Loading...
96-184 CITY OF CAMPBELL PUBLIC WORKS DEPT. 70 N. First St. Campbell, CA 95008 (408)866-2150 FAX (408)376-0958 OWNER OCCUPIED R-l NO FEE ENCROACHMENT PERMIT (for working within the public right-of-way) ($5,000 maximu value of work) ,Permit No. X-Ref. File Application Date CfIP.. J ?~ 1/21 Jc]7 I RECEIVED ISSUED APPLICATION - Application is hereby made for a Public Works Permit in accordance with Campbell Mutf! ~ole_on 11.04. (Application expires in 6 months if the permit is not issued.) PUbLIC \Iv',";," 40 1..,.." . ,MJ,~Sn~A T/ON A. B. C. Work Address 11'56 NA()}Nt. D~. Nature of Work ~e.PLACK, ~fR:&c:r 1'"ROf5 {(l"ft(jv~ 8'1 GJ'T'1 Attach three (3) copies of a drawing showing the location, extent and dimensions of the work. The drawing shall show the relation of the proposed work to existing improvements. When approved by the City Engineer, said drawing becomes a part of this permit. All work shall conform to the City of Campbell 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 securities. D. NAME OF APPLICANT Geo~ L. C OSGAAJ (Print Name) TELEPHONEr4-0f' ) 'g/'b - 077 7 / ADDRESS I/SO NAb/NO /)/(/' . C4W~ ,rA I tjS(jOf~ /7J. 4-- The Applicant hereby confirms that this work is being done by the property owner/applicant at their own residence. The Applicant hereby agrees by affixing their signature to this permit to hold the City of Campbell, its officers, agents and employees free, safe and harmless from any claim or demand for damages resulting from the work covered by this permit. The Applicant hereby acknowledges that they have read and understand both the front and back of this permit, and that they will inform their contractor(s) of the information. II ACCEPTED ~ L G,~ r-,}--f-:r Ap i ant/Permittee ( ignJ Date NOTES: ALL WORK SHALL CONFORM WITH THE ATTACHED, APPROVED PLANS AND ALL APPLICABLE CAMPBELL STANDARD DETAILS AND CONDITIONS. THE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AND MUST ARRANGE TO MEET WITH THE PUBLIC WORKS INSPECTOR AT THE SITE AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK. PER SECTION 4215 OF THE GOVERNMENT CODE THIS PERMIT IS NOT VALID FOR EXCAVATIONS UNTIL UNDERGROUND SERVICE ALERT (USA) HAS BEEN NOTIFIED AND THE INQUIRY IDENTIFICATION NUMBER (TICKET NO.) HAS BEEN ENTERED HEREON. USA PHONE: 1-800-227-2600. TICKET NO. SECURITY FOR FAITHFUL PE STANDARD 100% OF ENG. EST.) AMOUNT $tJ/A RECEIPT NO. N/A /.....tll.~7' Date APPROVED FOR ISSUANCE or City Engineer 6 Months After the Date of Issuance j: forms rlperml rev. kJ.f~ ~7/ :L.cd:',~ /../"-5 J~=kSIDC'.A. fr~ Jl/a.<I.~ ftJ'e-d' I ~ -I~L- ~ rJ~ by C~ ~/ <<w'4~ (j GENERAL PERMIT CONDITIONS 1. A SECURITY to insure FAITHFUL PERFORMANCE and completion of the work is required. This SECURITY is refundable upon completion of the work and written acceptance by the City. 2. A ONE-YEAR MAINTENANCE PERIOD for all work is required. Such period will begin on the date of written acceptance by the City. It is the applicant's responsibility to remove and replace unacceptable improvements within the one-year maintenance period. 3. REFUND or cancellation of the Faithful Performance security will be initiated by the written acceptance of the work by the City. 4. The Permittee MUST REQUEST IN WRITING a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing to the Permittee. 5. MAINTAIN safe pedestrian and vehicular crossings and free access to private driveways, fire hydrants and water valves. 6. REPLACE IN KIND any damaged or removed existing improvements, including planting. 7. SA WCUT for all PCC or AC removals. Prior to concrete sawcutting or washing, the Contractor shall place filter fabric material in the flow line of the gutter to retain all construction debris. All construction debris shall be wet vacuumed, broom swept, picked up and disposed of by the Contractor. Concrete sawcut debris shall not be swept or water hosed into the gutter and into the storm drain system. 8. Adequate signing and lighted BARRICADING is required on the job site. Failure to provide such signing and barricading as specified by the City Engineer may result in the City's renting such signing and barricades and charging the cost to the permittee. 9. The Contractor or Permittee will have a SUPERVISORY REPRESENTATIVE available for contact on the project at all times during construction. 10. This permit shall be kept at the site of work and must be shown to any authorized representative of the City of Campbell or any law enforcement officer upon demand. 11. No STORAGE of materials or equipment will be allowed near the edge of pavement, within the traveled way, or within the shoulderline which would create a hazardous condition to the public. 12. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other work for which a separate permit may be required, nor does it relieve the Permittee of any obligation to obtain any other permit required by law. 13. All necessary ROAD REPAIRS resulting from the permit work shall be made in accordance with City Standards and Specifications at the sole expense of the Permittee. 14. This permit does NOT RELEASE the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency. 15. This permit is NOT TRANSFERRABLE. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 16. Prior approval of inspector is required for any work done after normal working hours, on weekends or holidays and may require reimbursement of inspection costs at the current overtime rate. 17. Call back (call out) due to emergencies regarding this permit, shall be at the current overtime rate with a three (3) hour minimum charge per occurrence. Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above conditions. \4 \/~~ I~l? -91- ~cant () ~ Date Of'c'''-1t .... /)~ ;... ~ ~ l'" U. ,t"" -" 1- '" '" "- ,,' OkCHA\lO. CITY OF CAMPBELL Public Works Department January 14, 1997 Beverly Coggan 1150 Nadine Drive Campbell, CA 95008 Re: Encroachment Permit Application No. 96-184 Dear Mrs. Coggan: As discussed, enclosed is an application for an R-l permit to replace your street tree. Please sign both pages of the application and return it to us, so we can issue the permit. Please note that you may plant either a Raywood Ash or an Ornamental Pear tree, as noted in the permit application. No security deposit will be required due to the circumstances surrounding the removal of the original tree. Please remember to give me advance notification prior to planting the tree. We have enclosed a copy of our letter to you dated June 24, 1996, for your reference. Please contact me if you have any questions concerning this matter. Sincerely, EJ~otf Public Works Inspector Enclosures File: 96-184 H:\1150NAD.L TR(JD)(WP) 70 North First Street' Campbell, California 95008,1413 ' TEL 408.866,1150 ' FAX 408,379,1571 . TDD 408.866.1790 / ~ .Of'c"t'4,o ... ." ~ " .....,".,. ~ (t. -...~..:-.. ~::.;!.. r'" i.) .",.'">,,.....,r:.. ~ . ~~J;.i.~.~;:;..:ff . ~ .. ." --~" .. , . 04'CH""'O " CITY OF CAMPBELL Public Works Department June 24, 1996 C~3CW\. Beverly Coglin 1150 Nadine Drive Campbell, Ca 95008 Re: Tree Planting Dear Mrs. Coglin: In response to your request for information about street tree planting, the City has reviewed the trees in your area and determined that the variety of tree to be planted shall be a Raywood Ash. Please be reminded that an R-1 Encroachment Permit must be completed by you and issued by the City prior to any work being done. There is no fee for this permit; however, depending upon the scope of the work, a refundable surety deposit may be required. When returning the Encroachment Permit, please submit a simple scale drawing of the area between the curb and sidewalk, and indicate where you desire to plant. Once the permit has been issued, please contact me to arrange for inspection of the work. If you have any questions, I can be contacted at 866-2165. ~~ Public Works Inspector q &/Ig 4 h: 1150nadine.tre 70 North First Street' Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.379.2572 . TOD 408.866.2790 NEW PW FAX # ( " )./I::yf) ~ ' ') , .) ItJ /A/lf-7 (y y< I /7 c--P/ (1; ~T;;u('fY -) Of'C.44j ~. ....0;,1> "':. ~ ...... "'""" t"'" U " t"" ,.} . ,- .. ... 10 ... .-, .- '" ~ " r.JItCH" \\ \l "'-' \ IrJ CITY OF CAMPBELL ~UbHj;:~~ 9 Lf o-v- vJ( ~ 0/1-- o ( (""jt--.o\' r et/fC'--f~ May 29, 1996 hI....f Beverly Coglin 1150 Nadine Drive Campbell, Ca 95008 ~ Re: Tree Planting Dear Mrs. Coglin: Thank you for your recent telephone inquiry regarding street tree planting. Enclosed is an application for an R-1 Encroachment Permit which must be completed by you and issued by the City's Public Works Department prior to commencing work. There is no fee for this permit; however, depending upon the scope of the work, a refundable security deposit may be required. Also enclosed are the City's approved Tree List and planting requirements. The City requires that you plant a tree from the list which is consistent with the trees already planted on your street. We will review the trees in your area within two weeks and provide suggestions as to acceptable varieties. When returning the Encroachment Permit application, please include a simple scaled drawing depicting the general area and the relationship of your proposed improvements to existing streets, sidewalk, driveways, utilities, adjacent trees, and other facilities located in the immediate area. It is very important to establish that the placement of the new plantings will not interfere or damage existing improvements. Once the Permit has been issued, please contact me to arrange for inspection of the work. If you have any questions, please call me at 866-2165. ~lY~ )~# e~~ Public Works Inspector Enclosures cc: Vince Huppe, Park Maintenance Supervisor I 70 North First Street. Campbell, California 95008,1423 ' TEL 408.866.2150 . FAX 408.379.2572 . TDD 408.866.2790 NEW PW FAX # 4.nR_~"'7.r.: nn,..."