96-209
CITY OF CAMPBELL
DEPT. OF PUBUC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working within thc
public risbt-of-woy) @J
Issued 7 J '2~fib
Pcrmit expiIis in 12 months
Permit No. 96-209
X-Ref. tile
Application Date 7/22/96
Application expires in 6 months
APPUCAnON - Appliamon is hereby IIIIde for. Public worts Pamil in ICl:IlIfdaDce wld1 CaIIIpbcI1 MIUIicipII Code, Secdoo lUM. (AppI... apircl in 6111ll111bs
if Ibc permit is DOl iuued. Application Fee is -.rcfuDdab1e.)
A.Workaddrcuorlral:ll 151 W. Hamilton @ Dunster
Utility II'eIId1loaWn
B. NIIure of work
2' X3' cut in asphalt for emergency main repair
C. Aaacb four (4) copies of an qineered pllm IIaowiDi Ibc Iocaioa aad CIleIIl _Ibc work. aad four (4) cop.. _lbc preIIminIry EDaineer'a ilIdmMe _ work. Tbe
plana abIII abow tbe reIaIioo of Ibc proposed work to cDstiD& aurfKe and lIIIderpouDd improvaDaIII. WbcD IppRMld by lbc City BaIiueer, Aid pIaD becamea . pIIt of
Ibis permit.
D. All work ahall conform to lbe City of CaIIIpbcI1 SlaodIrd SpeclficIDoaI and DelalIs for Public Worts CoaaIruc:tioG; Ibc GaIcnI Pamil CftIIditiftno 1iated oa Ibc revene
aide; aad !be Special Provisions for lbia permit. lilted below. FmJure to abide by dICIc c:oadidoaa and proviaiolll u.y nRk III job abut4nvD lII/IJIor forfeinare of Failbful
PwfonJlllllCC SURUes and cub deposilS. (See GaIeraI Permit (,mditioas 1 and 2.)
E. THE CONTRACTOR MUST HAVE TlDS PERMIT AND APPIlOVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS DEPARTMENT AT
LEAST TWO DAYS BEFORE STARTING WORK. NOnCE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK.
NIIIIe of Applicant San Jose Water Co. (Jane - Emergency verbal) T~ 279-7847
(prill _)
Aclclress 1221 S. Bascom Ave., San Jose 95128 24 HOUR EMERGENCY TELEPHONE NO.
Is lbia work beiDa done by lhe property 0WlICI' lit !beir own raidCDce?
Yes
x
No
Tbe Applic:anllPermittee be:el:>y qrees by afflXina their sipalure to Ibis permit to bold !be City of CImpbeIl. iIs officcn, ... and employees free, life aad blrmleu from
any claim or demand for dama&es raultiD& from !be work covered by lbia permit.
Tbe ApplicanllPamiuee bmby a:tDowledaea lhIt lbey bave read and UDdemand boch lbc from and lid of Ibis permit. and Ibcy wID inform their ~s) of !be
information.
Aa:epted
SAN JOSE WATER COMPANY (Emergency verbal - Jane)
(Applic:amlPaminee) (sip)
7/22/96
Dale
.:rn OF CAMPBELL
)JWC0
'5 vi. )~ If,,--~.
CONTRACTOR:' 5'J vJQ
PROJECT NO. CJ b _)0 9
REPORT NO: I
DATE: 1--)1F,,9(P
WEATHER: ~,,/ .
INSPEC'l'OR: R. ~51fALL
FIELD ENGINEER'S DAILY REPORT
ITEM
DESCRIPTION
'5 vJG
tlk
aC/tJ
~ I w, /1 b fL ((e 6 t,A-V fA C,,<
~t
cc: PAGE: I OF I