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96-225 CITY OF CAMPBELL ENCROACHMENT PERMIT mit No. DEPT. OF PUBLIC ~O!U.<S- I V 1: ..) (for working within the A-Ref. File ~~;:I,F~~~8J: C t: ~ - pUblicrig~~f-Wa~ V- /~ Q/-7/Q (408) 866-2150 AUG 271996 Issued ""0 - I '-1j ~ Application Date CJ/~, -, &/ Fax (408) 376-0958 l"" . Permit expires in 12 m s. Application expires in 6 mot .I 1", ~C " ,J \$"" ..... APPLICATION - Appli:cat,iQO !~:f;rr~1l.Ydtialle 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 Application Fee is non-refundable). 9b-22S A. Work address or tract # 21~ C).;c~.r( L4/'JL 0 It/beLL Utility trench location ::J)(./7P cera '( L/l"J€ ;/' vV 10 (lCdsc -r<f LINO(Z, B. Nature of work 4 I :1.4' 6c;LL)-0~ E Of')'::: IDE//'..J4L/ /-1/ LA -rv Rt IYA(E..~ CAs ~t/ / CF 4r b -2.30J.2 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 part of this permit. D. 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 Sureties and cash deposits. (See General Permit Conditions 1 and 2.) E. THE CONTRACTOR MUST HAVE TillS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBLIC WORKS DEPARTMENT AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK. Name of ApplicantfPermittee Address / CYJ uO tJ Telephone 725 -;J 0'19 ~o ('~ 950/ " No The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell, its officers, agents and employees free, safe and harmless from any claim or demand for damages resulting from the work covered by this permit. J?,rJ.;:) -7' G, Date ] J 0 0::: L...J ::r:: >- Cl 39 >- --' a: >- 0 :z: a: :c 0 0::: L...J (.J") ::r:: <.J 0::: >- 0 L...J 0 ",c: >- U) 0::: 0 :z: w L...J 0 ::r:: 0 I- :z: ::l: C) 0 0 CD X ....... (.J") w 0 Ul L...J >- a.. U) ::l: a.. :::;) 0::: a: :c w 0::: ::r:: >- I- (.J") 0 C) c:ci 0 0::: L...J --' L...J >- I ::r:: 0 I >- :z: I C) I Ul I 0 U) I W L...J --' N W :z: w :::;) U) I- >- 0 0 --' :z: C) w 0::: :z: w w U) a.. 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L...J >- L...J ::c >- \1J a:: a:: a: L...J .J >- >- 0 ---' ~ a:: L...... ::c -.....: r-.. C\J :t .J ~ ~ ~ ~~C FI',=? CONSTRUCTIO ,( ity Cl (~Clrnpbell f" ,,..... [),,:,r;.-,!t. I",!n '1,.. L t", ~; .i \_1 ~ i ! i .... \;; '-.I. _...___.,,_ .__ Co,~t, ',etar mu~t have these plans n the iob site during construction. I .. - , ---' >- U) 0- X . "<T I........ ,M "" L... ....... 0- (") -<..:> :z: >- - a::: >- L..J (f) tf) - :z: >< -L...J <..:> ===== CHERRY L..J -J o :r: -J -J L..J L...J CO 06 _ <..:l <:1'"" a... x , >- <:1'"" CD LRNE f-- (j) = = =~=FOC TIED IT c.D G 2"HP STL ~--t=- = a::: L...J w:> :> 0 ---' <..J a: :> 0 :z: ---' a: 0- , L...J - ::c a: ---' a::: ......J L...... a: >- X U) >- :z: - -:3: W f-- o :z: :z: o a::: a::: a::: a::: a::: X :r: X :r: X ....... ........ ............... ....... :::::>::::>:::::>::::> :::::> ~ t'- t-- I-- t-- cococococo- ::c ::c ::c ::c ::c (f) ;:; ~ ~ ~I:::: : O(,")C\J_ r-.. 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(401) 988.7550 Fax (408) 259-5772 851 N. King Road. San Jose. Califom'a 95133 TO: J$cb ~/rv /~Sf7r3Ufl>/L) FROM: fi,~.dZz.> ~#.L7?.,.JdZ DATE: e#t' h? FAA#: ~) 37t- O'1'S""Y MESSAGE/ITEMS ENCLOSED: C.O,q~~ l?.(Jd/~? L.e,I(tL L?~ (..(...IO~/~f / tV V 0..) e. T?}V ,c) ~ ~-D e:,+;-r Q;tiJ L,/, S 7""r7> 1162<--- c> -...J f ,tL: ~J "'(~ud 4..vr,r 6:l\)~;?<M/" ,.-t't:~Sc ~~r ~.kf . ORIGINAL 0 WILL rILL NOT FOLLOW IN THE N\AIL. WE ARE TRANSMITTING A TOTAL OF --/--PAGES, INCLUDING THIS COVER SHEET.. IF YOU DO NOT RECEIVE ALL PAGES OF THE FAX, PLEASE CALL OUR OFFICE AT (408) 988.7550. DEPARTURE 11IIE FROM YAKD ARIUVAL TIME TO 1ST. J08_ DEPARTURE nME FROM lAST JOB LUNCH 112 DR. 1 HR. JOU3: TAG: ADDRESS: TAG: ' ADDRESS: TAG; ADDRESS: IlATBalAL: PINtsRBD NIP PG4E CAMPBELL 083139 ONE AREA SIDEWALK S" TIfICK. CH~RRY LN. 100' WIO CALIFORNIA . ;,,/, .-0 I I~ Ite I (0~'V '1 p.rC/l- f't. 0 084661 TWO AREAS SIDEWALK 4-nDCK 648 ASH cr.. @ ARC RD. J:::' S6ot68 ONE AREA SIDEWALK 4- TIna 301SDRlFnVOODW/OWINCHES1ERBLVD. ~ our5l/D/1. o,-"'i? c./7''/ l...t"1.l( j1 c.. c.. c"t f) , ",GL.. ---zc 'I(.,t(~ --Iv"'-tIL to"lL/ I'\.\r'p (__hI L ...J ( ,...' v...., /-'1.t( U/;~I , Mll..PITAS MAlERlALS ON WIlL CALL BlWN. l1-12..00PM 262-0656 YARDS