96-242
CITY OF CAMPBELL
DEPT. OF ptIDLIC WORKS
70 North First St.
Campbell, CA 95008
(408) 866-2150
Fax (408) 376-0958
ENCROACHMENT PERMIT ~
(fl" working within the / (' .
ic right-o:ay) / .' J
Issued :7.) 0 I
Permit expires in 12 mos.
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Permit No.
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Application Date q~ /tjcp
Application expires in 6 'mos.
APPLICATION _ Application is hereby made 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).
A. Work address or tract # 40' W. I-lAM IllOI\I A \JE
Utility trench location ACROs.s. EDl""N AVE. J APPlZo)r, so' N/N ~oseMAt2'( LN.
B. Nature of work MI\IN, "''f~At-JT ) ~\/Ice. 'N'S.TPt(.L....n~
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c. Attach four (4) copies of engineered plans showing the location and extent of the work, and four (4) copies of the prelim~ Engineer's '.
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. ~j>ff<:\~ by
the City Engineer, said plans become a part of this permit. ' 1~9fi
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D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the Geri~tal.ncU.niti~~i,tiOns
listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and provisions may restIlt'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 THIS 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 Applicant/Permittee SAN Jose lAlA1Cl2:. Co.
Address ('2.'2 J S:. ~~l:ol'1 ~E.. _ s:.....J ~SF.:..
Is this work being done by the property owner at their own residence?
TelephoneAng - :2.14 -1r41
C,e... 9611. ~
Yes ;X 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 hannIess from any claim or demand for damages resulting from the work covered by this permit.
The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit, and they will inform their
contractor(s) of the information:
E.~"J L-. t1~&,.I..D ~~. eNb.~P8l"r ~
(Applicant/Permittee) print/sign
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Date
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San Jose
Water
Company
374 West Santa Clara St.
San Jose, CA 95196-0001
Phone Number (408)279-7827
Fax Number (408)292-5812
Writer's Direct Number (408)279-7847
February 5, 1997
City of Campbell
Dept. of Public Works
70 N. First Street
Campbell, CA 95008
RE: Eden Ave.
Permit No.: 96-242
The design for the installation of water facilities on Eden
Ave. has changed due to field information. Please review the
revisions on the supplied plans and issue a new approved copy
for our construction.
For your information and review, we are enclosing four new
prints of our drawing, No. E6-276, which shows the proposed
work. If you have any questions or comments please call me
at (408)279-7847.
Sincerely,
4rJ... . ./h ) /)~1~
C..-(}UUI./,,,",-~/~LV0
Edwin L. Mello, P.E.
Engineering Supervisor
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RECEIVED
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ADM'N~STR.A TlON
Permitle6-276