96-238
CITY OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT
(for working within the
public right-of-way)
Issued CJ )~ jC] v..JlP0
Permit expires in 12 months
Permit No.9 6 - 238
X-Rd. file
Application Date 9 /2 4/9 6
Application expires in 6 months
APPUCA TION - Applicllioo is bereby IIIIdc for . Public Worb Permit ill ICCOlduce wkh CaIIIpbeIl MuIIicipal Code. Secdaa 11.04. (App\icIIiaa apinl ill 6 IIIlIIIbs
If lbe permit is DOl issued. Applicllioo Fee is ~Ie.)
1697 Luika Place
A. Wart addreIs or InCl ,
Utility IIaIl:b IocaIion
B. NaIure or wort
EMERGENCY PERMIT - Relocate joint trench across street
C. AIIIdI four (4) copies or III qiDeered plans IlIowiDa lbe Ioc:IIioD aad ClIII:d ~ lbe wort, aad faur (4) copica ~ lbe ~ EaP-r'1 ~ of wort. The
pi-. aball abow the relaIion or lbe propoaed wort to c:IistiDa aurtacc and lIIIdeqrauDd iIaprovemIaII. Wbea approved by lbe Cky EaP-r, IIIid ,.. \Iel:IDmm . pan or
Ibis permit.
D. AU work aball coafonn to lhe City of Campbd\ Scandard SpecificIUoaa and DIDila for Public Worb Caaatruc:IioD; lbe Gcaenl Permit ConcIw-1iated OIIlbe revene
lide; and die Spa:ial Provisiona for Ibis permit, listed below. Failure to lIbide by lbeae COIIdiIioaa and proviaioaa ~ ~ ill jab abul-cIowD lIJIJIor forfeilure or Failbful
PafCJr1lllllCC Sureties and cash deposits. (See GaIeral Permit Coadilioas 1 and 2.)
E. THE CONTRACTOR MUST HAVE nus PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBIJC WORKS DEPARTMENT AT
LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBIJC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK.
NIIDe of Applic:ant-E r, F., F.
T~ 725-2011
(priDl _)
AdcIrcss 109 0 0 N _ R 1 n ney. Cupert i no 95014 24 HOUR EMERGENCY TELEPHONE NO._
11 Ibis worlc beiD& done by die property owner Illbeir own raideJll:e? Y cs No
The ApplicantlPcnnillee berdly fIree5 by affJXina their lipIIure to Ibis pcnDilto bold die City or CaIIIpbeIl, iIa ofticen, ...... and employes free, life and barmleu from
any c1aim or denwId for dlIma&cs rcsulliD& from lbe worlc covered by Ibis permit.
The ApplicanllPmniuee berdly IIttDowlqcs IbIllbey ~ read and lIIIIlr:mand boch lbe frod and bide of Ibis permit. and lbey will iDform lbeir CCIIIInC:lOI{s) of lbe
iafonnalion.
~ Al Glynn (EMERGENCY VERBAL)
(ApplicadlPermiaee) (lip)
9/24/96
DIfc
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ARE L 0 C , E LEe T . SEe 0 N D A R Y ~~~\~~/ln~'IlClnEv(i
LU I KA PLACEs'upsiis'
CAMPBELL, SANTA CLARA COUNTY SUPSO BY
SHE [T NO'LO
PACIF1C GAS AND ELECTRIC COMPANY
SAN rRRNCISCO. C~LlrORNIA
OS~I[83470