96-243
CITY OF CAMPBELL
DEPT. OF PUBUC 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) ~
/''-,/l
/'~'/ /~/-:" ,/pl1/'---""
Issued L../, ;' I ~'
Permit expires in 12
Permit No. 9 6 - 2 4 3
X-Ref. file
Application Date 1 0/1/9 6
Application expires in 6 months
APPUCATION. Applicltion is bereby IIIIde far a Public Worb Permit ill IClXII'dIDcc willi CaIIIpbdI MIIIIicipII Code, SeI:doa 11.04. (AppIicIIiaD expirel ill 6111ll111ba
if die permiI is DOt issued. Application Fee is --rrIuadlIble.)
A. Wort8ddrcu orlnl:tl 940 McG1incey (w/s of McG1incey - 383 I n/o Curtner)
Utility treDd1localion
EMERGENCY Repair of Water Service
B. NaIure of wort
C. AlIadl four (4) copies of ao qiDeca'ed planllbowiDa !be Iocaioa aad CIleIIl of die wort, aad fClllr (4) cop.. of die pn::IiIIIMy EapIecr'. IiIdmIre of wort. Tbc
plans ahaII show die relation of die propoaed wort to Clistiua aurr.:e aad lIIlderJrowad iqIro~....-bo. WbcD approved by die City EaaiDaIr, IIid pIao..... a JIIrt of
Ibis permiI.
D. AU wort .ba11 coDform to lbe City of CampbeU SllIDdanI SpeciIicatioas aad DcaiIa far Public Worb Coaacnx:Iioa; die GaIcnI Permit C-'itino!Iliated OIIlbe reverse
.ide; aad !be Special Provisions for this permiI, Iiated below. Failure to _ide by lbeIe CllIIdiIioaI aad proriaiaaa may nauIt ill jab aIJut..dowD fII1IJIor forfeiIuR of Failhful
PafOOlllllCe Sureties IIId casb dqIosill. (See GcoenI Pamit ('~itiaaa 1 aad 2.)
E. THE CONTRACTOR MUST HAVE TIDS 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.
Name of Applicant San Jose Water Company T~ 279-7979
Addn:ss 12 21 S. Bas corn , ~~ ~ s e 9 512 8 24 HOUR EMERGENCY TELEPHONE NO.
Is Ibis work being done by !be property 0WDer Illbeir own raideDce?
Yea
No
Tbc Applic:antlPenniaee bereby aarees by attlling lbeir .ipIIure to this permilto boJd die City of CampbeU, ill officen, .... aad eqlloyeea free, ale IIId IwmIeu from
any claim or demand for dImaaea rauhing from die wort COYa'cd by this permiI.
Tbc AppIic:amlPmniaec bereby ICtnowIcdJa lblIllbey have I'ClIId aad IIIIdenIaad boCb die from aad bICk of Ibis permit. aad Ibey will iDform lbeir COGIl.Jur(s) of !be
iaformation.
Accepled
Jane Leinberger (EMERGENCY VERBAL)
(ApplicamlPermiuec) (.ip)
10/1/96
Date