S) OTHER THAN NAMED ABOVE
l :""2C"2"="C2"=-==2"2""::2-~=2""C2"2":"""O""'~"Z': '::::::-"" ,,",,"';,:::2C. =c:, "=,"C:C::: ::<:_.
@1993 NATIONAL NOTARY ASSOCIATION. 8236 Remmel Ave., P.O. Box 7184. Canoga Park. CA 91309.7184
CALIFORNIA ALL-PUR" uSE ACKNOWLEDGMENT
"
o personally known to me - OR - ~ed to me on the basis of satisfactory evidence
to be the person(s) whose name(s) is/are
subscribed to the within instrument and ac-
knowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s),
or the entity upon behalf of which the
person(s) acted, executed the instrument.
[',Z22~~~~~~~~~z-~~-zz:::.=:
\
~. State of
On
L.,4.L I ,4;, {l./V J A-
<)~I"'+ c.c...A--fl-A-.
7-- 1'1- - '1 C-
OATE
-~--"'''-'------'.......<-~..---_.,._.- .-".~ -~'_."'''._.,.-.,--.-..- _. - _.' --. .',.~
...... ."-' ,.... - ~ .~ -,," ,.. ~ ,.. .....' -" _.. ..- #'. -. .-
----------- ---.-"'---.--.- -.--.. -, --- --" -,~- ---~,--~ -~- .-..
No. 5907
.. , ...- -, '
..--, .-..- -".-'..
'l3>
County of
before me,
?
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~
~
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,
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personally appeared
'8(~U
't
tv'
NAME. TITLE OF OFFICER - E.G.. 'JANE DOE. NOTA
"
~el~~--~~" B~;~;C:L~ ~ ~ J
i. COmmission # 1 039510 z
!. Notary Public - CaUtom/a ~
Santa Clara Colllty
My Comm. Expires Oct 5.1998
D *1/1 P ik:>t..J L N
NAME(S) OF SIGNER(S)
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
o INDIVIDUAL
o CORPORATE OFFICER
TITlE(S)
o PARTNER(S)
o LIMITED
o GENERAL
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
l.;:~~~~~=~~2Z2~~..-::.::;.~=~~~~=::==.:.:=::. _._
o ATTORNEY-IN-FACT
o TRUSTEE(S)
o GUARDIAN/CONSERV ATOR
o OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
-. '-',-...-..."--....-. -"--'-'-- .~
~ ..- ,~ .'~. ... -' ',' . ~. " ,
------------~--_._-_.__.---,-
@1993 NATIONAL NOTARY ASSOCIATION. 8236 Remmel Ave.. P.O. Box 7184' Canoga Park. CA 91309-7184
BP.1) FOR FAITHFUL PERFORMAJ'T~ -
- -
. .
BOND NO.#006008025
PREMIUM: $2,~80.00
We, the undersigned LITTLETON PLACE PARTNERS . (hereinafter
.Contractor") and FAR WF.Srr INSURANCE COMPANY . a corporation organized under the laws of the Stuc of
NEBRASKA ,and authorized to transact business in the State of Califomia, as Surety. are
obligated to the City of Campbell, (hereinafter .City.) a municipal corporation under the laws of the State of California,
in the sum of One Hundred Twenty-Four Thousand Dollars ($ 124,000.00 )
for the payment of which sum we obligate ourselves and our successors and assigns, jointly and severally by the
following provisions:
The condition of this obligation is:
Because the obligated Contractor bas, on A.l.)~sr
Contract with the City for the Project entitled Permit 96-151,
attached and made a pan of this bond, for construction of Project.
~ . 19 ~G::. . entered into written
Tract 8846 . a copy of which is
~.
Now, therefore, if the Contractor shall faithfully perform the work in accordance with the plans, specifications
and contract documents during the original term, and any extensions of the contract which may be granted by the City.
with or without notice to the surety. and if it shall satisfy all claims and demands incurred under the contract, and shall
fully indemnify and save harmless the City from all costs and damages which it may suffer by reason of failure to do
so, and shall reimburse and repay the City all outlay and expense which the City may incur in making any default, then
this obligation shall be void; otherwise to remain in full force and effect.
If any legal action be filed upon this bond, it shall be filed within one year after final payment bas been made
under the Contract excluding the warranty period, if any. provided for in the Contract, and venue shall lie in the County
of Santa Clara, State of California, and that surety. for value received stipulates and agrees that no change, extension
of time, alteration or addition to the terms of the Contract or to the work to be performed under it or the specifications
accompanying it shall in any way affect its obligation on this bond, and it does by this means waive notice of any change,
extension of time, alteration or addition to the terms of the Contract or to the work or to the specifications, and thereby
waives the provisions of Section 2819 of the Civil Code of the State of California.
In witness. contractor and surety have executed this agreement as of AUGUST 5
.19~.
~~
;Z
nee . , ~resident
B&C Homes, Inc.
(ContraCtor)
By I iTfL~ ~~ ?A<>~""s.
~ -r;;::<A4./) ~s. ~. ~ ~.
1itle ~ ,/'"'v...,\r://; ~.
,
SO. BASCOM AVE., STE:370
(Surety)
CAMPBELL, CA 95008
(Attach Acknowledgements)
~urety's Bond Number 006008025
(Both Principal's and
Surety's Attorney in Fact)
(Accompany this bond with Attomey-in-fact's
authority from Surety to execute the bond,
certified to include the date of the bond.)
NOTARY A CKND WLEDGMENl
Slate of
CALIFORNIA
County of
SANTA CLARA
In AUGUST 5, 1996
before me,
VERONICA RAMIREZ
ROY G. FLETCHER
(here insert name)
\lotary Public, personally appeared
lersonally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
ubscribed to the within instrument and acknowledged to me all that he/she/they executed the same in hislherltheir
.uthorized capacity(ies). and that by his/herltheir signature(s) on the instrument the person(s), or the entity upon behalf of
rhich the person(s) acted. executed the instrument.
IITNESS my hand and official seal.
gn.lure ~tU 13fiLt~L
J..........................................................
@.:,...,.VERONICARAMREZ J
(S I) :;c .,.. Commission' 1094210
ea ~ -G -<,~I NotayPublc-CaItomIa I
~ ~~ Santa Clara Cotntv -
~_~~:~:~~~1:~1
CAPACITY CLAIMED BY SIGNER SIGNER REPRESENTING
NAME OF PERSONlS) OR ENTTTYIIESI
_ INOIVIDUAUS) L PARTNER(Sl L...; GUAROIANlCONSERV A TOR
_ CORPORATE :x ATTCRNEYI~FACT UOlHER FAR WEST INSURANCE
OFFICERS -; TRUSTEEiSl COMPANY
CJ SUBSCRIBING WITNESS
A'TTENTlON NOTARY: Although the Information reauested belOw is OPTIONAL it COUld Dl'IMInt fraudulent auac:nment of this cemftcale.
THIS CERTIFICATE MUST Document TiU. or Type: PERFORMANCE BOND
SE ATTACHED TO THE
JOCUMENT DESCRIBED Numller 01 Pages: ONE (]) Document Dale: AUGUST 5, 1996
-lEREIN:
Signensl other than named abOve:
CALIFORNIA ALL.PURPOSE ACKNOWLEDGMENT
No. 5907
State of C4q.L..1 roLNI}'}
County of ~4JV,,4 (" L-IIILA-
On 8--z- 0;0 before me,
DATE
p~ .I1../;i aJEUA' 11#o??i!:fr ;?t/1/J ~/~ /,
NAME, TITLE OF OFACER - E.G., "JANE DOE, NOTARY UBUC-
personally appeared IHnWlri"'5 u104~ ct (J(l-I.A cA: (3(}lt.J tI. rJ
NAME(S) OF SIGNER(S)
o personally known to me . OR - 0 proved to me on the basis of satisfactory evidence
to be the person(s) whose name(s) is/are
subscribed to the within instrument and ac-
knowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies). and that by his/her/their
signature(s) on the instrument the person(s),
or the entity upon behalf of which the
per s cted, executed the instrument.
,..........,.. -6.....,. ..... J7'o. ~ ..... ..-. ~ ..-. ..... J
, dL~:..: BRm N1COlETll
<: "". Commission #1039510 z
~ ... ~. Notary P\bIic - CaUfomIa S
~ - ~ . Santo Clara Col.l'lty I
-.. " My Comm, Expires Oct 5. 1998
................",.-~--......~............................
SIGNATURE OF NOTARY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
o INDIVIDUAL
o CORPORATE OFFICER
DESCRIPTION OF ATTACHED DOCUMENT
TlTLE(S)
TITLE OR TYPE OF DOCUMENT
o PARTNER(S)
o LIMITED
o GENERAL
o AlTORNEY-IN-FACT
o TRUSTEE(S)
o GUARDIANlCONSERV ATOR
o OTHER:
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
SIGNER(S) OTHER THAN NAMED ABOVE
@1993 NATIONAL NOTARY ASSOCIATION. 8236 Remmel Ave., P.O. Box 7184' Canoga Park, CA 91309-7184
WORKER'S COMPENSATION INSURANCE INFORMATION
The following worker's compensation insurance information is required for all Applicants and
Contractors. One of the following items for each Applicant and Contractor must be submitted
prior to working under a Public Works permit or contract.
WORKERS' COMPENSATION INFORMATION:
Name of Contractor/Applicant ---1d Aq /1\ )?--5:.
~~?~5=;7~,
o A Certificate of Consent to Self-Insure issued by the Director of Industrial Relations; OR
o A Certificate of Workers' Compensation Insurance
Insurance Co.
Policy No.
Expiration Date
; OR
o A signed Certificate of Exemption from the Workers' Compensation laws as printed
below.
CERTIFICA TE OF EXEMPTION
I certify that in the performance of the work for this contract, I shall not employ any
person in a manner so as to become subject to the Workers' Compensation Laws of
California.
Title
J~r" ~\~L-
?~4.
Date
~3/76
/
NOTICE TO APPLICANT/CONTRACTOR: If after signing this Certificate of
Exemption, you should become subject to the Workers' Compensation pr.ovision of the
Labor Code, you must forthwith comply with such provisions or the Permit or Contract
will be cancelled or revoked.
j: \forms\ workcomp (rev6/96)
WORKER'S COMPENSATION INSURANCE INFORMATION
The following worker's compensation insurance information is required for all Applicants and
Contractors. One of the following items for each Applicant and Contractor must be submitted
prior to working under a Public Works permit or contract.
WORKERS' COMPENSATION INFORMATION:
Name of Contractor/Applicant
\ \ \ ~ \ ~'\ .~:--..-\~ \
L\~ \ L-~, ,"'-. \. C '* ~ . c: >\-\. \''(-0 v'. .~
o A Certificate of Consent to Self-Insure issued by the Director of Industrial Relations; OR
o A Certificate of Workers' Compensation Insurance
Insurance Co.
Policy No.
Expiration Date
; OR
~ A signed Certificate of Exemption from the Workers' Compensation laws as printed
below.
CERTIFICA TE OF EXEMPTION
I certify that in the performance of the work for this contract, I shall not employ any
person in a manner so as to become subject to the Workers' Compensation Laws of
California.
n'<.~d/ .Z~4:'--
~n~.i I _
~----
---
Title '\ -r- ,,- " .'~ _ \ ,.--
, .,
Date
/' ~ . 1 c l
~e., - . \ y \ (
NOTICE TO APPLICANT/CONTRACTOR: If after signing this Certificate of
Exemption, you should become subject to the Workers' Compensation pr.ovision of the
Labor Code, you must forthwith comply with such grovisions or the Permit or Contract
will be cancelled or revoked.
j: \forms\ workcomp(rev6/96)
DAN BOZZUTO INSURANCE
3425 S. BASCOM AVE. #100
CAMPBELL, CA, 95008
408-377-8712 408-377-5741
HASTINGS DEVELOPMENT
7127 CAllEN DRIVE
SAN JOSE"CA 95120
408/ 268-7440
AX: 408/ 997-9586
RECEI'/E
AUG 2'( 1996
MID CENTURY INSURANCE COMPANY
INSURED
COMPANY
B
I'" C.' ..; i..., ".... ':(i' ,_' ~'\.;, 10,_
COMPANY
C
ADMINISTRATIOI',
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY ,'ERIOD
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (llIIIDDlYY) DATE (MIIIDDlYY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!] OCCUR
A X OWNER'S & CONTRACTOR'S PROT 60167 2 5 03
02-24-96
02-24-97
GENERAL AGGREGATE $ 2 0 0 0 0 0 0
PROOUCTS - COM PlOP AGG $ 2 0 0 0 0 0 0
PERSONAL & ADV INJURY $ 1 0 0 0 0 0 0
EACH OCCURRENCE $1000000
FIRE DAMAGE (Any one Ii",) $ 5 0 0 0 0
MED EXP (Anyone person) $ 5000
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
X SCHEDULED AUTOS
A X HIRED AUTOS 60167 25 03
X NON-OWNED AUTOS
COMBINED SINGLE LIMIT
$1000000
BODILY INJURY
(Per person)
$
02-24-96
02-24-97
BODILY INJURY
(Per eccident)
$
PROPERTY DAMAGE $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONL Y: :~m~~~t~tt~:iW . .
EACH ACCIDENT $
AGGREGATE
EACH OCCURRENCE
AGGREGATE
GARAGE LIABILITY
ANY AUTO
EL EACH ACCIDENT
THE PROPRIETOR!
PARTNERSlEXECUTIVE
OFFICERS ARE:
OTHER
EXCL
EL DISEASE - POLICY LIMIT $
EL DISEASE - EA EMPLOYEE $
INCL
DESCRIPTION OF OPERA TIONSlLOCA TIONSlVEHICLESlSPECIAL ITEMS
RE:1222 HARRIET AVE.PERMI #96151 TRACT 8846. ALL WORK IN PUBLIC RIGHT OF
WAY. CITY OF CAMPBELL, CAMPBELL REDEVELOPMENT AGENCY, ITS OFFICERS, EMPLOYEES
AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS AS RESPECTS LIAB. PER CG2009
-- .AI
AUnM)R~=TA~ \ ~ '
t_~i~111II~lt~1~~~~1~1~1~~~i~1~1~~~1~1~~~1~1~~1~~1~~~~~~~1~~I1~1~~~1~1~1~1~1~~~1~1~1~~1~1~1~~~1~~i~1~1~1~~~~~~~i~I1~~~~~i~r!:j~~t~~~j~~~~~~~~~~j~~j~j~j~~~~~~~~~~~~~j~~~~j~_~r~~~~j~~~jr~j~j~~j~~~j.j~~III~_.III:OO
CITY OF CAMPBELL
ATTN: DEPT. OF PUBLIC
70 NORTH FIRST STREET
CAMPBELL, CA 95008
WORKS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED LiEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 1'.:,\
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
r 1 Ilr . ~
...
-...........u
-- .
.n RlrnlUIH'
FOUCY NUM2E::!: 60167 25 03
~MERClAL GENERAL UA81UTY
~/ THIS eNCORSEMENT CHANGCS n1E POUCY. Pt.EASE REAe rr CAREFtJLl.Y.
ADDITIONAL INSURED - OWNERS, LESSEES or
CONTRAc;TORS [Form A]
This en do rsement modifies insurance provided under the following:
COMMERCIAL GENEMAL UA81LITY COVERAGE PART
SQi!OULE
Loc:ulcn at
Cowrvd Oceratfons
RE: 1222HARRIET AVE. ALL WORK IN PUBLIC RIGHT OF WAY. CITY
OF CAMPBELL, CITY OF CAMPBELL REDEVELOPMENT AGENCY, ITS
OFFICERS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL
INSUREDS AS RESPECTS LIABILITY PER CG 2009.
Name 01 Person or Organization (AdCItionaJ Insured):
CTY 0' CAMPWIU.
ATTH: OUT. OF JIIUSUC WCl~K2
10 NORTH FmST smUf
CAJot~ CJ. IICCI
Pfemitlm Basis
Bodily Injury and
Prcpert'1 Oama;e Uatlility
C:st
AdVw1ca F'mnium
Ratn
(P1!J'
"000 of c=st)
s
TctaI AdvanCa F'rerniIn S
(If no entrY ~Hr3 a=cve. Infcrmation required to c=mpf8l8 ttlts endo~ w;11 oe shewn in the Cedanttlens
as appllca.t:lt8 to this InCCrsement.)
1. WHO IS N.f INSlJ~EO (Sdcn II) Is amend8d 10
Induce as an Inswwd the ptnCn or Of9~
(called "addltfcnaJ In8unlcr shewn In the Schld-
ute cut onty witt! ~ 10 I18ClIIy artslng out at:
A. -Your 'NOne- fer the 1ddItfcna1 Insured(s) at
the IccUicn d88i;nmd cave. or
e. Ac=s or omtaions 01 hi addJtlcnai lnJR.lrwd(s)
In ccnnedon with !heir ;.nlral sweMsicn
ct -ycur wc~ . the Icr::attcn shewn in d'te
ScMed\Jle_
2. WIth ~ to the Insuzm:a affcn:ed th...
addfticnaJ insuIwCs, the 10jlcwing addltla'W
previSiens ~
A. None at tl1e a:cCusicna under CQvemc;e A.
8~ exdusiQns (.~, (d}. (e), (f). (h2), (I).
and (m), apply to. this InstJnutC3.
s. Addlt1cnal C=U3tcns. This lnsurar.cs dees
not atlplv to:
(') "Scdity Injurl or "J:rr:perty damage.
fer wnlc.., me aCCmcnaJ insurad(s) are
OCUgated to ptJ! damac:. by reascn of
the assumpticn of llaCirrty In a ~mrad or
a;reement. This eXCJsion dees net appty
tc lIaclllty for damages that the addlttonal
Insul9d(a) would have In the sesanes at
the contract or 39!'Mmem.
(2) "SOdlly injury" or "pro;:eny damage'
oe:::-Jrnng atter:
~
(a) AD ~ on, the prcf8ct (ether than
~. mairlt8nanca. or repajrs) to
t:e PIf1crmed by or on behakf at tl'le
1d6na1 insured(s) at UtI! site of thl!
ccvered ~rm1cna has been CQm.
gt.. or
(b) 'That pcrtfcn of -your wcr1(' our at
wntd'1 ln1ury or damage arises has
belIn ~ to It! Intended use by alrf
pencn or ~cn other 1han an-
CCher c::cntractcr or sui::contradCr
.tn;aQ~ In pencrming o;:enldcns fer
. ~ II a pan 01 the same
orciC.
(3) -SodBy ."urr or ~perty damag8.
arising aut of any ~ or omission 01 the
addtlcnal Insuntd(a) or arrf of ~elr .m.
. '. piC'f'188 other 1hlIn the genera! stn'8rvi.
, lien of wcrk perlcnned tor 12'\e addftional
1ns1JI"Id(s) by Y!'u. -,
(~) "?T'l:Pl!Jf1y damage- to:
(a) F~~ny OWI"Ied. U!ed or cc:'.J~ed by
Of T8nt8d to the addftlona1lnsut8d(s);
(tl) Prq:eny in 1ne QU"I, custody or CQn-
tre' of the addlticMi insured(s) or
oqrwnich the addft10naJ insul'8d(S)
ant fer any pU1l'ose cc8nslng pnys..
-= ~ntrol; or
(c) "Your WQ~ fer the additional In-
S&nd(s}.
CG 20 09 11 8S
Cor:::yrl~ht. Insurance Service Office, Inc., 1984
Insured Name HASTINGS DEVELOPj1ENT
f()l1cy # 60167 25 03
PRIMARY WORCING:
SUeJECTTO AU. OTHER ~MS ANC PROV1StONS OFiHEpOUCY, SUCH lNSURAHCCN3
~OVIOED BY THIS ENCORSEMENT Sl-4Au. BE Oe:MEC PRIMARY, BUT ONLY W1lH
AESPECTTO WORK PSiFORMED t!'f OR FOR THE NAMED INSURE) IN CCNNEC'T10N WITH
THE ABOVe oesCl'tBED CoNTRACT.
Certificate of Insurance
THIS CERTIFICATE IS ISSl'ED .\S A ;"IATTER OF II'. vlr\TJON ONLY AND CONFERS NO [{leH15 UPC)N YOU n J<TIFICATE HOLDER. THIS CERTIFICATE IS NOT
AN INSURANCE POLlCY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THF POLICIES LISTED BELOW.
,hiS Is to Certify that ~ r.: C if. ~ V E D--,
,r~~ ~"'""'tl - I
SANCO PIPELINES, INC. c: ""'tP 18 1996
213 CRISTICH LANE v .
CAMPBELL, CA 95008 riU;;UC '..; u;<.K~
L ADMINISTRAT10i'. ~
Is, at the issue date of this certifical8, insured by !he Company under the poIlcy(ies} lisl8d below, The insurance afforded by the listed policy(iesl is sublect to a1llheir
1Ierms, exclusions and conditions and is not a1t9ied by MY requirement, term or Condition of any contract or other document with respect to which this certllicalB may be
f-
Name and
address of
Insured.
LlBER~ttt, ':'
MUTUAL@ -
~suecL
EXP.DATE
· 0 CONTINUOUS
TYPE OF POUCY o EXTENDED POUCY NUMBER LIMIT OF LIABILITY
181 POI ICY TFRM
WORKERS COVERAGE AFFORDED UNDER WC EMPLOYERS UABIUTY
COMPENSA TION LAW OF THE FOLLOWING STATES: Bodily Injury By Accident
04101196 $1,000,000 Each
Accident
To we 161 030020 146 CALIFORNIA Bodily Injury By Disease
04101197 $1,000,000 Policy
Limit
Bodily Injury By Disease
$1,000,000 ~~~!'nn
GENERAL General Aggregate - Other than Products/Completed Operations
LIABILITY $2,000,000 PER PROJECT
181 OCCURRENCE 04101196 ProductslCompleted Operations Aggregate
To 'TB2 161 030020 116 $2,000,000
0 CLAIMS MADE 04101197 Badly Injury and Property DamaQe LiabiUty
Per
$1,000,000 Occurrence
Personal and Adver1ising Injury Per Personl
I RETRO DATE I $1,000,000 Organization
Other $50,000 FIRE LEGAL \ Other $5,000 MEDICAL
UABIUlY PAYMENTS
AUTOMOBILE $1,000,000 Each Accident - Single Umit
LIABILITY B.1. and P.D, Combined
181 OWNED 04101196 Each Person
To AS7161 030020 U6 Each Accident or O::currenoa
rg] NON-OWNED 04101197
rg] HIRED Each Accident or O::currenoa
OTHER O4IOV96 TIn 161 030020 136 $4,000,000
UMBRELL EXCESS To
LIABILITY 04101197
ADDITIONAL COMMENTS
RE: ALL WORKINPUBUCRlGHT-OF-WAY
It ADDmONAL INSURED: CITY OF CAMPBELL, CITY OF CAMPBELL REDEVELOPMENT AGENCY, ITS OFFICERS,
EMPLOYEES AND VOLUNTEERS
. If the certificate expiration date Is continuous or extended term, you win be notified if coverage is terminated or reduced before the certificate expiration date,
SPECIAL NOTlCE.otlO: ANi PERSON WHO. wm-t INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER. SUBMITS
AN APPLICATION OR FILES A ClAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
N01lCE OF CANCELLAOON: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE
THE STATED EXPIRATION DATE THE COMPANi WU NOT CANCEL OR REDUCE THE INSURANCE AFFORDED
UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS
NOTICE OF Sr=LLATION HAS BEEN MAILED TO: lJ
CITY OF CAMPBELL . lV' J jl
CERTlFK:AlE ATfN: DEPT. OF PUBUC WORKS !vf "-'~/ vl/
~ 70 NORm FIRST STREEI' l(A, ,ri.V N r~ ... /
CAMPBELL, CA 95006 ,.. - r}'\'. L~' 0' \: I
L l ' if (~} ----l
"v ' ,
IF \( v
~ ~.
J;u;;;.G ro up
ALMA G. SABLAN
AUTHORIZED REPRESENTATIVE
SAN JOSE, CA
OFFICE
(408) 453.3580
PHONE NUMBER
09/13/96 pcm
DATE ISSUED
. ,..~.wll....., I 1H.~';'>T\ \..11 :Tl. \1 C-:RClljP ,1S re~['ll'cts ...;uch insur,lDl:e dS is ,lffl)rded b\ Tlh'lSI.' Clm'lF'<lnil's
BS 772L R2
1182-161-030020-116
SANCO PIPELINES, INC.
TIllS ENIXJRSEMENT CHANGES THE POllCY. PLEASE READ IT CAREFULLY.
POllCY NUMBER:
ADDITIONAL INSURED - OWNERS, LESSEES, OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMEROAL GENERAL UABILITY COVERAGE PART
SCHEDULE RE: ALL WORK IN PUBUC RIGHT-OF-WAY
Name of Person or Organization:
CITY OF CAMPB~ CITY OF CAMPBELL REDEVELOPMENT AGENCY, ITS OFFICERS,
EMPLOYEES AND VOLUNTEERS
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section IT) is amended to include as an insured the person or organization
shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by
or for you.
PRIMARY INSURANCE
Such insurance as is afforded by this endorsement is primary insurance.
CG 20 10 1185
Of'C.41lt
. A
-I. ~
f..,' ~
... r'
U t""
.. -.
10~ ,-,"-
'OJ/CHAIlO
CITY OF CAMPBELL
Public Works Department
September 9, 1998
Littleton Place Partners/Hastings Development Inc.
7127 Cohen Drive
San Jose, CA 95120
SUBJECT: PERMIT NO, 96-151
LOCATION: 1222 Harriet Avenue, Tract 8846
ONE YEAR MAINTENANCE INSPECTION - ACCEPTANCE
Dear Messrs. Bowen and Rouse:
The City of Campbell has made the [mal one year maintenance inspection of subject Public
Works improvements and fmd that no remedial work is required.
Your warranty requirements and any surety, therefore, are hereby released.
Please find attached your original Maintenance Bond which we are returning to you.
Sincer/7#' bi-
Alan~
Public Works Inspector
MQ/
Enclosure
cc: Permit 96-151
Public Works/Maintenance Division
Far West Insurance Company, 152 North Third Street, Suite 550, San Jose, CA 95112
H:\ WORD\PERMITS\96151ACC(JD)
70 North First Street' Campbell, California 95008,1423 ' TEL 408,866,2150 ' FAX 408,376,0958 ' TOD 408,866.2790
--r~""-r 1--lo. 9tp - 15 1
Far West
Insurance Company
CITY OF CAMPBELL
70 N. 1ST STREET
CAMPBELL, CA 95008
~"'....,.....
if.( _..:;r:. "~J
.~ ~ ' j1-:r'0
MAlt 1 6 199; .
FINAlfC~
W C DE?T,
Far West Insurance Company
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
RECEIVED
MAR 1 8 1998
PUBL./C
AOM/N/sr'l'ORK,
R A rlOH
FEB 28, 1998
Bond No.: 006009532
Subdivider: B & C HOMES, INC.
Amount: $89,000.00
Description: SUBDIVISION OFF-SITE PUBLIC IMPROVEMENTS PERMIT NO.#97-160
Location: 1365 HARRIET AVENUE, CAMPBELL, CA
Effective Date: 11-26-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
1. Have the improvements been completed?
2. If not, what percent has been completed?
3. Is the work progressing satisfactorily?
4. Has this work been accepted?
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
DYes
zr; %
IZJ Yes
DYes
[ZJ No
D No
D No
COMMENTS:
Signed by:
aki.
.
Date:
3 - 20 - ~g
Phone:
I1lan Itm
~~) &6' - '7,1 b 8
Name:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
Of.C.4tl1
~~.~.o<1>~
U r"
. .
.. ...
1- ...
~ (..'
OIlCHA\1.'O
August 29, 1997
CITY OF CAMPBELL
Public Works Department
Littleton Place Partners/Hastings Development, Inc.
7127 Cohen Drive
San Jose, CA 95120
SUBJECT:
PERMIT NO. 96-151
LOCATION: 1222 Harriet Avenue, Tract #8846
FINAL INSPECTION AND ACCEPTANCE
Dear Messrs. Bowen and Rouse:
The City of Campbell has made a [mal inspection of subject Public Works improvements and finds the
work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the
improvements .
The one year maintenance period stated in the permit begins as of the date of this acceptance letter. The
permittee is responsible for the repair and/or replacement of any defective work or failures that occur
within one year. The City will inspect the improvements within one year and notify you, in writing,
whether or not any repairs are required.
The City will continue to hold your Faithful Performance Surety bond of $124,000 until such time as a
bond of $31,000 (25% of the original bond) is received as your Maintenance Surety. Enclosed is a
Maintenance Bond form for your use if you desire to provide one. Also enclosed is your $124,000 Labor
and Material Bond. Additionally, your cash deposit of $4,960 minus $529.92 for overtime inspection
charges on June 16 and November 3, 1996 ($4,960.00 - $529,92 - $4,430.08, plus any interest due, is now
being processed and will be sent to you under separate cover.
If you have any questions, please call me at (408) 866-2165.
S~relY ,
?0'~ dWd(
Rand~eJl(.
Public Works Inspector
MQ ~lLt
cc: Far West Insurance Co" 152 N. 'Third St., Ste. 550, San Jose 95112
Suspense - 11 months
Permit #96-151
Inspector File
h:\word\permits\96151mtc(mp)
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TDD 408.866.2790
Actual Plan Check and Inspection Charges
Invoice/or Invoice/or OT Staff/
PPE Hourly Hourly Regular Overtime Invoices Date
Name Date Rate Rate Hours Hours Incl 20% OH Received
Littleton Place (96.151)
Westfall, Randy 06/16/96 39.22 55,20 1.00 66.24 1 0/09/96
Westfall, Randy 11/03/96 39.22 55.20 7.00 463.68 11/06/96
8.00 529.92
401 W. Hamilton (96.180)
Gade, Derek R. 01/12/97 26.48 37.94 3.50 2.00 202.27 01/15/97
3.50
2.00
202.27
Grand Total
1,915.30
91,00
111,518.02
8/26/97 10:07 AM
Subdiv98
10
Actual Plan Check and Inspection Charges Summary
For the pay period ending June 1, 1997
Regular Overtime Total Total
Hours Hours Hours Costs
PERMIT 94-222
2 Way Railway 1,001.00 175.50 1 ,176.50 70,620.89
II PERMIT 94-203
A. 500 Railway Offsites (Msc.) 48.50 48.50 5,198.33
B. KennedylWinchester Signals 77.00 3.50 80.50 3,871.03
Permit 94-203 Total 129.00 9,069.36
III PERMIT 95-145
Pollard Road / New City Dev 710.50 25.00 735.50 35,460.92
IV Permit 95-201
Emily Chen 4.50 4.50 279.55
V PERMIT 95-215
San Jose Water Co. 20.00 2.00 22.00 1,008.88
VI PERMIT 95-218
1522 McCoy 505.50 32.00 537.50 39,042.59
VII PERMIT 95-223
18755 Bascom 672.80 13.50 686.30 34,588.84
IX PERMIT 95-264
Hatcher Court 1.00 1.00 66.24
X PERMIT 96-138
Gold's Gym 1.50 1.50 93.19
XI PERMIT 96-151
Littleton Place 8.00 8.00 529.92
XII PERMIT 96-180
401 W. Hamilton Ave. 3.50 2.00 5.50 202.27
Grand Total 3,038.80 268.50 3,307.30 190,962.65
(O.OO)
6/11/97 3:11 AM
Subdiv
Actual Plan Check and Inspection Charges
l Name
~_.----
\ ~on Place (96-151) '-.
i Westfall, Randy
\ Westfall, Randy
\
"
"",.
01 W. Hamilton
/'
ade, DeJ.eI( R.
___._~:~~:/~!---~~~~,_.,. ._...._~~o
Grand Total
Subdiv
Invoice/or
PPE
Date
06/16/96
11/03/96
Invoice/or
Hourly
Rate
OT
Hourly
Rate
Regular
Hours
Overtime
Hours
39.22
39.22
55.20
55.20
1.00
7.00
Staff/
Invoices
Incl 20% OH
66.24
463.68
8.00
529.92
Date
Received
10/09/96
11/06/96
./~
15
190,l*)Z.65
/
0.00
6/11/973:12AM
Far West
Insurance Company
c?/11- Of c~
??/zj07
MAY 18,1997
Far West Insurance Company
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
CITY OF CAMPBELL
NORTH FIRST STREET
CAMPBELL, CA 95008
RECE'''ED
MAY 8 0 1997
"-U;;'j,,/( ~v' .
4DM/N/STR 0'(I\S
AT/ON
Bond No,: 006008025
Subdivider: LITTLETON PLACE PARTNERS
Amount: $124,000.00
Description: SUBDIVISION IMPROVEMENTS AT 1222 & 1228 HARRIET AVENUE
Location: CAMPBELL, CA
Effective Date: 8-05-96
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
1. Have the improvements been completed?
2. If not, what percent has been completed?
3. Is the work progressing satisfactorily?
4. Has this work been accepted?
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
DYes
1~. 7/ %
IZ1 Yes
DYes
D No
Q;NO
[2] No
! (,-/)'-'77
COMMENTS: .[",,f ,.,..1-1-/',) .r;~ M-t,.;!f .Rr4M//? -/; k S~!&t
Date:
Name:
;f2~ weslkl/
(~ p ft h-/ jj {, ~../
Signed by:
Phone:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
Actual Plan Check and Inspection Charges
Invoice/or Invoice/or OT Staff/
PPE Hourly Hourly Regular Overtime Invoices Date
Name Date Rate Rate Hours Hours Incl 20% OH Received
Littleton If'
Westfall, Randy 06/16/96 39.22 55.20 1.00 66.24 10/09/96
Westfall, Randy 11/03/96 39.22 55.20 7.00 463.68 11/06/96
8.00 529.92
401 W. Hamilton (96-1801
Gade, Derek R. 01/12/97 26.48 37.94 3.50 2.00 202.27 01/15/97
3.50
2.00
202.27
Grand Total
3,017.80
266.00
189,807.19
0.00
5/14/97 3:32 AM
Subdiv
15
SURETY INSURANCE SERVICES
Of CALIfORNIA
Far West
152 N, TIurd Street
Suite 550
San Jose, CA 95l12-5552
TEL 408 287-8995 FAX 408 237-8997
RECEIVED
IfAr1 S_
~UC;LK V
A\DMINIST~~T~~~
CITY OF CAMPBELL
CITY CLERKS OFFICE
70 NORTH FIRST STREET
CAMPBELL, CA 95008
MAY 13, 1997
Bond No.: 006008025
Subdivider: LITTLETON PLACE PARTNERS
Tract No.: 8846*
Amount: $124,000.00
Description of
Improvements: PERMIT 96-151
FAR WEST INSURANCE COMPANY is Surety on the above captioned bond.
would appreciate your cooperation in providing the information
requested below. Please return the form to us so that we may have
current status information on the above captioned improvements. A
postage-paid envelope is provided. Thank you very much for your
assistance.
We
1.
Have the improvements been completed?
Yes
/ No
2.
If not, what percentage has been completed?
rf
/
Yes
No
/NO
%
3.
Is the work progressing satisfactorily?
4 .
Has this work been accepted?
Yes
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
Comments: ~",J ~ d~l<:,f /~ .Ie. ~7t:1i.
I
information is provided by:
Name
Phone No.
(4~t) R0b-Ji6 S-
~/;~/~7
Title
III $ftl c+..,
,
Date
Actual Plan Check and Inspection Charges
Invoice/or Invoice/or OT Staff/
PPE Hourly Hourly Regular Overtime Invoices Date
Name Date Rate Rate Hours Hours Incl 20% OH Received
Littleton Place (96.151)
Westfall, Randy 06/16/96 39.22 55.20 1.00 66.24 1 0/09/96
Westfall, Randy 11/03/96 39.22 55.20 7.00 463.68 11/06/96
8.00 529.92
401 W. Hamilton (96-180)
Gade, Derek R. 01/12/97 26.48 37.94 3.50 2.00 202.27 01/15/97
3.50
2.00
202.27
Grand Total
2,971.80
266.00
187,636.70
0.00
4/8/97 10:20 PM
Subdiv
16
Actual Plan Check and Inspection Charges Summary
For the pay period ending February 23, 1997
Regular Overtime Total Total
Hours Hours Hours Costs
PERMIT 94-222
2 Way Railway 1,001.00 175.50 1 ,176.50 70,620.89
II PERMIT 94-203
A. 500 Railway Offsites (Msc.) 48.50 48.50 5,198.33
B. KennedylWinchester Signals 77.00 3.50 80.50 3,871.03
Permit 94-203 Total 129.00 9,069.36
III PERMIT 95-145
Pollard Road / New City Dev 694.50 23.50 718.00 34,608.54
IV Permit 95-201
Emily Chen 4.50 4.50 279.55
V PERMIT 95-215
San Jose Water Co. 20.00 2.00 22.00 1,008.88
VI PERMIT 95-218
1522 McCoy 398.00 27.50 425.50 33,806.63
VII PERMIT 95-223
18755 Bascom 669.80 13.50 683.30 34,442.10
IX PERMIT 95-264
Hatcher Court 1.00 1.00 66.24
X PERMIT 96-138
Gold's Gym 1.50 1.50 93.19
XI PERMIT 96-151
Littleton Place 8.00 8.00 529.92
XII PERMIT 96-180
401 W. Hamilton Ave. 3.50 2.00 5.50 202.27
Grand Total 2,912.30 262.50 3,174.80 184,727.57
3/11/97 3:50 PM
Subdiv
Actual Plan Check and Inspection Charges
Invoice/or Invoice/or OT Staff/
PPE Hourly Hourly Regular Overtime Invoices Date
Name Date Rate Rate Hours Hours incl 20% OH Received
Littleton Place (96-151)
Westfall, Randy 06/16/96 39.22 55.20 1.00 66.24 1 0/09/96
Westfall, Randy 11/03/96 39.22 55.20 7.00 463.68 11/06/96
8.00 529.92
401 W. Hamilton (96-180)
Gade, Derek R. 01/12/97 26.48 37.94 3.50 2.00 202.27 01/15/97
3.50
2.00
202.27
Grand Total
2,912.30
262.50
184,727.57
0.00
3/11/97 3:50 PM
Subdiv
15
Far West Insurance Company
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
Far West
Insurance Company
FEB 10,1997
CITY OF CAMPBELL
NORTH FIRST STREET
CAMPBEL.L, CA 95008
IlEce,,,
. ED
FEs 181997
PUJL 'c.
I Vol'
40M1fV/sr ... "'\.,J
RA TlON
I"" I -,
-L:!F'j'C.c ED ~ .... '.
90 -- /~)/
L~J- (~/e
c!)~ J 9.'3
RECEIVED
FEB 1 8 1997
FINANCE DEPT.
Bond No,: 006008025
Subdivider: LITTLETON PLACE PARTNERS
Amount: $124,000.00
Description: SUBDIVISION IMPROVEMENTS AT 1222 & 1228 HARRIET AVENUE
Location: CAMPBELL, CA
Effective Date: 8-05-96
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
1. Have the improvements been completed?
2. If not, what percent has been completed?
3. Is the work progressing satisfactorily?
4. Has this work been accepted?
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
[81 Yes
DYes
DYes
%
D No
D No
o No
COMMENTS:
uJ('
~ ZZ, /9f8
Phone:
Signed by:
Name:
Date:
AlAN f/O'P'l
t/oB) B~' - 21'8
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
Actual Plan Check and Inspection Charges
Invoice/or Invoice/or OT Staff/
PPE Hourly Hourly Regular Overtime Invoices Date
Name Date Rate Rate Hours Hours Incl 20% OH Received
Littleton Place (96-151)
Westfall, Randy 06/16/96 39.22 55.20 1.00 66.24 1 0/09/96
Westfall, Randy 11/03/96 39.22 55.20 7.00 463.68 11/06/96
8.00 529.92
Grand Total
2,838.30
252.00
180,410.25
0.00
1/9/97 4:25 PM
Subdiv
15
of'CA.1t
.....~....,'O~
f.. . . ~
,; . t'"
.... . t""
a ., f. .
;. "-
-So ...
~, ,-,'
O~CHA\lO'
CITY OF CAMPBELL
Public Works Department
December 10, 1996
Mr. Bruce Bowen
Hastings Development, Inc.
7127 Cohen Drive
San Jose, CA 95120
Subject:
Permit #96-151
Littleton Place
Backcharge for Inspector Overtime
Dear Mr, Bowen:
This letter is to provide an update on the total inspector overtime charges, to date, which will
be deducted from your cash deposit for the subject permit. Pending no further charges, a total
of $529.92 will be deducted from monies to be refunded to you at the end of the project.
On 10-4-96 repaving of the storm trench on Luika Ct. ran late and required 1 hour of overtime
inspection, Saturday paving of the main cul-de-sac on Littleton Place was scheduled in advance,
and resulted in 7 hours of overtime inspection, The resultant backcharge was calculated using
my current overtime rate of $66.24, which includes 20% overhead. 8 hrs. x $66.24 = $529.92.
If you have any questions, please call me at (408) 866-2165.
1f
cc: M. Quinney, City Engineer
70 Norlh First Streel . Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.379.2572 . TDD 408.866.2790
NEW PW FAX #
.40R_'I'7Ii_llo<;:n
Actual Plan Check and Inspection Charges
Invoice/or Invoice/or OT Staff/
PPE Hourly Hourly Regular Overtime Invoices Date
Name Date Rate Rate Hours Hours incl 20% OH Received
Littleton Place (96-151) )0/'1' /1b
Westfall, Randy ~6 39.22 55.20 1.00 66.24 10/09/96
Westfall, Randy 11/03/96 39.22 55.20 7.00 463.68 11/06/96
8.00 529.92
...--.....
G Total ~.30 /275.50~ 180~
-'---'" - (0.00), d
0.00~
11/15/96 12:11 PM
Subdiv
16
Employee Name: WESTFALL RANDY R
Employee # 2279
Employee Pay Type: 001
CITY OF CAMPBELL
Bi-Weekly Time Sheets
.~
Pay Period: 10/21/96 To 11/03/96
Program: 730
TOTALS
I
prog I proj
# 1 #
AC"rIVITY
I Mon I Tue 1 Wed 1 Thu 1 Fri I Sat I Sun 1 Mon I Tue I Wed I Thu I Fri I Sat I Sun I I
1-------------------------------______________________-----4~-______________________/ I
1 21 1 22 1 23 1 24 I 25 I 26 I 27 1 28 1 29 1 30 I 31 I 01 I 02 I 03 I 1
----------------
~...........-....-....------.....-...-.............................--...--.---..-----------..-----..-----..-------1'-------------____
Regular Hours / y I g 1 ~ 1 r; I ~ 1 1 I Y 1 g I ~ 1 ~ 1 V I I 1/ 8 6 1
1_1_1_1_1_1_1_/_1_1_1_1_1_1_11 1
051 - Comp Used 1 1 1 1 I I 1 1 1 / 1 I 1 I II 1
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052 - Self Sick 1 1 1 1 I / I / 1 I I I 1 I II 1
1_1_1_1_1_1_1_1--':1_1_1_1_1_1_11 I
054 - Vacation I 1 1 1 I 1 1 I 1 1 1 I I I II 1
1_1_1_1_1_1_1_1_1_1_1_1_1_1_11 1
055 - Float Hol 1 1 1 1 I I 1 1 1 1 1 1 I I II 1
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DAILY TOTAQ;
REG I O.T.
~~._~_~_32__2._______.._.________.___.~_____==____.___.___....___.______________._________________._______________________________~_=
Work Codes Leave Codes
001 - Regular Pay
-"
002 - Temporary Pay
010 - Overtime 050- Administrative Leave
012 - Standby Pay 053- Family Sick 057- Safety Job
011 - Call Back 056- Paid Holiday Injury
014 - Comp Time Earned 059- Paid Holiday(LTEA)
016 - Telephone On Call (Police) I 101- Bereavement Leave 058- Misc Job
031 - Working Higher Class 102- Jury Duty Injury
033 - Split Shift 103- Conference
034 - Trainer Pay 104- Professional Meeting 099- Leave of
040 - Meal Allowance 105- Staff Development Absence
***MUST BE FILLED OUT IN INK***
CITY OF CAMPBELL
FIELD ENGINEER'S DAILY REPORT
PROJECT NO__ --rt2, ~4C-
FS2-K \ Co. - \"'S I
REPORT NO:
DATE: \6- \ \_~~
WEATHER: e:~t2. \. \<:::~l t21
L-..
CONTRACTOR:
INSPECTOR:
c:::::....... G,c:::::. l..'---1.E:"""2-
ITEM
DESCRIPTION
~\ \ e-~'--L "2
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----
PAGE:
CITY OF CAMPBELL
FIELD ENGINEER'S DAILY REPORT
PROJECT NO.-rtz. ~~~
REPORT NO:
DATE: \ C::> "- \- l-~, c-
WEATHER: e..~l ~"12-1
....,. ~"
CONTRACTOR:
INSPECTOR:
C. @ ~.~
ITEM
DESCRIPTION
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CC: \-J\ c=r \ \2J..c)) '-*'A-, ~ g G::,- \ -:s;. \
PAGE: ~ OF~
CITY OF CAMPBELL
Bi-Weekly Time Sheets
Employee Name:
WESTFALL RANDY R
Pay Period: 09/23/96 To 10/06/96
Program: 730
Employee # 2279
Employee Pay Type: 001
1
Prog 1 Proj
# 1 #
ACTIVITY
I Mon I Tue I Wed 1 Thu 1 Fri I Sat I Sun 1 Mon I Tue I Wed I Thu 1 Fri 1 Sat 1 Sun 1
1-----------------------------------------------------------------------------------1
I 23 I 24 1 25 1 26 I 27 I 28 I 29 1 30 I 01 1 02 I 03 I 04 1 05 I 06 I
TOTALS
REG 1 O.T.
___..._____________~.___.____________g_______________________._________________...____._.___....___...._._._------1 ._._a__.______...
7 3~ I I Regular Hours I Q I g I q I g I <l 1 I 1 ~ I g I f 1 ~ I ~ I I I t 6 I
_1_1 1_1_1_1_1_1_1_1_1_1_1_1_1_1_1 I
I I 051 - Comp Used I I I I I 1 I 1 1 1 1 I 1 I 1 1
_1_1 1_1_1_1_1_1_1_1_1_1_1_1_1_1_1 I
I 1 052 - Self Sick I I I 1 I 1 I I 1 1 I I I I I I
_1_1 1_1_1_1_1_1_1_1_1_1_1_1_1_1_1 I
I I 054 - Vacation I 1 I 1 I 1 I 1 1 I I I I I I I
_1_1 1_1_1_1_1_1_1_1_1_1_1_1_1_1_1 1
I 1 055 - Float Hol I I 1 1 I I 1 I I I 1 I 1 I 1 1
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DAILY TOTALS I C:l I ~ 1 '(' I I I I I I 6 I I I.J/ I /2- I I II I 4-
~.--_.._-----.------------------=--_.--------_.--=-------------------------------------------.-----..--------------------------------
Work Codes
001 - Regular Pay
002 - Temporary Pay
010 - Overtime
Leave Codes
101- Bereavement Leave
058- Misc Job
Injury
/YZu
050- Administrative Leave
012
011
014
016
031
033
- Standby Pay
- Call Back
Comp Time Earned
- Telephone On Call (Police) I
- Working Higher Class
- Split Shift
053.. Family Sick
056- Paid Holiday
059- Paid Holiday (LTEA)
057- Safety Job
Injury
034 Trainer Pay
040 - Meal Allowance
102- Jury Duty
103- Conference
104- Professional Meeting 099- Leave of
105- Staff Development Absence
ture
***MUST BE FILLED OUT IN INK***
"
Sep-l7-96 04:56P Duryea/Carroll
408 265 4772
P.Ol
FIle., eftt:- CJ~-'s-I
~vl~+-I
LJ;tt...*" ct-
DURYEA/CARROLL
3150 Almaden Expressway Ste. 103
San Jose, CA 95118
408-265-4770
Fax: 408-265-4772
FAX TRANSMISSION COVER SHEET
Date: September 1 7, 1996
To: Ranqy Westfall
Fax: 376-0958
Re: Tract 8846 - Luika Court, Littleton Place
Sender: Bryce E. Carroll
YOU SHOULD RECEIVE 2 PAGE(S), INCLUDING THIS COVER SHEET. IF
YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CALL 408-265-4770.
Randy,
This memo is for the purpose of providing an alternative solution to the Luika
Ct/Hacienda storm sewer manhole connection as shown on the approved plans.
Problem:
An existing 3 to 4 inch gas line running parallel to Hacienda passes through
the designed location of a new manhole as shown on sheet three of the plans. Also,
the contractor was able to fit the new 15" line into the manhole with some
disturbance to the westerly 12" lateral and no disturbance to the easterly lateral.
From data our office received from the project superintendent and the contractor, it
appears the existing manhole can be used (thus eliminating the need for the manhole
at the gas line location), However the conflict between the 12" lateral and the IS"
main must be remedied as follows:
Solution:
Break the sides of the 12" and 15" back from the manhole entry point about
12" (per contractor measurement) so that the entire diameter flow sections of the 12"
and IS" are maintained into the manhole without restriction. This will require a
Sep-17-96 04:57P Duryea/Carrall
408 265 4772
P_02
substantial collar around both of the 12" laterals and the 15" main. All soil shall be
removed from the manhole (clean existing concrete surface) to at least 24" along each
pipe from the manhole to a minimum depth of 6" clear of all soil around and
underneath each pipe. Drill and epoxy 12" lengths of rebar at 8" OC into the
manhole wall about 3" above and on the sides of the 12" and 15" pipes allowing the
rebar to protrude into the new concrete collar about 8 or 9". The void shall be filled
with Class A concrete to minimum 6" thickness all around so as to completely and
totally seal all cracks to prevent any leakage of storm water from the pipes or manhole
to the surrounding soil. Such concrete shall be allowed to set to sufficient hardness
prior to backfilling the trench so that displacement will not occur through dropping
soil or compaction efforts.
The interior of the manhole, pipes, transitions and joints shall be grouted
smooth so as to provide good unobstructed flow capability and to completely seal any
points of potential leakage.
Bryce
ce Saneo Pipeline 377-7405
Bruce Bowen 378-2307
Dave Lerson 379-9756
1.
2.
3.
4.
5.
6.
7.
CITY OF CAMPBELL
ENGINEERING DIVISION
LAND DEVELOPMENT SECTION
DEVELOP:MENT CHECKLIST
APPUCATION NO:
TRACT NO.
ENCROACHMENT PERMIT NO:
ADDRESS:
APPLICANT NAME AND PHONE:
CONSULTANT NAME AND PHONE:
\~ q'L... -0 \ \ S~G::.-(O\ -O~)
~~4~
9.4::. .- '\ ~ \
\~'(.~ ~~L-\~
~.~\~~ ~C>~~L:) ;<
D ~ ~ ~t'2..i::2-C>u..
"'-z- ~~-4'\ c::.
REQillRED RECEIVED
ENCROACHMENT PERMIT ISSUANCE CHECKUST v-"
ENCROACHMENT PERMIT APPUCATION V'
ENCROACHMENT PERMIT INSURANCE CERTIFICATES /
FEES, SECURITY AND CONSTRUCTION ESTIMATES
a, Engineering Plan Check and Inspection Deposit ~rzC" 4~-q~
b. Engineering Plan Check and Inspection.Fees:\t\t;\.-\~FP ~.. '=t~~~~~1
, . ~~t'=L ~C?'= u._-"".:.u~,-,,~ co, 1*-0lGf..c.x..,~"o"1--:;:.
c. FaIthful Performance Secunty ~~M-..~v~. "'u 'l.,,-..,.~~(..
Lab d M 'a1 S' 4:( ~~ b e; I -S:L.:..~e.G'-~'~~7~':J(;:>~:>'':''<Z
d. or an aten ecunty ...~...1....<7..;..... <<<..-;;.-G\.....
e. Maintenance Security . . .. .... . . . . .. . . .. . .. v
f. Emergency Cash Deposit ~.~H~~...f?h"" V
g. Storm Drain Area Fee ~~.?:-~...... V
h. Record Map Fee ~.)"':';Q::;........ ~
1. Traffic Engineering Fee .. .. . .. . .. . .. . .. .. . . . "--' 7-
M . . S' -4,.,.....<.. \. (:P<.t> C. V
J. onumentatIon ecunty ~." .................
<\\ <6.""2.4." o"=. 0 tt: 'Co ;,..o-,c;,.;-~- V
k. Park Impact Fees ?-;\;; ; ::-r:"".... . . . . . , . .
1. Miscellaneous Fees ~'"":t.~..,..., ~
m. Construction Cost Estimate <t.\'l.,.~l.l?(7CI. . . . . . V
STANDARD AGREEMENT AND ATTACHMENTS........ V
SPECIAL AGREEMENT AND ATTACHMENTS............ V
RECORD MAP
a. Easements and Dedication ..................,
b. Taxes and Assessments Letter ...................
c. Non-Interference Letters (NILS) .,.................
d. Signed Check List by Engineer/Surveyors . . . . . . . . . .
e. Current Preliminary Title Report ...................
f. Subdivision Guarantee .. . . ..... . . . . . . . .. .
g. Fictitious Name Certificate ...................
h. HOA Management Agreement ...................
1. CC&R's ..........,........
J. Mylar Copies After Recording .............,.....
0-;0, -, (' ~ 4-S-9-<C:.
~<?\4 ~(?L.
,.- l<:'"~
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V
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V
V
~ - \ -4.<'..... ~~,- (~ ~"'t(._
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1
RIGHT-OF-WAY BY SEPARATE INSTR..............."..
SOILS REPORT TCS\~cs~.~hq>.I.<;1k.."
PLANS
a. Street Improvements . . . .. .. .. . .. .. .. .. . .
b, Grading and Drainage . . .. . .. . .. .. .. . . . .. .
c. Landscape ?~<-?~ ~'-~~~...
d. Traffic Control ....................
e. Other ........... ..,......
11. CLEARANCE LETIERS OR PERMITS FROM OTHER AGENCIES
a. SCVWD PROP. EASEMENT LTRS.................. t-....)~
b. WVSD "c:::..o-~?\..~,o,::-~" ".......",..,...... V
c. SJWC "" " II ".....,.........,... V-
d. PG&E "" " " "................... ~
e. Pacific Bell" " " "................... v---
f. TCI "" " II ",.........,..".... V
g. SCCFPD (Central Fire) .................... V
h. Cal Trans ........,........... kt fi,...
1. City of San Jose .................... WI::....
J. Town of Los Gatos ....................~,t...
k. Private .. .. .. .. . . .. .. . . . . . , v'
l. Other ....................
12. SOILS REPORT "\~l.E"--h--,;~...~l\~d~.
13. LETTER FROM DEVELOPER TO PAY ADDITIONAL
PLAN CHECK EXPENSES
14. UTIUTY COORDINATION PLAN ...................... ~
15. APPUCANT LEITER STATING COMPUANCE WITH ~
CONDmONS OF APPROVAL (... ----z.r=;;.-9.<.o
16. SPECIAL SUBMITIALS PER CONDITIONS OF..........
APPROVAL
17. PLANNING DIVISION APPROV AL .. .. .. .. . . . .. , .. .. . .
18. BUILDING DIVISION APPROVAL ....................
19. TRAFFIC DIVISION APPROVAL ....................
20, SERVICE CENTER APPROVAL .............,.....,
21. ESCROW LEITER WITH RECORDING INSTRUCTIONS
22. CITY COUNCIL AND PLANNING COMM.RES..........,
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CITY OF CAMPBELL
F,LI) j (.,~-rr~
WhcD Recorded Mail To
City Clerk
City of Campbell
70 North First Street
Campbell, CA 95008
(Space Above This Line For Recorder's Usc)
GRANT OF EASEMENT FOR DRAINAGE PURPOSES
FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged.
David Rogers and Donel Rogers, Husband and Wife, as Joint
Tenants ~ 51P~/3?4-
hercby GRANT(s) to the Cil}' of Campbell. a municipal corpor;;non, of dle COUDl}' of Santa Clara, Stale of
California, an easement to build and maintain an underground pipelinc, and necessary devices and appurtenances.
over, under, along and across, all of that certain real property within said Cil}' and more panicularly described as
follows:
EXHffiIT A-I
LEGAL DESCRIPTION
FOR A STORM DRAINAGE EASEMENT
OVER THE PARCEL 1 (One)
646-M-31
An ease:mt:nl (15.00 ft:et in width) for the purposes of the: installation, maintenance:. and re:pair of an
underground storm drainage pipeline, ovt:r under, and upon that certain strip of land situale.: in the Cily
of Carnpbdl, County of Santa Clara, State of California, tht: ..:cntcrline of said e:ase.:me.:nt bt:ing dcs..:nbcd
as follows:
1
'I
BEGINNING at the Southerly corner of Parcel One as said parcel is shown upon that cenain Parcel Map
rc:cordcd on May 4, 1993 in Book 646 of Maps at page 31. Santa Clara County Records, also bt:lI1g the:
Nonht:aSlerly corner of Lm 5 as said 1m is shown upon that ce:nain Tract Map No,6125 rc:cordcd on
N ove:ber 16, 1977 in Book 407 of Maps at page 44, Santa Clara County Records; tht:nce along the:
general easterly line of said Parcel One North IS" 50'00" West 13.38 feet 10 the TRUE POINT OF
BEGINNING of this description; thence leaving said easterly line nortbwesterly along a curve: to the Idt,
from a point with a radial bearing of Nonh SO" 45'22" East. with a radius of 200.00 feet, through a ce:mral
anglt: of 10" 58'57' to a point with a radial bearing of Nonh 39' 46'25" East; thence Nonh 15.' 50'00" W CSl
143.86 fcetto the nortberly line of said Parcel One, said point being the terminus of this de:scriplion, 111~
nonhcrly lerminallint: of said e:asement bt:ing tht: said northwe:slerly line: of Parcel One and th~ !:asl~rly
lerrninalline: beIng the said easterly line of Parcel One.
SL:e allacht:d Plat which is a pan herL:of.
Said property contains 0 0 h acres, more or less, and is generaJly shown on dle attached Plat Map.
Page I of 5
The Grant of Easement herein contained shall include the right to enter said premises, to survey, construct,
reconstruct, lay. relay, maintain, operate, control, use and remove said pipeline, its fixtures, appurtenances, and
to remove objects interfering with the construction, operation and maintenance thereof. The Grantor reserves
the right to occupy and use said premises for any purpose not inconsistent with the rights and privileges above
granted and which wil~ not interfere with or endanger said pipeline, its tixtures and appurtenances or the use
thereof. The City shall use due care in the construction, operation and maintenance of said pipeline, its tixtures
and appurtenances.
The provisions hereof shall inure to the benefit of and be binding upon heirs, successors, assigns, and personal
representatives of the respective panies hereto.
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SIGNATURE ,/ /J
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Printed!) / /
Ir (.}nl/()O a (~ tJ /\.,C]
SIGNAtURE J
D(\)JF I R60p l__'l
Printed ...J
STATE OF CALIFORNIA
COUNTY OF -S {l (J'Vc (I \ d /( Ll
On ---S:-:llt t \ q I {j q l., before me,
the undersigned, a N~tary Public in~said
S~ personal~peared~'-"I f l. ~r'ritJ I?~
'~ \...:XA C ,(\ ~ C9 t' (( S personally known
to me (or proved to me on the basis of satisfactory
evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged
to me that he/she/they exe.cuted the same in his/her/
their authorized capacity(ies), and that by his/her/
their signamre(s) on the instrument the person(s), or
the entity upon behalf of which the person(s) acted.
executed the instrument.
Wl{NESS y and:an~ official seaQ j1 ~ l. \
Si~ .f;cf<<'~ '--.---L _~>L M<./
N~et11 ~, e n(' f .{:+t"{l-e ~U2t1 f ~
(typed or printed) This area for official notarial seaL
Page 2 of 5
j: \forms\grantdrain
ACCEpTED ON TH1S ~ ti d3Y of ~ I /99t
for a".! nn b9n(J!f of the City nf CJmpbell.
a rv;U'l:'~i)31 Cor~Or'3tj0n, of c'1~ S"3te of
C2lifr'r-:ia, pL;rsu~.t 10 Res~'!/ion No. 749.
recorjed in Book 4509 ~ Santa Clara
County Records. ~
Anne Bybee, City Clerk
City of Campbell, California
Page 5 of 5
-.
144.32'
TRACT NO. 8846
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o~ 0"
~rorv ,,4" 1
34.50'
"
~TRACT NO. 6125
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3
A.P.N. 403-13-103
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403-13-104
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~1:S-6'~ 1 S04029'38"E(R) . ." .' . ..' i I ::,
~ ~ .....-; --:-,::: ;-"'"'. Gj N1SOS0'O' O';W' '. :'143-86-;-'. i. "-7:;7 c-f : I: '.'
~ . I . _:,t':""1'S'(ljS'-;-O'E' "( ,; . ' OR-:-: i ')' ' :::;
. ': ',:,i;:;~:12.;;,'; ,..:,~.::, ' ,;" '~/'
- -1S'-STORM-DRAI t ~\
/ ~ = 45034'22" EASEMEN' ;>. :\
! R = 40.00' ~~\
I L = 31.82' A P N / ~ ~~:\
w . . . / //: r - / J f' ~
o. I PAR./ c::.. /' / J Cp
~ ~: . (641 ~.:1(;7'e1Y !:J
~ ~I VCt"7?(
1"--- 10' P.S.E. (646-M-31)
N15'50'OO"W 150.55'
- POINT OF
,: .' y i BEGINNING
',/ \ Do = 10.58'57"
\ R = 200.00' L{')
\ L = 38.34' ~
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STREET DEDICATION TO
THE CITY OF CAMPBELL
0.182 ACRES
EXHIBIT A-2
OF A
Design By: MJD DDURYEA/CARROLL Scale: 1"=40'
En 0 eers and Surveyors
Drawn By: MJD . s.J':",a.en .............. SuI.. .03 Date: JULY 1996
San Jose CA 95118
MJD tel: \408~ 265-4770
Check By: fax: 408 265-4772 Job No. 95-285
Page 3 of 5
CONSENT OF LIENHOLDER
The undersigned beneficiary under that certain Deed of Trust recorded
September 8, 1995 as Recorder's Document No. 13008012 of the Off' , 1
Recor~s of County of Sant~ Clara, State of California, consents ~~1~he
creat10n of the storm dra1nage easement recorded herewith.
Dated
7!~ciJqG
/ /
Lienholder
Louise Bogdan
~.
/
~...7U/1/-
r--r - -~,
/ .
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/1(~ c 6 //[
/
STATE OF CALIFORNIA
County of ~lJL,tC\. ~\C\ Y'Cl
,~ 4- I C I Cf (p
Title or type of Document (c F-r rrlC))'rt-
Number of Pa!!es Date of Document
Si!:ner(s) Other than named below
On
before me ~L~II1t( (j \S. ~I ~r
personally appeared
basis of satisfactory evidence) to be the person(~) whose name(s) is/are
ledged to me that he/she/they executed the same in his/her/their authorized
'gnature(s) on the instrument the person(s), or the entity upon behalf of which
rument,
(Seal)
Y .-. -.. -. ..... /~ ......... <:' ~
Or ~~" Sh"-l': ~ ~lior~7
~.\.~ r;J _, t'\.~l \:; -;:.
in' \>} Comm ''',.1''.'''1 ~.
V ~ <-:J' c . ... ~\j".J" c:l
Il:: :.cr' I'/OTARY PUBLIC c.;lI:=C~NI~'"
6:. , SANTA CLARA COUNT' (I
Comm. E::p. Aug. 13, lWll .l.
r ~'"
o~,;.); Sherr; S. Keller s:
Cl -ft'. Comm. #1068851
~ \~ -,", NOTARY PUBLIC CALlFOR. NIA G)
~ ~< ~ SANTA CLARA '~c~;r;TV ()
J- ~ Comm Exp Aug. 1 j 1 C<10 ....
~ -/V- '-~ "'.---~'Z:~.,,"'~~
Page 4 of 5