96-240
CITY OF CAMPBELL
DEPT. OF PUBLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-$58
ENCROACHMENT PERMIT
(for working within the
public right-of-way)
Issued q f..:1-(p /91..R ~
Permit expires in 12 mo~ ..
Permit No.
X-Ref. file
96-240
Application Date 9/2 5/9 6
Application expires in 6 months
APPUCATlON _ AppliallioD is bereby IIIIde for. Public Worb Pamil ill ~ wiIb CaaIpbdI MIIIIicipII Code. SecdoIIll.CM. (App\icIIiDa apifts ill 611111111hs
If 1bc permit is DOt issued. Appliallion Fee is 1IIlIH'CIundab1c.)
A.WorkaddrelsorlnCt' 816 J3unnY9ark Court (s/s of Sunnvpark. 209' e/o Virqinia)
UtiIily umcb Iocalion
B. NIluR of work
EMERGENCY Repair of 3/4" Water Service
C. Aaacb four (4) copies of an qu-ed plans IbowiDa 1bc \ol:aIloD and alaa fA 1bc wuk, and four (4) copill fA 1bc pnlIminary ~'a IiadIIIIIe fA wort. The
plana abaII abow tbe reIIIion of tbe propoaed work 10 c:UtiDa aurfIce and \IIIderpouDd id.9roveaall. WbcD IppIoved by 1bc City ~. aaid plan becoaIea . pan of
this permit.
D. A1I work abaII conform 10 tbe City of CaaIpbdI SatndIrd SpecifiI:IIioaa and DlaiIa for Public Worb Coaatnac:IioD; 1bc General Pamil o-titWto Iiafed 0II1bc mrcne
aide; and tbe Special Provisions for this permit. Iiafed below. FIiIure 10 Iblde by lbae CIlIIIdilioaI and proviaiODa may .wi ill job abut4nnl raJlor forfeiIurc of Failbful
PafonDllDCC Sureties and c:asb deposils. (See General Pennit CoalIilil- 1 and 2.)
E. THE CONTRACTOR MUST HA VB THIS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBUC WORKS DEPARTMENT AT
LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK.
N_ofApplicant San Jose Water Company
AcIcIress 1221 S. Bascom, ~r:n~ose 95128
T~ 279-7979
24 HOUR EMERGENCY TELEPHONE NO.
Is this work bein& done by the property owner II their own reaidence?
Yes
No
The ApplicanllPenniuee hereby aarees by affJXin& tbeir lipllure 10 this permit 10 bokl tbe City of CaaIpbdI. ill offiI:cn. ... and employees free. safe and \Iarm1esI from
any claim or cIenwId for clamqes resultin& from tbe work covend by this permit.
The ApplicanllPmniuee bereby lICknow1ed&es tbII they baYe reId and lIIIdenIand boIh 1bc: froIIlIIII bICk of this permit. and they will inform tbeir CllIIIJ'KIOI'(s) of 1bc:
iDfonnation.
Accqlted
,Ton Kihhp. (EMERGENCY VERBAL)
(Applic:lmlPamiUee) (aian)
9/25/96
Dale