96-239
01-16-96
17:20
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QI 002
,rmit No. Q'b ---231
X-Ref. File
Application Date '}' I ,,;2-4P I ? &
OWNER OCCUPIED ..1
NO FEE ENCROAC'ijMENT PERMIT
(for worklllj within tbe
public risht-of~way)
($5,000 maximwn value of work)
ISSUED 7/iji7 3[1" 2". 199f!
APPLICATION. Application is hereby made for a Public Works Permit in accord~e wich Campbell Municipal Code. Section
11.04. (Application cxpircs in 6 monchs if che permit is not issued.)
CITY OF CAMl'BELL
PUBLIC WORKS DEPT.
70 N. Firat St.
Campbell. CA 95008
(408)866-21.50
FAX (408)376-09S8
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A. Work Address 560. )~9. 5~OIi'l'<lor;>v l1\fl[ ('U4:r'u1in
B. NatureufW\1rk HF~Tt)~^TIQ~ OF A.slJF~rll'
C. Attach three (3) copies ofa dtawina showiJlj the location. extent lAd dlmeDlioDl of the work. The draw1n& aIIan.how
the relation of the propo5Cd work to existinl improvementa. Wben approved by &be Ciry Enainccr. uid drawinl becomes
a p~n of chis permit.
D. All work shall conform to the Cily ofCampbelJ SWldard Specltlcatlona and Details for Public Works Constl'\lction; the
General Permit Conditions listed on che reverse side; and the Special Provi.ioDl for this permit, lilted below. Failure
to ahide by these conditionl and provisions may result in job .lnn-down andlor forfeiture or Faithful Performance
seCuriUc8.
NAME OF APPLICANT ABLE SEPTIC!GLTm vi. GILBERT
(Print Name)
TELEPHONE 377-9990
ADDRESS
P.o. nOl 24819. SAN JOS~. CA 95154
The Applicant hereby confirms that this work is being done by the property owner/applicant at meir own residence.
The Applicant herehy aarees by affiXing their signature to thil permit to hold the City of Campbell. Its oMcen. a,enll and
employees free. safe and harmless from allY claim or demand for damaits reaultinl from the work covered by mil permit.
The Applicant hereby acknuwledges that they have read and understand both the front and b.~k of this permit. and tbat they will
Inf.'."h,j"..'ICI.(('/ 1lh,;nformllion. ;. . /, 'f J, j 14/
X ACCEPTED / )0-'1. ~ .,--~~-J' (<7"' fl'IQ
ApplicanVPermiuee (Si,n) Date
NOTES: ALL WORK SHALL CONFORM WITH THE ATTACHED. APPROVED PLANS AND ALL APPLICABLE
CAMPBELL ST ANDARD DETAILS AND CONDITIONS.
THE CONTRACtOR MUST HAVE THIS PERMIT AND APPROVED PLANS AND MUST ARRANOE TO MEET WITH
THE PUBLIC WORKS INSPECTOR AT THE SITE AT LEAST lWO 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 VAUD 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.
00':': .
SECURITY FOR FAITHFUL PE
,.
S'I:ANDARD
(1 ~ OF ENG. EST.)
City Enlincer
ontht After the Date of Ilsuance
w
APPROVED FOR ISSUANCE
( SEE OTHER SIDE)
l'UBLIC WORKS DEPARTMENT RECEIPT
Effective July 1. 1996 1b;,J34
TO: City Clerk PUBUC WORKS FILE NO.
PROPERTY ADDRESS 5bo IS WId" f'-1
Please collect &. receipt for the following monies: .................................l
ACer. I ITEM .... ..... ....... .............................. :AMOUNt ....
435.535.4921 Proiect Revenue (specify project) S
ENCROACHMENT PERMIT
4722 Applicalion Fee
Non-Utility Encroachment Permit ($225)
R-I First Permit !No Feel. Subseauent PermitlYr (SIOO
Utilitv Encroachment Permit
Arterial/Collector Street S32S)
Residential StreetIOther Areas $225)
2203 Plan Check Denosit - 2% ofENGR. EST. SSOO min) .
2203 Faithful Pert'onnance Security IFPS) 100"/0 of ENGR.EST.l .
2203 Labor and Materials Security 100"/0 ofENGR. EST)
2203 Monumentation Security 100"/. of ENGR.EST) .
2203 Cash Deoosit 4% ofENGR.EST.VSSOO minlSlO 000 maxI .
2203 Labor and Material Security 100"/0 ofENGR. EST.) .
Plan Check &. Inspection Fee !Non-Utility)
4722 Engr.Est. < $250,000 (12% ofENGR. EST.)
.. 2203 EnlU.Est.>S2S0,ooo IDeoosit 8% of ENGR. EST.1S30,ooo min.)" .
4722 Utilitv < SIOO,ooo 18%)
Minimum Charae Per Locotion (SI20)
ConduitslPipelines up to 500 Feet (SL60Ift)
Above 500 Feet (S1.1 OIft.)
ManholesN aultsIEtc (SI05/ea)
Pole SetlRemoval (SIOS/ea)
Street Tree PlantinlliRemoval (SIOS/tree)
.. 2203 Utilitv> SI00,ooo Actual Cost + 20% .. .
4760 Pro. ect Plans &. Soecificalions Pro'ect No.
4760 Standard Soecificalions &. Details (SllPa SI2IBook)
4760 Cooies of Enaineerino Mans &. Plans S.50/SQ.ft. )
4722 Penalties: Failure to restore Dublic imorovements (SIOO/Calendar Dav)
(Muni Code Section 1 1.34.0 I 0\
4722 PenaJties: failure to correct unsafe conditions (S I OO/Calendar Dav) flOD.b6
LAND DEVELOPMENT
4722 Lot Line Adiustment S500)
4722 Parcel Map (4 Lots or Less) SI,06O + $2SlLot
4722 Final Tract Man (5 or More Lots) SI,380 + $2SlLot
4722 Certificate of ComDliance S500)
4722 Certificate of Correction S300)
4722 Vacation of Public Streets &. Easements SS50)
4722 Assessment S_ation or Reapportionment
First Split (S5S0)
Each Additional Lot (SI70)
4721 Stonn Drainage Area Fee Per Acre (R-I, $2,000)
(Multi-Res. $2,250)
(All Other, S2,500)
4920 Parkland Dedicalion Fee
4965 P05la2e
TRAFFIC
4728 Intersection Turn Counts ITwo-Hour Count) $60)
4728 Intersection Turn Counts (a.m. or p.m, oeaks) SI2S)
4728 Traffic Flow Man -iDailv Traffic Volumes) S27\
4728 CamDbell Traffic Model (Full Scooe Assessment) S2,250)
4728 CamDbell Traffic Model (Reduced Scooe Assessment) S74O)
4271 Truck Pennits S3Sltrio)
4728 No Parkina SilinS SI/each or $25/100\
OTHER
TOTAL S 10 do Db
NAME OF APPUCANT MlvveR ~ bll:7soN DBA- ABLG ::; epn C->
NAME OF PA YOR M/ L-LE t? ~ c;./ A c;{);J PHONE 377-QQ00
ADDRESS 170'BDK LL./-t/4 S~ ZIP 06154
~
"Actual Cost Plus 20% Overilead (Non-Illlcrest bearina deoosit)
. \
FOR RECEIVED ~~ :..:::. ...
OTY CLERK ..... ....
ONLY Date ~ . \ RoceiDl ~ 103S<bS. ........................
\ \\ .. . .. .. .... RECEI
\ 'f
'For Plan Check and Cash Deposits, send yellow copy to Finance. .. I
. .< Date! Initials <I 0 2
VED
h:Irecfrm4. wk3(mp )rev7/1196
JUL 1997
CITY. CLERK'S OFFICE
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CITY OF CAMPBELL
Public Works Department
September 20, 1996
Mr. Glen Gilbert
Able Septic Tank Service
15001 Los Gatos Blvd.
Los Gatos, CA 95030
Subject:
Work in Public Right-of-Way Without Permits
560, 569 and 580 Emory Avenue
Dear Glen:
This letter is to confIrm that your crews were found to be working in the public right-of-way
at the subject addresses on August 30, 1996. Furthermore, yesterday you were directed to
remove the debris piles from the public right-of-way.
As discussed in our telephone conversation today, Able Septic will incur penalties of $100 per
calendar day, beginning today, until the debris pile is removed. Additionally, the enclosed
application for an Encroachment Permit must be completed by Able Septic for the work already
done and permit fees will be four times the normal amount set forth in the City's current fee
schedule as a penalty for working without a permit.
If you have questions, please call me at (408) 866-2165.
i(lIY'J:(4(
Rand?:estfa1l
Public Wodes Inspector
cc:
~chelle Quinney, City Engineer
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h:\ablesep.ltr(mp)
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.379,2572 . TDD 408.866.2790
NEW PW FAX #:
408-37fi-09:'iR