96-246
CITY OF CAMP13ELL
DEPT. OF PUBLIC WORKS )
70 North First 51. V-- .J ~
Campbell, CA 95008 . ~~ LiW\ (,
(408) 866-2150 tC-' Q.j:,~~
Fax (408) 376-0958. C ?}..fft(\
ENCROACHMENT PERMIT
(for working within the
public right-pf-way)
~Permit No, C3tb -~ <;...
X-Ref. file
Issued
Permit expires in 12 mo
Application Date \D. - \ C:::. -~
Application expires in 6 months
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 #~c:sr ~. ~:FtL '-- l&.~ \ ~~C ,.(" I-J~U- t2.-t::::::,
Utility trench location
B. Nature of work 'R)~ C-. .::::::::;~~ l H t';:7~~~f-...:IT
C. Attach four (4) copies of an engineered plans showing the location and extent of the work, and four (4) copies of the preliminary Engineer's Estimale of work. The
plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by the City Engineer, said plan becomes a pan of
this permit.
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit Conditions listed on the reverse
side; and the Special Provisions for this permit. listed below. Failure to abide by these conditions and provisions may result in job shut-down and/or forfeiture of Faithful
Performance Sureties and cash deposits. (See General Permit Conditions I 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.
~e> ~ - Cot, C::>~- 9.,0,=
~/ Name of Applicant ::to\.\t-J ~. l>' \. e..o L \ Telephone ~ ~ ~- \ 1.."2...1
~ . ,~~nt nameh~ ,I :---L . / _ ".:r-" ~
V"" Address I ~. \ \~!).c4_ ~. .."",~"" V~/24 HOUR EMERGENCY TELEPHONE NO. Lf6 6-/ 2-2- 7
N4'clv;:,~.4U~VJAv{ &;fl(')4V)U qYOCfA!.b/l&.~ ~~ d.-\~-~G:Fl>-~.'L\
Is this ,Jo'd'bc:ing done by the pr~ny ow~er at their M residence? Yes "X No
The ApplicanllPermiuee hereby agrees by affixing their signature to this permit to hold the City of Campbell. its officers, agents and employees free. safe and hannless from
any claim or demand for datnages resulting from the work covered by this permit.
The Applicant/Permittee hereby acknowl es that they have read and understand both the front and back of this permit. and they will inform their contractor(s) of the
information.
(sign)
"-"""1\ccepted
SPECIAL PROVISIONS
t..t41. Street shall not be open cut for underground installations. Minimum cuts !!!!Y. be allowed for connections or exploration holes. Such cuts may be spec:ilically
approved by the Inspector prior to CUllin!!.
Pavement may be cut for underground installations and must be restored in accordance with the Utility Trench Restoration Standard Details. Method 'A' Baclcfill.
unless otherwise approved by Inspector.
Work to be staked by a licensed Land Surveyor or Civil Engineer and two (2) copies of the cut sheets sent to the Public WorksDepanment before starting work.
Per Section 4215 of the Government Code this permit is not valid for excavations until Underground Service Alen (USA) has been notified and the inquiry
identifICation number has been entered hereon. USA Phone 1-800-227-2600. USA TICKET NO.
Thprnn+r~r+nr ~h~ll ~~~h~;~atr~f~;~ ~oD~~ol' pl~R~~d ~r3f~igggR~r91
~~h~dnlp fnr rpvipw ",nrl ""pprlm=>l hy ...h.... ('~t-y of iiaR ..10E9 alui tile city
Enqlneer prior to any lane closure and/or orfsite work.
1:::::::.2.
........3.
~.
~.
PERMIT APPLICATION FEE
PLAN CHECK DEPOSIT
SECURITY FOR FAITHFUL PERFORMANCE/LABOR'" MATERIALS
CONSTRUCTION CASH DEPOSIT
PlAN CHECK'" INSPECTION FEE
l-n-t.L.....J.....j.~.:-r' I~'i:~l...:-'J.~,I'"'*-.y'-
TYPE
~iD
AMOUNT
~"S,GO
nb";; . -e..
~~i~
RECEIPT NO.
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES
APPROVED FOR ISSUAN
G\~f!A~
<:tc:.,. flo. 4c:-
.~
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I DO 'D ~
6'~
City of, Campbell - Refundable Deposit Check Request
To: Finance Director
Check Payable To:
Bucknall Development Co.
Address - Line 1:
c/o John Nicoli
Line 2:
496 South Murphy Avenue
City:
Sunnyvale
State: CA
Zip: 94086-6114
Description:
Refund Deposit
Total Payable:
$4,044.00
(Exact Amount)
Account Number:
101.2203
Amount:
$4,044.00
Account Number:
Amount:
Account Number:
(Finance Dept only)
101.540.7448
Amount:
Interest Earned
(Finance Dept only)
Purpose:
Refund of Monumentation Security and Construction Cash Deposit
Voucher #:
Requested by:
I.
Approved by:
BiI
Finance Dept Only:
Verified by:
Permit #: 96-246
Date: 03/14/1997
Title: Land Dev. Engineer Date: 08/31/2000
Title: land Dev. Manager Date: 08/31/2000
Title: Accounting Clerk II Date:
Title: Accountant Date:
Approved by:
~ecial Instructions For Handling Check
Mail As Is:
Mail in Attached Envelope:
Interim Check:
Needed By:
Return To:
Joanne D'Ambrosia
(Name)
Public Works/City Hall
(Department)
Other:
fIn: Forrns/excellehkreq - Revised 02100
PUBLIC WORKS DEPARTMENT RECEtPT Gtb - "'2.....4-c.-
Effective July I, 1996 PS2.0--t l"r- Sko "1 ~ to
TO, Cily Cle", PUBLIC WORKS FILE NO. 'T~ <.:-,--r ~.....GI.. '?~
PROPERTY ADDRESS l G::a9-\ 'B.J __.v i "ll. I I
ACcT. .. < <<-~:r-- ..... ......._.... .......<........ .... .<<<.... ...... ... .....
435.l3l.4921 I Project Revenu'.: (specify project) S
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encroachment Permit (S225)
R-I Fint Permit (No Fee), Subsequent PermitIYr (SIOO)
Utility Encroachment Permit
ArteriaUCollcctor Street (S325)
Residential Street/Other Areas (S225)
22113 Plan Check Deposit. 2Y. of ENGR. EST. (SS()()min) .
22113 Faithful Performance Security (FPS) (llIlI"/. or ENGR.EST.) .
22113 Labor and Materials Security (J(K~loorENGR. EST.)
2203 Monumentation Security (Ill(~/. orENGR.EST.) . ? . . -0
22113 Cash Deposit (4'Y.orENGR.EST.)(S5011 minlSlll,lIOO max) . 't '" a-.c. .c:.O
"... 'L.L Plan Check & Inspection Fee (Non-Utility) 41_ --..-, ~
4722 EDge.Est < S250,OO(J (12'Y. orENGR. EST.)
.. 22113 Engr.Est.>S2S0,OOO (Deposit IWoofENGR. EST.1S30,O(}O min.)" .
4722 Utility < SIOO,UOCl
Minimum Charge Pcr Location (SI211)
ConduitslPipelines up to sou Feet (S1.6HIft)
Above SOO feet (SLlO/ft.)
ManholesNaultsIEtc. (SI05/..)
Pole Set/Removal (SI05/..)
Street Tree Planting/R.emoval (SI1I5/1rcc)
.. 22113 Utility> SIOO.OOO Actual Cost + 20-;' .. .
4722 Street Tree PlantinglRemoval Permit (SI05)
47611 Project Plans & Specifications Project No.
4760 Standard Specifications & Details (SliP. S12IBook)
47611 Copies of Engineering Maps & Plans (S.511/sq.ft.)
4722 Penalties: Failure to restore public improvements (SIOO/Calendar Day)
(Muni Code Section 11.34.0lO)
4722 Penalties: Failure to correct unsafe conditions (SIOII/Calendar Day)
LAND OEVELOPMENT
4722 Lot Line Adjustment (S5tKI)
4722 Parcel Map (4 Lots or Less) (SI,06O + S251L0t)
4722 Final Tract Map (5 or More Lots) (SI.3811 + S25/Lot)
4722 Certificate of Compliance (55110)
4722 Certificate of Correction (S3(KI)
4722 Vacation of Public Streets & Easements (S5511)
4722 Assessment Segregation or Reapportionment
Firsl Splil (S5511)
Each Additional Loc (SI711)
4721 Storm Drainage Area Fee Per Acre (R-I, S2,(KKJ) '\:O l\ 0(7
(Multi-Res. S2.250)
(All Other. S2.5(KI)
49211 Parkland Dedication Fee
4965 Postage
TRAFFIC
4728 Intersection Turn Counts (Two-Hour Count) (S611)
4728 Intcrsection Turn Counts (a.m. or p.m. peaks) (SI25)
4728 Traffic Flow Map (Daily Traffic Volumes) (S27)
4728 Campbell Tmffic Model (Full Scope Assessment) (S2.2511)
4728 Campbell Traffic Model (Reduced Scope Assessmenl) (S7411)
4271 Truck Permits (S35/trip)
4728 No Parking Signs (SI/each or S25/11I1I)
OTHER
TOTAL S
NAME OF APPLICANT
~C..J~--4 ~U- b~. ~. LLe.
NAME OF PAYOR \~l .~[" t'~c-~, PHONE 4-~~- \~""'L7
-Sc.e:>~ V~~l c.-. q ~<..:.r~
ADDRESS ZIP
.. Actual Cost Plus 21Jll/o Overhead (Non-Interesc bearing deposit)
/
FOR
CITY CLERK
ONLY
RECEIVED BY
Inn::;
~.\).\j.,;g-
.For.Plan.Checkand.C1sh Deposits;.scnd'>'cJlow copy to Fmance
70
~ECEIVED
.. 1 "_
CITY CLERK'S OFFICE
Date
h:\recfnn4{exc)mp(rev 1f1.197)
...
...r-"IJ7l r;
I\Ci..vu u Y: .]ANH
PtlYliw' - '''''' '" . 010001 fl."e:<.,.
, II, .J'11 1!UI..,/{ijALi m:U;:~,. /' "': 4Vvw.l...;
..""......, .,.. 1\" .. ""'..., ~U. 1
fULiHT-;:; [itlTF': {i'\/14/"'''' -"w
"''''r.Tr'lT,..r. "'- ;/'1.:: _ ... ~../
"CO'~lcn DA'E. ~7!</ ;'"'~
J . V1oi.r' .t'li ~.; T, T'."7.tr-.. of;. _
... ll.4<; :26
CITY OF CAHPBELL C4
CITY OF CAMPBELL, CA
DESCRIPTION
"'11/"1.,., &
r:.r'iur. SUBDTU FT'1 Tun ,..
5 ""il;. '. Ii - ... · lI...! iVLi r
. !",:N JWIi]H J;:j:t-c; ;-"._
'II, II , &., 101 rrl,;
RECVD BY: .JANH
PAYDR: BUCKNALl DEV CO, LL
TDDAY~S DATE: 03ii4/97
REGISTER DATE: 03/14/97 TIHE:
01000100512
......"'.......
lli.jOilf
MfOUNT
TOTAL DUE:
----------------
$4 t7? 1\'1 /
'w-,... .V't,'
$1 ::Ol.i. 11(1
"
DESCRIPTION
REF rlEPOSns
REF DEPOSITS
AMOUNT
-101.2203 $2~500.00
.A4 ~~^~ .~ ~h~ ~^
-jvl.~~V~ il,~~~.vv
CHECK PAIIJ:
CHff'K MG..
- ff 101/103
TE ~iii J;1. I:D .
i'r"~I\!..' ::
r"""",,,,
.A1HI'!!1t :
$5:-643.00 /
iDr AL DUE;
- ------ ------ ---
$4,044.00
$5,64J.OO
$5,643.00
~
TENDERED:
CHANGE~
CHECK PAID ~
CHECK NO: 102/104
$4~044.00
$=00
... t. r. J. I. "\/l
:;:.r rl",:a;.l.j _ \lV
'.U0
~
PUBLIC WORKS DEPARTMENT RECEIPT
Effective July I. 1996 q fv;< Jr&
TO: City Clerk PUBLIC WORKS FILE NO.
PROPERTY ADDRESS Ilpg, YJu 1/1 11(114114 ~ V
IACcr:. Please collect & ~ following monies:
.. ............ ..
I .:ITEM ...... ...
435.535.4921 Pro'ect Revenue (soecifv oroject) S
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encroachment Pennit (S225)
R-I First Permit (No Fee). Subseauent Permit/YrlSloo\
Utilirv Encroachment Permit
Arterial/Collector Street S325)
Residential Street/Other Areas S225\
2203 Plan Check DetlOsit - 2% of ENGR EST. S500 min \ .
2203 Faithful Perfonnance Securirv (FPS) 100% ofENGR.EST) .
2203 Labor and Materials Security 100'10 ofENGR. EST.\
2203 Monumentation Security 100'10 ofENGR.EST\ .
2203 Cash DetlOsit 4% ofENGR.EST.)(S5oo minIS I 0,000 maxI .
2203 Labor and Material Security 100'10 ofENGR. EST. .
Plan Check & tnspection Fee (Non-Utility)
4722 Engr.Est. < S250,OOO (12% ofENGR. EST)
.. 2203 EnlU.Est.>S250,ooo lDeoosit8% ofENGR. ESTJS30,ooo min.\" .
4722 Utilirv < Sloo.ooo (8%)
Minimum Charge Per Location (SI20)
ConduitslPipelines up to 500 Feet (S1.6O/ft)
Above 500 Feet (SUO/ft.)
ManholesIV aultsIEtc. (S I 05/03)
Pole SetlRemoval (SI05/ea)
Street Tree PlantinWRemoval 1S105/tree
.. 2203 Utility> Sloo.ooo Actual Cost + 20% .. .
4760 Proiect Plans & Soecifications Proiect No.
4760 Standard Soecifications & Details (S11P2 SI2IBook)
4760 Copies of En2ineerin2 Maps & Plans '(S.501,.,.ft. \
4722 Penalties: Failure to restore public improvements (Sloo/Calendar Dav \
(Muni Code Section 11.34.010)
4722 Penalties: Failure to correct unsafe conditions (Sloo/Calendar Dav)
LAND DEVELOPMENT
4722 Lot Line Ad' ustment S5OO\
4722 Parcel Map (4 Lots or Less) SI,06O + S25/Lotl ./
4722 Final Tract Map (5 or More Lots) SI,380 + S25/Lot\ /5 ~'7 ./
4722 Certificate of Compliance S5OO\
4722 Certificate of Correction S3OO\
4722 Vacation of Public Streets & Easements S550\
4722 Assessment Segregation or Reapportionment
First Split (S550)
Each Additional Lot (SI70)
4721 Stonn Drainage Area Fee Per Acre (R-I. S2,OOO)
(Multi-Res, S2.250)
(All Other, S2,5OO\
4920 Parkland Dedication Fee
4965 Postalle
TRAFFIC
4728 Intersection Turn Counts (Two-Hour Count) (S6O\
4728 Intersection Turn Counts (am. or p.m. peaks) 1$125\
4728 Traffic Flow Map (Daily Traffic Volumes) (S27\
4728 Camobell Traffic Model (Full Scope Assessment) S2,250)
4728 Camobell Traffic Model (Reduced Scone Assessmenll 5740\
4271 Truck Permits S35/trin\
4728 No Parkin2 Silll1s $l/each or $25/100)
OTHER
TOTAL $/SS-S-
,
NAME OF APPLICANT (7.i~ , ~./7..L/~ .
/,1
NAME OF PAYOR C:;,t{/k..-r./" pc;" "7//// ~ f/ .
PHONE
ADDRESS (//t;? j/ M~A'. C~ .~ ./ --z LI-;T7:. ZIP 9" S 6 k, ;;'.
.. Actual Cost Plus 20% Overhead (Non- lIlerest bearin2 detlOsit) t/~//dl
I vr } L I . ./
FOR RECEIVE~ 7f:PIIIA rIA REC
CITY CLERK
ONLY \ . CV10\\S
Date ReceiPt # DEe
Date! Initials
EIVED
o 5 1996
CITY CLERK'S OFFICE
'ForPIanCheck and Cash Deposits, send yellow copytoFilWlCe:
h:\recfnn4. wk3(mp )rev 7/1/96
~
ell
o
ell
CD
'<f
~
a:
o
u..
DATE /9t - 5 - qLO 124
RECEIVED FROM JOHN N I CD LA 19 - NO. 1
ADDRESS I (pf) I .[)ll ML/J A Lv IZOAb
FOR 9LP. ~.4-u Jf7:;?~ r'. JA DOLLARS $/,5'5""5'!t}! /
_ rlN. J..;. fRAC!.T MAP
,
B
OAM f.8l? l,L,
"
City of Campbell - Refundable Deposit Check Request
To: Finance Director
Check Payable To:
John Nicoli
Address - Line 1:
Line 2:
496 South Murphy Avenue
City:
Sunnyvale
State: CA
Zip: 94086-6114
Description:
Refund Deposit
Total Payable:
$705.00
(Exact Amount)
Account Number:
101.2203
Amount:
$705.00
Account Number:
Amount:
Account Number:
(Finance Dept only)
101.540.7448
Amount:
Interest Earned
(Finaoce Dept only)
Purpose:
Refund of Plan Check Deposit
Voucher #:
Requested
Permit #: 96-246
Date: 10/10/1996
Title: land Dev. Engineer Date: 08/31/2000
Title: land Dev. Manager Date: 08/31/2000
Title: Accounting Clerk II Date:
Title: Accountant Date:
I.
Approved by:
Bill
Finance Dept Only:
Verified by:
Approved by:
~ecial Instructions For Handling Check
Mail As Is:
Mail in Attached Envelope:
Interim Check:
Needed By:
Return To:
Joanne D'Ambrosia
(Name)
Public Works/City Hall
(Department)
Other:
fIn: FormslexceVchkreq - Revised 02100
'UBLIC WORKS DEPARTMENT RECEIPT
Eft'ective July I. 1996
TO: City Clerk PUBUC WORKS FILENO. atC:. -- <- ~
lG::>~\ ~C-1<" J....J f':;,.LJ.--
PROPERTY ADDRESS
Please collect &: receipt for the followina monies:
ACer. . I I1'EM . .... . ............................. ....... ..::::::::::::.:::AM01JN:t::.::.::.
435.535.4921 Proiect Revenue 'ect) S
ENCROACHMENT PERMIT
4722 Applicalion Fee
Non-Utility Encroochment Permit (m5) h-~, taG>
R-I Fin! Permit (No Feel. Sub_uent PermitIY r (S 1001
Utilitv Encroachment Permit
Arterial/Collector StreeI S3251
Residential StreetIOther Areas m51
2203 Plan Check Deoo,it- 2% ofENOR. EST. S500 minI . J~.o.e.
2203 Faithful Pcrfonnance Securitv lFPSl 100% ofENOR.EST.l .
2203 Labor and Material, Securitv lOO'~ ofENOR. EST.)
2203 Monumenwion Security 100% ofENOR.EST.) .
2203 Cash Deoosit 4% ofENOR.EST.XSSOO minlStO 000 maxI .
2203 Labor and Material Securitv lOO'~ ofENOR. EST.l .
Plan Check &: Inspection Fee (Non-Utility)
4722 Engr.Est. < S250,ooo (l2"~ ofENOR. EST.)
.. 2203 Enlll'.ESI.>S250,ooo iDeoosit 8% of ENOR. EST JS30 000 minJ" .
4722 Utilitv < SI 00,000 (8%)
Minimum CharJle Per Location (SI20)
ConduitslPipelines up 10 SOO Feel (SL6OIft)
Above 500 Feel (Sl.JO/ft.)
ManholesIV aultsIElc. (SI05/ea)
Pole SetlRemoval (SI05/ea)
StreeI Tree Plantinalllemoval (SI05/tree)
.. 2203 Utilitv> SIOO,ooo ACIUaI COSl + 20% .. .
4760 Proiect Plan, &: Soecificalion, Proiect No.
4760 Standard Soecificalion, &: Detail, (SllPg S12/Book)
4760 CODies of En.ineerin. Man. &: Pion. (S.50/SQ.ft.)
4722 Penalties: Failure 10 restore Dublic imorovemenu (SIOOICaIendor Dav)
(Muni Code Section 11.34.0101
4722 Penalties: Failure 10 correct WlSIfe conditions (S 1 OOICalend..- Day)
LAND DEVELOPMENT
4722 Lot Line Adiustment S500
4722 PII'cel Man (4 Lou or Lessl SI,06O+ S251Lot
4722 Final TIlIC\ Man (5 or More Loul SI,380 + S251Lotl
4722 Certificate of ComDliance S5001
4722 Certificate of CorrectiDn S300
4722 Vacation of Public Streets &: Easements S5501
4722 Assessment Segregation or Reapportionment
FimSplit (S550)
Each Additional Lot (SI70)
4721 Slorm Drainage Area Fee Per Acre (R-I. S2,ooo)
(Multi-Res, S2.250)
(All Other, S2,5001
4920 PII'klond Dedicalion Fee
4965 PDS\aRe
TRAFFIC
4728 IntenectiDn Turn CounU ITwo-Hour Countl S601
4728 In_ion Turn Counu (Lm. or p.m. oeaksl S125)
4728 Troffic Flow Man maily Troffic Volumes) S271
4728 CarnDbell Troffic Model IFull Scone Assessmentl S2.250)
4728 Campbell Troffio Model (Reduced Scope Assessment) S7401
4271 Truok Permits S35ltriDl
4728 No Parkin. Sions S lleach or S2511001
OTHER
TOTAL .c::Iit s _ .0. a::.
NAME OF APPLICANT
.
NAME OF PAYOR .'\.-.......,..1...L "J S. l ()t r '-""'Lt PHONE 4-- ~ ~-"" - \ -.z.-'1-,
ADDRESS \ b \ --n......l .., ~l..- t':::::.o.-... ZIP 9'~e""c..,
~~~ '-l~
.. ACIUaI Cost Plus 20% erhea.fiNon-Inten:sl bearina deoosiO
^
FOR \ :...
...:..:
CITY CLERK RECEIVED BY
ONLY ( t \0
Date RECEl
v... .: ... ..:... .... ....
,/
b:1recftm4. wk3{mp )rev7/1196
VED
OCT 1 0 1996
CITY CLERK'S OFFICE
'For Plan Checl<and Cash Deposits, send yellDwcop)' 10 Fi......... .... .... tc:>.- e;; .""".
~ .D8teI.lnitlal.
CITY OF CAMPBELL, CA
CITY OF CAMPBELL, CA
RECVD BY: LISAB 01000096845
PAYOR: JOHN NICOLI
TODAY~S DATE: 1Q/10/96
REGISTER DATE: 10il0/96 TIME: 15:40:58
RECVD BY: USAF
PAYOR: JOHN NICOLI
TODAY'S BRiE: iO!i0!96
010000%846
REGISTER DATE:
i.'\! ~.'\ If'':.''
1. V! lV! :;!J
TIME: 15:41=39
DESCRIPTION AMOUNT
ENGR & SUBDIV FILING F
$ryryc:: i\^
.;.,:..;.V\l
m:-c;r-rHPTTfil>l 6i4Jijjj.JJ
....~\.I\oI'I'.a.1 1.&."". 111'1011011\1
REF DEPOSITS FUND 101 $705,00
TOTAL DUE:
""'''I:'f'.,"./
''':::':..I::':h!
TOTAL nUE:
$705.00
CHECK P6iil~ 'f22S.(i(j ~ CHECK pA:.Tn. $705.00
1 ::..,11'. nJ..iJ. ~
CHECK un:a 273 r~~'-'v. NO: '1ry1'
~iJ. \.I,a,.Llt ~i"';
TENDEF-~ED: $225.00 iENDERED: .~705:00
rWe.tJ~t:' I: $~OO CHANGE: to ,'\(,
...,1 HIIt\,/;... =: .,"u"';
- ..2 .tf~
NG
STAT.E P.O. BOX 807, SAN FRANCISCO,CA 9410 h0807
COMFleNSATION
INS URAN CE
FUN D CERTIFICATE OF... WORKERS'COMPENSATION INSURANCE
ISSUE DATE: 01-01-02
POLICY NUMBER: 229-02 UNIT 0011230
CERTIFICATE EXPIRES: 01-01-03
CITY OF CAMPBELL
70 NORTH FIRSTST
CAMPBELL CA 95008
RECEIVED
DEe 2 6 2001
PUBLIC WORKS
AgM'N'SlRAT'O~
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not .an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to Which this certificate of insurance may be .issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies.
y r-/~
~isIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
STANDARO.EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
LEGAL NAME
\JOHNS... NICOLI
AND uACQUIE NICOLI
175 TAN OAK DR
SCOTTS VALLEY CA95066
NICOLI, \JOHN AND
NICOLI, uACQUIE
12-18-01
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10265 (REV 2-01)
PRINTED:
P0408
962<-Jh
NG
STATE P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
COMPENSATION
INS U.RA NeE
FUN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-01-02
POLICY NUMBER: 229-02 UNIT 0011230
CERTIFICATE EXPIRES: 01-01-03
CITY OF CAMPBELL
ATTN DEPT. OF PUBL I C WORKS
]0 NORTH FIRST STREET
CAMPBELL CA 95008
- ~
RECEIVED
DEe? 62001
PUBLIC WORKS
.\DMlNISTRATIO.H
-_._-_.-..,,>~
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days'advance notice should this policy be cancelled prior to its normal expiration.
This certificate <of. insurance is I)ot an insurance policy and does not amend. extend or alter the coverage afforded
by the policies listed herehNotwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate Of insurance may be issued or may pertain, the insurance afforded by the
policies d19scribed herein is subject to all the terms, exclusions and conditions of such policies.
.J/ r/ ~
~~IDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
LEGAL NAME
,",OHNS.N:tCOLI
AND,",ACQUIE NICOLI
175 TAN OAK DR
SCOTTS VALLEY CA950S6
NICOLI, ,",OHN AND
NICOLI, ,",ACQUIE
12-18-01
PRINTED:
P0408
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10265 (REV 2-01)
NG
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-01
POLICY NUMBER: 229-00 UNIT 0011230
CERTIFICATE EXPIRES: 01-01-01
CITY OF CAMPBELL
70 NORTH FIRSTS!
CAMPBELL CA 95008
REC~'VED
DEe 2 3 1999
PU81..iC WORKS
ADMINISTRATION
This is to certify that we have issued a valid Workers' Compensation insurance policy in a from approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded
by the policies listed herein. notwithstanding any requirement. term. or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain. the insurance afforded by the
policies described herein is subject to all the terms. exclusions and conditions of such policies.
~'D~
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
LEGAL
...0.... S, NICOLI
496 S MURPHY AVE
SUNNYVALE CA 94086
NICOLI, "'OHN AND
NICOLI, "'ACKIE
PRINTED: 12-19-99 P0408
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10265 (REV 2-95)
NG
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-01
POLICY> NUMBER: 229-00 UNIT 0011230
CERTIFICA TE.EXPIRES: 01-01-01
CITY OF CAMPBELL
ATTN DEPT, OF PUBLIC WORKS
70 NORTH FIRST STREET
CAMPBELL CA 95008
ReC~IVE:D
DEe 2 3 1999
fUBI-Ie WORKS
ADM1NISTRATION_
This is to certify that we have issued a valid Workers' Compensation insurance policy in a from approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance pOlicy and does not amend. extend or alter the coverage afforded
by the policies listed herein. notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies.
~'D~
EMPLOYER'S LIABILITY LIMITINCLUDINCfDEFENS.E COSTS: $1.000,.OOO.()OPERQCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS> AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
LEGAL NAME
.JOHN S, NICOLI
496 S MURPHY AVE
SUNNYVALE CA 94086
NICOLI, .JOHN AND
NICOLI, .JACKIE
PRINTED: 12-19-99 P0408
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND self 10265 (REV 2-951
Permit #
mSURANCEREQumffiMENTSCBECKLffiT
q r.o - ;;L LI (p
CIP Project #
The following insurance is required of all contractors working in the City of Campbell public
right-of-way. Insurance certificates must be accepted by City staff before work can begin.
These insurance requirements apply to work being performed under an Encroachment Permit
and work being performed under contract for Capital Improvement Projects.
Limits
Commercial General Liability for bodily, personal injury and property damage:
JQ $1,000,000 per occurrence, and
C Ov(rf:-() h II ~ $1,000,000 general aggregate l~i~ applying separately to the project, and
- -~ 0 $2,000,000 general aggregate llIDlt. <0
~ Policy expiration date II/ ,3) ~
Automotive Liability - "any auto" ~
I&J $1,000,000 per accident for bodily injury and property damage
~ Policy expiration date II J L 0 I '1l
trker's Compensation and Employer's Liability ~fCtJ? ~rf1 bU'L)~. '-b
$1,000,000 per accid~ injUIy~disease 1...~.f\L,~ L'
Policy expiration date (2o~(=-t V\ r u....
. 1/ I ~ f;:}l-~) V" ~lv
Course of Construction (if required in Special Provisions)
o Completed value of the project
o Policy expiration date
Required Endorsement to General Liability and Automobile Liability Policies
Additional Insured Endorsement
~ The City, the City of Campbell Redevelopment Agency, its officers,
. employees and volunteers are named as additional insured.
~ The insurance coverage afforded to the Additional Insured is primary
insurance.
Workers' Compensation Insurance Sheet Submitted
o For General Contractor
~Subrogation Clause ~
",,",ance Certificate ReVieWe~ -!.~
Initi~ls
)8(
Date
"'I- Copy of Insurance Certificate placed in tickler fIle mie month prior to expiration.
j:\forms\inscklst 4/96 (rev 6/96)
NG
STATE
COMPENSATION
INSUAAKCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-01
POLICY NUMBER: 229-01 UNIT 0011230
CERTIFICATE EXPIRES: 01-01-02
CITY OF CAMPBELL
ATTN DEPT.OF>PUBLI C WORKS
70 NORTH FIRST STREET
CAMPBELL CA 95008
This is to certify that we have issued a valid Workers' Compensation insurance pOlicy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies.
~'D~
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
RECEIVED
DEC 2 f lOOt
'''UBI..IC WORKe
",OMU"'STRAT10N
LEGAL NAME
JOHN S. NICOLI
AND JACQUIE NICOLI
175 TAN OAK DRIVE
SCOTTS VALLEY CA 95066
NICOLI, .JOHN AND
NICOLI, .JACQUIE
PRINTED: 12-16-00 P0408
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10265 (REV 2 %)
-,
NG
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-01
POLICY NUMBER: 229-01 UNIT 0011230
CERTIFICATE E><PIRES:01~01-02
CITY OF CAMPBELL
70 NORTH F I RST>ST
CAMPBELL CA 95008
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies.
~'D~
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
RECEIVE
DEe l 1 wou
LEGAL
;UBLIC WORKb
",n~INla"RA,TION
JOHN S. NICOLI
AND JACQUIE NICOLI
175 TAN OAK DRIVE
SCOTTS VALLEY CA 95066
NICOLI, ~OHN AND
NICOLI, ~ACQUIE
PRINTED: 12-16-00 P0408
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 102651REV 2-95)
/'Ji
) I
/\; "\/1
! b ~.-<! ,-10
City of Campbell
70 North First Street,
Campbell, CA 95008
FAX
Date:
02/19/98
Number of pages including cover sheet: , .!5
To: From:
Jeff Joanne D'Ambrosia
Bennie Bartle Agency
108 Whispering Pines, Suite 100
Scotts Valley, CA 95066
Phone: (408)438-7288 Phone: (408)866-2150
Fax phone: (408)438- 7293 Fax phone: (408)376-0958
CC:
REMARKS:
o Urgent
o For your review
[gI Reply ASAP
o Please comment
We received the latest version of the certificate of insurance for Century Development /John Nicoli & Keith Pierce but find
that there are still some missing items. Three of the deficiencies mentioned in my fax of 1/30/98 have been corrected
(additional insured clause, cancellation clause, and primary endorsement). In regards to the automobile liability, however, we
require coverage in the amount of$I,OOO,OOO per accident for bodily injury and property damage. Also, we require that "Any
Auto", "Hired Autos" and "Non-Owned Autos" be checked in the Automobile Liability area of the certificate. I have attached
a copy of the latest certificate we received as well as the expired certificate which showed the automobile liability coverage
correctly. I do apologize for the delay in responding to you following our receipt of this latest certificate but only now had the
time to review it in depth. Thanks again.
l
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BARTLE AGENCY
Fax:408-438-7293
Feb 6 '98
12:09
P.02
A.OeII..
....';~~~v~.......t:.~,.f...~ '~"~'~'~'t;.. v "...""'""...",,\:.\:.,,, t..~. '...~....\ a
. , .:<~ -": ;~ r ~:"'~ ,"<,~':-:~~:~~~';::f:;ffi:' .
; t:>:-]... ~l... '0';' ,,\\' '~'(I.," v"",~.y, ,\",,, .~... \\..",~"".
IMTI!(flIMOm')
ZMIII
THIS CERTIFICATE . IIIU!D M A MAnER OF t4F0RMATlON
ONLY AND CONFER8 NO RIGHTS UPON THE CEJn'IIICA'YE
HOLDER. THIS camFlCATE DOES NOT AMEND, DTEND OR
AlTER THE COVElUGE AFFORDED BY ~ POl.JCaE8 BELOW.
coMPANIES AfPONIING COVIMOE
CREDIT GENERAL INSURANCE COMPANY
MODUCIiR .......1IutIlt AgInCJ
111 WIUpMng PInes Dr.
Bulla 110
Sc:aa. V.11ef CA .....
(401"--7211
CODE: _ CODE:
COMPANY
A
U1_ED
CENTURY DEVELOPMENT COMPANY. LLC
JOHM NICOLI AND KEITH PERCE
11A COLONY STReET
MT VIEW. CA M04a
COMPANY
8
FARMERS INSURANCE EXCHANGE
COMPANY
C
TRUCK INSURANCE EXCHMGE
COMPANY
D
THIll TO CERTIFY THIlT THE POUCIE8 Of'lNSuRANCE USTEO l!lELOW HAV!: II!l!:N ISSUED TO TH~ ~ NNCDMOW !"Oft ~ POUCY peRlOO
INDICATED. NOTWlTHSTANDINCUNY REOJIREMiNT. rEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIlli RUPECT TO WHICH THE
ceRTIFICATE MAY IE ISSUED CIA MAY PERTAIN. THE INSURANCE N'FOADED BY THE POlICIES DeSCRIBED tfERDII8 SUIJECT TO AU. THE TEMtS.
EXCLUSIONS AND CONDITIONS OF Suc:H POl.ICES. LMTS SHowN MAY HAVE Bf:EN REDUCED BY PAID ClMIIi.
co TTf'I! 01' INSUItMCC POlICY NUMIIEft POUCY EFFECTIVE POlICY IilII'IMTlOM LMT8
LTR DATE'MMlDllNYl DATE IIIIIIIlOtYV)
UMIIUTY OIiNERAL I\OGREOAlli .
" OENERAL IJAlIILJTY ARTOeOHfI 11/1lW1 11/1.....
MADE I (J I OCCUR. ~. AlN I'IJURY
OWNER'S & CCHl'RAC'RlR'S PROf fACti
FIRE DAMAGe (Nf _ FIIlt)
MEDElIP (Any_~ ,
LE UAIIIUTY
(J ~ED.NGUii UMIT .
MY f'MTQ
0 AU. OWNED AUTOS IiOOLY INJURY .
B 181 SCI4EDULEO AUTOS 111....11 411111 411/1' ,.. ....-n)
0 HIRED AVTOS 8001.. Y INJUflY
,.. --.rj $
NON-OWNED 4VTOS
0
PROPERlY DA*OE $
OMAOE UUIUTY NJTOCNlY . EA ACCIDENT ,
(JAHYAlITO ~ floIAN AU10 0Nl. y-
O EI\DI ACCIlEHT' .
AOORI!OAlli: .
EACH 00CUIlRB<<:E ,
AOGREOAllO .
I
WORKiIW ~"'TlDN AND o STAlVTtlKY lIMIT3
EIIfILOYDa' UMlLlTY EJICH N::CDStr S
'l'H!!~ ~INCL
PMTNIItlIIEXI!!CUTM DI8eA8& . POUCY LIMIT ,
0f'FlCERS ARE 09(1 0ISEAlIe. EACH EMPL~ .
OTHeR
C UMBRELLA 100II04OI 11121117 11121.
OIiSCIUPTIONDFDf'EMTIONM.DCA~ITEMS q (p -2% 1~81 ~1-~
10 day notice of cancellation due to non~payment of premium.
DO,IOI
IIGO,IOI
110""
1,oao._
, " ,;.. . '0~ik{f 'r""'~'~it;'~:"",. "'~{'~'~'.)#"~ .':::. '~~~~~
CAMPBELL. CA....
SHOULD ANY OF THE lIBlWE 0...:__ PaUCIII IE c.a--'" ~ THE
illPlltATION DATi THEftEO'. THE IAUlNG COMIWIY WIU ENDU~ TO 11M.
~DAYII WHITTY NOTICE 10 TME CERTIFICATE llOLOBt~lOntEl.iFT.
BUT FAlLUJU! TO MAIL lIUCH NOTICE SIW.L IMl'OIE NO OIUMTlClIII at UAaITT
QlI ~NY KIND Uf'OlIl TIlE COIIIIPANY. IT. MIiNT1I OR --.nATIYU.
AUTHORIZED RE"RESENTAT~
CITY Of CAMPBELL
"TT PUBLIC WORKS DEPARTMENT
70 NORTH FIRST STREET
, '. "~~ ':t,: ;::x ,::" ~~~: (, ~~;~~r\fl ~.}::-;~:\;t,
BENNIE BARTLE
BRRTLE RGENCY
Fax:408-438-7293
Feb 6 '98 12:10
P.03
COMM. ;1.'- CJ&N&RAL ~IAIILI'TY
THI. PlDO.........T CHAM.' THI POLICY. 'LIA.. MAD IT CA"."'LL Y.
ADDITIONAL INlURID · OWNI.., L..... OR
CONTMCTOM (PO" I)
nil tftCIOfMmtnt modm" '"luran. p~'G'" under "', fOIIOWI"I:
COMMIRCtAL GENlML 1.1AIIL.ITY COVl"ACIE PART
ICMIQUlI
""'1 II ttlllIIl I,O..,.",RI
City of Campbell, City of Campbell Redevelopment Agency, its
officers, employees and volunteers are named as additional
insureds as respects to liability per CG 2009.
(" no .ntrv ........ .... InfOnftdOn reQulr.d to com"'" thlt endOl'HfMnt will .. .hOW" In UMI OMI.,..
"one H 1'''.__' to "''' ,ndorltfMl't,)
WHO. AN tNlURID (I",ton n) II .lMftild to include II In 1"lured the ".rlOr~1 =:':' fD~t'I::: I~~
,fit ICtledu". Dut anlr with r.l..et 10 nlbllltv ''''alnG out Df yoyr ongotn. OD'"
,u..
Subject to all other terms and provisions of the policy,
such insurance as provided by this endorsement shall be
deemed primary, but only with respect to work performed
by or for the named insured in coonect1on with the
attached contract.
. 't: ~ '"
0...... __
~M. '''.II,.."C1 """ct. ~
. ..me.., f1ft:., 1.
---....---
9p,J(P
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
I
CITY OF CAMPBELL
DEPT OF PUBLI C WORKS
70 NORTH FIRST STREET
CAMPBELL CA 95008
CERTIFICATE .oF WORKERZ~PENSATION INSURANCE
FEBRUARY 19, 1 998 ~ \\1 ~ POLICY NUMBER:
C~' ~\ CERTIFICATE EXPIRES:
~~. . t ~,~ ~S
~~, . ~O~\O~
~~"'~~,,~
~...Q~~
229-98 UNIT 0011230
1-1-99
JOB:
THIS SUPERSEDES AND
CORRECTS THE CERTIFICATE
ISSUED ON 02-13-98.
ALL WORK IN PUBLIC RIGHT-
RIGHT-OF-WAY CITY OF
CAMPBELL CITY OF CAMPBELL
REDEVELOPMENT AGENCY
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer.
We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with
respect to which .this certificate of insurance may be issued or may pertain, the insurance afforded by the policies
described herein is subject to all the terms,exclusions and conditions of such policies.
?7~~~
AUTHORIZED REPRESENTATIVE
I(~
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,1211210 PER OCCURRENCE.
ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE
01/14/98 IS ATTACHED TO AND FORMS A PART OF THIS POLICY.
THIRD PARTY NAME: CITY OF CAMPBELL
EMPLOYER
I
N I COLI JOHN AND N lCaL!
JOHN S NICOLI
496 MURPHY AVENUE
SUNNYVALE CA 94086
JACKIE
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10262 (REV. 3-95)
L
.~."
City of Campbell
70 North First Street,
Campbell, CA 95008
FAX
Date:
02/17/98
Number of pages including cover sheet: 5
To:
From:
Mary
Joanne D'Ambrosia
State Compensation Insurance
Fund
Public Works Department
Phone:
(408)866-2150
(408)376-0958
Phone:
Fax phone:
(408)363-7600
(408)363-7640
N/A
Fax phone:
CC:
REMARKS:
o Urgent
o For your review
~ Reply ASAP
o Please comment
We have now received a third Certificate of Workers' Compensation Insurance covering John and Jackie Nicoli that does not
meet our insurance requirements for companies doing work in the public right-of-way. The original certificate we received in
5/97 did meet our requirements (included waiver of subrogation) but upon its expiration in 1/1/98 we have not received a
replacement which matches the original certificate. Copies of the original certificate as well as the three incorrect certicates
follow for your reference. Please issue and mail to us, as soon as possible, a new certificate which includes a waiver of
subrogation clause. I may be contacted at (408)866-2150 if you have any questions concerning this matter.
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
FEBRUARY 13, 1'398
I
C!TY OF CAMPBELL
DEPT. OF PUBLIC. WORKS
70 NORTH FIRST STREET
CAMPBELL CA 95008
RECE'VED
FEB \ 7 1998
PUBI..ICWORKS
ADMINISTRATION
POLICY NUMBER:
CERTIFICATE EXPIRES:
229-98 UN IT 0112302
1-1-99
JOB:
ALL WORK IN PUBLIC RIGHT-
RIGHT-OF-WAY CITY OF
CAMPBELL CITY OF CAMPBELL
REDEVELOPMENT AGENCY
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer.
We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with
respect to which this certificate of insurance may be issued or may pertain, th.e insurance afforded by the policies
described herein is subject to all th.e terms, exclusions and conditions of such policies.
;7~~~
AUTHORIZED REPRESENTATIVE
I(~
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
EMPLOYER
I
NICOLI, JOHN AND NICOLI,
JOHN S. NICHOLI
496 MURPHY AVE
SUNNYVALE CA 94086
JACKIE
~~41-C
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10262 (REV. 3-95)
L
q to A'~. Lf Y>
NG
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
CERTIFICATE .OF WORKERS'COMPENSATlON INSURANCE
ISSUE DATE: 01-01
POLICY NUMBER: 229"'98 UNIT 0011230
CERTIFICA TE'<EXP1RES: 01-01- 99
CITY OF CAMPBE
70 NORTH FIRST ST
CAMPBELL CA 95008
This is to. certify that we have issued a valid Werkers' Cempensatien insurance pelicy in a ferm appreved by the
Califernia Insurance Cemmissiener to. the empleyer named belew fer the pelicy peried indicated.
This pelicy is net subject to. cancellatien by the Fund except upen 10 days' advance written netice to. the empleyer.
We will also. give yeu 10 days' advance netice sheuld this pelicy be cancelled prier to. its nermal expiratien.
This certificate ef insurance is net an insurance pel icy and dees net amend, extend er alter the ceverage afferded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to. which this certificate of insurance may be issued er may pertain, the insurance afferded by the
pelicies described herein is subject to. all the terms,exCl.Usions and conditi.ons efsuCh<Policies.
...~...........d~
~~DENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,OQO,OOO.OO PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
LEGAL
IJOHN S. NICOLI
496 S MURPHY AVE
SUNNYVALE CA 94086
NICOLI, IJOHN AND
NICOLI, IJACKIE
12-18-97
..~. -."-
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 102651REV 2-95)
l
q b~..J-
~
NG
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
CERTIFICATE OF
INSURANCE
ISSUE DATE: 01-01
POLICY NUMBER: 229..,98 UNIT 0011230
CERTIFICA TEEXF'IRES: 01""Ot-99
CITY OF CAMPBELL
ATTN DEPT. OF PUBLIC WORKS
70 NORTH FIRST STREET
CAMPBELL CA 95008
,{
':;:.}
19q;
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded
by the pOlicies listed herein. Notwithstanding any requirement, term. or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain. the insurance afforded by the
policies described herein is subject termS,.exCIUSions and conditions of.s\Jchpolicies.
~iDE~
EMPLOYER'S LIABILITY LIMIT II\ICLUDINGOEFENSE COSTS: $1,000.000.00 PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
fOR BENEfITS AS EMPLOYEES UNDER THIS POLICY.
EMPLOYER
\JOHN S. NICOLI
496 S MURPHY AVE
SUNNYVALE CA 94086
NICOLI. \JOHN AND
NICOLI, \JACKIE
12-18-97
-:.: . ..~.:
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10265 (REV 2-95)
BARTLE AGENCY
Fax:408-438-7293
Ma':j 6 '97
14:07
P.01
DATE IMIIl/OOIYVI
6IfII1
THIS CanlFICATE IS ISSUED AS A MATTER OF INFORMATION
oN\.. Y AND coNFERS NO RIGHTS UPON THE CERTlFtcAlE
HOLDER. THIS CERTIFICA~ DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POlICIES BaOW,
MEa AFfORI)INQ ccNl!RAGE
CO'tIfi'flNY CIE1\ITURY &URETY COMPANY
A
CC1iIfIJNl'f TRUCK INSURANCE EXCHANGE
8
[AOei"-~
,,0DUCEft BENNE 11M .E AGENCy
101 WHlSPEI ,c; PINeS
aeons VAl :v CA,....
(4OIJ'3I-72I
CODE; .,,- aua COIlE:
ItIoUUO cENTURY DI .co..LLC
MR JOHN S. :ou
.. So MURP ' AVENUE
SUNNYVALE A....
COMPI\NY
C
COMPN<<
D
THIS IS TO CERTIfY ~ THt POUClH 0If11N5\1WM% UST~g BELOW HAVE BeEN I88UEO TO THE INSURED tW/IEO NJOVf. FOR Tt4E POUCY PIRIOO
INDICATED. NOlWITH! NDING ~ RE~, TERM OR C()NDIT1ON or MY coNfRACT OR OTHER DOCUMENT WITH RESPECT 10 WHICH THIS
csmACATE PlAY lie I uED OR PlAY PERT", 1'HE INSURANCE N'fORDED BY THE POLICIES DESCRlIlED H&REIN IS sUBJECT TO AU THE TERMS.
EXClUS10NS AND oct noNS Of' &UCH pa.1ClU. LMT8 sHC1NN MAY HAVE BEEN REtlUCW BY plIIO ClRoA&.
0 ~ Of' 1...uRI ;E lIOI.ICY NU_ pClUI:Y Ef'FIlC'TM PClL.lC'f ElU'IRATlON LIMITS
1ft OIlTl!~ DAn; (1iIlMlIlf'fY}
QENERAL~~
lIABlLllY ccP 1sno 11/1.. 11/1W1 PROOUCT8 .~1lGG
IJOCCUR PER8C)NAl. .l\DY 1IlIJ\JRI"
Jlt8 PROT. !ACH oec:uRR5NC&
FiRe DAMAOE lNY _ I""l
IlIED EXP f!Irtt - peIIllII) s
....0401 111Z0111 COMllIED $INGlE LIMIT 5
111201I7
II""'. 11120M 111D11 BODL y IIlIJURY
(PIrJlMCl") S
-- 1112011I 111ZC1117 lJODIl y INJU~
tOO.,. 11110III 1111C11t1 jPw8GG>CIlIIlO s
PROPERTY DNMOI; S
AU1tl ONLY. EA M::CIJENT ,
0Tl4&R ll4Nl AUTO ONLY'
AGGREGATE
EACH OCCUMB<<:E
....~ 111201II 11/Z011T AOGREGI'.1lO
"R:lftM
WDIUtBaI COII-...T" UID STAl\JTCR'/ LIMITS
EIIII'UrtElUl' LIMIILm
nE~ lNCL ~ A<;QDEtfT
PAImItiiR~ [lISEASI; . POLICY LIMIT
0l'f'ICI:R8 AItE: EXCL
llISeASE- EACH eMPLOVEE I
DTHEft
0EICM'1l0II OF QPEAATIOIIlS
~: 11111UC1CNEU It(
CITY OF CAMPIIEU. RE
INSUREDS All RESfIEC
1,G111,1IO
1,G11111O
1__
100.000
UOO
1,DOO.000
1.000,-
1.000.000
Q.
CIoTKllllllftM~ 11Ba
t), PERMIT..... TR _ ALL WORK IN PUBlIC RIGHT -Of.JNAY, CITY OF CAMPBELL
VELOPMEH't AGENCY. rrs OFFICERS. EMf'LOY&B AND VOLuNTEEIlSA RE NAMED AS
UAIIUTY PER CO"
tHOULD fIM't M TNI! MOlII! DI!lICIllIII!O IICllKlIES .. QUICIlLEO IIFOM THE
EXPIMT\Olt DATE THERI!Of, TNI! ISIUINlI COIII"NtY WILL MAIL
10
_MYS W11ITTIIt NOT~ TO T~ CERTIFICATE HOUIElUIMEDTOTNEI.9T.
CITY Of CAMf !LL
AnN: DEPT, ( PU8UC WCRK8
70 NORllt FIR: STREET
CAMPBELL, Co -
. ""..?'. ':~\ ;.... .,. . . ,.' ~
Bf=lRTLE f=lGENCY
Fax:408-438-7293
Ma~ 6 '97 13:17
P.03
CENI RY DEVELOPMENT COMPANY, llC
MR. J iN S. NlCOU
496 S fURPHY AVENUE
sum VALE. CA 94086
FOLIC . tCCP 13790
600680408
SUB! :T TO ALL 011IER TERMS AND PROVISIONS OF THE FOLlCY, SUCH AS
rNSU ~CE AS PROVIDED BY THIS ENDORSEMENT SHALL BE DEEMED PRIMARY, BUT
ONL' ~ RESPECl' TO WORK PERFORMED BY OR FOR THE NAMFD lNSURJ:D IN
CONI :CTION WITII THE ABOVE DESCRIBED CONTRACT.
o~ . CAIl1
. /.lQ>
.~ <"
- (""
V r-
'-
'-
O?CH A. \lV
CITY OF CAA1.PBELL
Public Works Department
September 20, 2000
John S. Nicoli
Bucknall Development
175 Tan Oak Drive
Scotts Valley, CA 95066
SUBJECT: PERMIT NO. 96-246
LOCATION: 1681 Bucknall Road/Tract No. 8922
ONE YEAR MAINTENANCE INSPECTION - ACCEPTANCE
Dear Mr. Nicoli:
The City of Campbell has made the fmal one year maintenance inspection of subject Public
Works improvements and find that no remedial work is required.
Your warranty requirements and any surety, therefore, are hereby released. Enclosed is a
check made payable to Bucknall Development, in the amount of $4,758.00, which represents a
refund of both your Monumentation Security and Construction Cash Deposit. A second check,
in the amount of $844.71, is also enclosed, made payable to John Nicoli, which represents a
refund of your plan check deposit, Both checks also include accrued interest.
Also, please find attached your original bonds for Labor & Materials and for Faithful
Performance which we are returning to you.
Sincerel~ ~
Alan~
Public Works Inspector
Enclosures
1\
MQ~~
cc: Permit 96-246
Public Works/Maintenance Division
Far West Insurance Company, 425 California Street, Suite 350, San Francisco, CA 94104
H: \ WORD\PERMITS\96246ACC(JD)
70 North First Street Campbell, California 95008-14:!3 rEl 408 866.::! 150 . FAX 408.376.0958 . TOO 408.866.2790
~ FOR LABOR AND MATERIi
FAR WEST INSURANCE
We, the undersigned JOHN S. NICOLI , (hereinafter "Principal") and COMPANY , a
corporation organized under the laws of the State of NEBRASKA , and authorized to
transact business in the State of California, as Surety, are obligated to the City of Campbell (hereinafter "City"), a
municipal corporation under the laws of the State of California, in the sum of THIRTY-EIGHT THOUSAND SIX
HUNDRED Dollars ($ 38.600.00) for the payment of which sum we obligate ourselves and our successors and
assigns, jointly and severally by the following provisions:
The condition of this obligation is that the Principal entered, or is about to enter, into acertain written Contract
with the City dated , 19_, and entitled TRACT NO. 8922, EP 96-246 , a
true and correct copy of which is presently on file in the office of the City Clerk of the City of Campbell, which said
Contract is hereby referred to and made a part hereof.
Because Principal is required to furnish a bond in connection with the contract, providing that if Principal, or
any of its subcontractors, shall fail to pay for any materials, or other supplies, or for any work or labor on the contracted
work of any kind, or for amounts due under the unemployment insurance act with respect to any work or labor on this
project, the Surety on this bond will pay for the debt, in an amount not exceeding the sum specified in this bond, and
also, in case suit is brought upon the bond, a reasonable attorney's fee to be fixed by the court.
Now, therefore, we, JOHN S. NICOLI , as Principal, AND FAR WEST INSURANCE COMP~lit
Surety, are obligated to the City of Campbell, in the sum of $ THIRTY EIGHT THOUSAND , lawful money of
the United States, for the payment of which sums will and truly to be made, we the said Principal and Surety bind
ourselves, successors and assigns, jointly and severally, by these provisions.
The condition of this obligation is that if Principal, its successors or assigns, or its subcontractor, or
subcontractors, shall fail to pay for any labor, materials, or other supplies, used in the performance of the work
contracted to be done, or for amounts due under the unemployment insurance act with respect to this work or labor, then
the Surety on this bond will pay for them, in an amount not exceeding the sum specified in this bond, and in case suit is
brought upon this bond will also pay a reasonable attorney's fee, to be fixed by the court.
No prepayment or delay in payment and no changes, extensions, addition or alteration of any provision of said
Contract or in any plans and specifications referred to herein, and no forbearance on the part of the City shall operate to
release the Surety from liability on this bond, and consent to make such alterations without further notice to or consent
by the Surety is hereby given, and the Surety hereby waives the provisions of Section 2819 of the Civil Code of the State
of California.
In witness, the parties have executed this agreement as of MARCH 13
,19 en .
(Principal) JO~ NlfOLI
BY~ \ ~'A
Title cC/~
-
(Attach Acknowledgments)
Address of Surety:
CAMPBELL. CA
Surety's Bond Number 006008530
(Accompany this bond with Attorney-in-fact's
authority from Surety to execute the bond,
certified to include the date of the bond.)
(Both Principal's and
Surety's Attorney in Fact)
h: \landdev\buckbond( mp) wd
~ County at
J
On
before me.
OATE
"WoIE. finE 01 OIFCER . E G. '.woE:>oE. NOTARY PUIlC.
personally appeared
~WE(SI ~ SlGHEAtSI
o personally known to me . OR . 0 proved to me on the basis of satisfactory evidence
to be the person(s} whose name(s} is/are
subscribed to the within instrument and ac-
knowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies}, and that by his/her/their
signature(s} on the instrument the person(s},
or the entity upon behalf of which the person(s}
acted, executed the instrument.
Witness my hand and otticial seal.
o INOIVIOUAL(S)
D CORPORATE
OFFICER(S)
TITLE 5.
o PARTNER(S)
o ArTORNEY./N,FACT
o TRUSTEE(S)
D SUBSCRIBING WITNESS
o GUAROIANICONSERVA TOR
o OTHER:
SIGNER IS REPRESENTING:
IWoIE 01' PERSOH($IOR ENTITY(IESI
SlGHATUM 01' NOTARY
ATTEHTlOH NOTARY: AlIhough me inIoIlNlion flqUelllCl below IS OPTIONAL, It could ptevellll'iUdulellliltKhnlenC oIlIlIa cerlllici.elO UNulllcWed document
THIS CEATIFICA TE
MUST BE A IT ACHED
TO THE DOCUMENT
DESCRIBED AT RIGHT:
Title or Type of Document
Number ot Pages Date at Document
Signer(s) Other Than Named Above
.' ._.\.-. .
ALL. PURPOSE ACKNOWLEDGMENT I-
?~~~~~~~~~~-S~~~
State of r ~\ \ \ k-,\'y\ \6 } CAPACITY CLAIMED BY SIGN
/'~ . J:J. (' l' 0
County of '--JO' ~ \. ~ Ie;' INOIVIOUAL(S)
.~ \ I ?31 C'l; before me, ~~
- ~TE
On
personally appeared
--=s~\ ~
t' <::'2- I,
c
"
NAAotE(SI OF SIONERISI
o personally known to me ...~OR - 1sl proved to me on the basis of satisfactory evidence
, T to be the p6rson~ whose name~ isJal:a.
subscribed to the within instrument at,d ac-
knowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(.i&st; and that by his/her/their
signature~ on the instrument the person~
or the entity upon behalf of which the per~o~}
acted, e~Iecuted the instrument. /
Witne ~"h~nd and iat. se
t:,/ I
:U; ,It
~~~~~_::::--......;..::--.~ ~-'--"""":""""""':::-":''::.:-<1
· ./.~> "H'R .-'. .' ~. .... r . .. ~
,.. <;:~'0.'1 I 1..: "''';\''.j e1j\jfiG j
a: :,~~":\)~\ >J I ''':'~ :...~-:.Jl . .~ ~,
'~~I Comm.; ,v~O.3/ ;;0
$:~) NOT.4Je C'lJ2L.': '.~!'c:"ORNlA .:;:;
r"I '~:'~~J' SarlJ :~:ar;) C~'U1'itY, ~
-;' '~ :'*! Ccmm. E!:PlfOO JJrv :9.;?~
~-.,,.,,-..~~.......,.-......,-~~~ 0,""
....---
o CORPORATE
OFFICEA(S)
T1TLE1SI
o PARTNER(S)
o ATTORNEY.iN.FACT
o TRUSTEE(S)
o SUBSCRIBING WITNESS
o GUAROIANICONSERV A TOR
o OTHER:
SIGNER IS REPRESENTING:
NAAotE 01' PERSOH(SI OR ENTlTYllESI
ATTENTION NOTARY: Altllough ene in'orm.lIOn fequ8SIed below i~ TIONAl, it could pt8V8n1I'iudulentin.1lCllment 0' Chis c8rtdic:i1810 ulliUlIlOlIled docUmoIOI.
THIS CERTIFICATE
MUST BE A rr ACHED
TO THE DOCUMENT
DESCRIBED AT RIGHT:
Title or Type of Document
Number of Pages
Signer(s) Other Than Named Above
Date of Document
READ CAREFULL Y
This document is printed on white paper containing the anificial watermarked logo (A ) of Amwest Surety Insurance Company, the parent co. of Far West
Insurance Company (the "Company"), on the front and brown security paper on the back. Only unaltered originals of the POA are valid. This POA may not be
used in conjunction with any other POA. No representations or warranties regarding this POA may be made by any person. This POA is governed by the laws of
the State of California and is only valid until the expiration date. The Company shall not be liable on any limited POA which is fraudulently produced, forged or
otherwise distributed without the permission of the Company. Any party concerned about the validity of this POA or an accompanying Company bond should
call your local branch office at (4011) 559-6988
KNOW ALL BY THESE PRESENT, that Far West Insurance Company, a Nebraska corporation (the "Company"), does hereby make,
constitute and appoint:
ROY G. FLETCHER
AS AN EMPLOYEE OF FAR WEST BOND SERVICES
~
its true and lawful Attorney-in-fact, with limited power and authority for and on behalf of the Company .... ~ execute i
thereto if a seal is required on bonds, undertakings, recognizances, reinsurance agreement for a MilIero~ perfo~ce
the nature thereof as follow: ~
All Other Bonds $**5,000,000.00 ~
Federal Contract (perfonnance & Payment) $****479,000.00
.............. A_ C......... ...... up In S"USO,ooo.OO ~ ~~-.....,
.... .. bi'" "" '''''''''' """"'. Tho 'ppu;"mrn, ;, """, ,"'" md by ,,~,~,-r.....<l~~~h = oow i, full f,= md ,ff""
I, the undersigned secretary of Far West Insurance Company, a Nebras~~on~DO ~}'Rp~at this Power of Attorney remains in full force and
effect and has not been revoked and furthermore, that the resolutions ill ~ ofDir i s~o~ ~~wer of Attorney, and that the relevant provisions of
the By-Laws of the Company, are now in full force and effect. ~ ~
Bond No. 006008530 Signed&Sealedthi~O M ML~1 ..--/ P ~
- , ~ Karen G. Cohen, Secretary
. . . . . . . . . . . RES IONS~ O~ F DIREcrORS . . . . . . . . . . .
Article II, Section 7 of the By-Laws of Far West~rance Compan . P is sign d sealed by faCSimile under and by the authonty of the following
resolutions adopted by the Board of Directors 0 est Insu e om y a~eet g duly held on July 28, 1983
RESOLVED, that the President or any IC es ent, IO~Ctl WI~ ~cretary or any Assistant Secretary, may appomt attorneys-in-fact or agents With
authonty as defined or limited in the ins nt e den~in ent in ~Cl\ case, for and on behalf of the Company, to execute and deliver and affix the seal
of the Company to bonds, undertakm ces, ty Ip o~ons of all kmds, and said officers may remove any such attorney-in-fact or agent and
revoke any POA previously granted to c persO$]n ~V
RESOLVED FURTHER, that any bo ,unde 'ng, r gm~ suretyship obligation shall be valid and bind upon the Company
(i) when signed by the President or any Vi res t an~st and sealed (if a seal be required) by any Secretary or Assistant Secretary; or
(ii) when signed by the President or any c res' ent tary or Assistant Secretary, and countersigned and sealed (if a seal be required) by a duly
authorized attorney-in-fact or age t; or l ,
(iii) when duly executed and sealed (i required) ~ne or more attorneys-in-fact or agents pursuant to and within the limits of the authority evidenced
by the power of attorney issued by e ompany to such person or persons.
RESOLVED FURTHER, that the signa re of any authorized officer and the seal of the Company may be affixed by facsimile to any POA or certification
thereof authorizing the execution and delivery of any bond, undertaking. recognizance, or other suretyship obligations of the Company; and such signature and seal
when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, Far West Insurance Company has caused these presents to be signed by its proper officers, and its corporate seal to be hereunto affixed
this 14th day of December, 1995. ~ ~1"__/ P ~
9~ ~hn E. sava~:%~ ~ Karen G. Cohen, Secretary
State of California
County of Los Angeles
On December 14. 1995 before me. Peggy B. Lofton Notary Public. personally appeared John E. Savage and Karen G. Cohen, personally known to me (or
proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me all that
he/she/they executed the same in hlslher/thelr authorized capacity(ies), and that by hlslher/their slgnature(s) t :;='nenyhe~l'S..Q..n~ o~e.Ji..nt~ u~n.ll.ehl
of which ~fil\Wm~~~ s) acted. executed the mstrument
""," l 'R J\ ""'" WITNESS hand and offiCial seal . PEGCWI.LOFIaf
", c.. V ,., A, '" ,._ .J..I.-
,,"'_\.~.................~.Vl"\"'" $ ~#10MlM1 ~
,," ,~... ~POA ....~<<'..,.., ~ NoIartN:llc-CaIfDriI ~
!Io.../'CP "'1/:...... \ Signature ' (Seal)! LoIAngeleeCcu'lty I-
ff (J) ! ~ ~ \ () l ~ Comm, ExpIMeAug6. 1999
"W: DEC.14, :0"
~ ~ \. 1995 .f ~ ff "Car West - - ~ - - - - - - ~ - -
" '. ~ ~ : 't1 " r;
\ ~>.. ~8R" S~ ../~ l
""',,:;:, .;.....:...f......~t.."""" Insurance Company
"""""UII"""""\\\
NOTARY ACKNOWLEDGMENT
Slate of CALIFORNIA
County of SANTA CLARA
On 3/13/97 before me, VERONICA RAMIREZ
Notary Public, personaUyappeared ROY G. FLETCHER
(here insert name.1
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me aU that he/she/they executed the same in histher/thelr
authorized capacity(ies), and that by hislherltheir signature(s) on the instrument the person(s). or the entity upon behalf aT
which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
r
Signature \ll\nlLC
(Seal)
J....lI.......................................
~ VERoNICA RAMREZ J
i Commission' 1094210
~ -,,; Notary PubDc - CalIfomla f
Santa Clara County -
My Comm. ExpIres Apr 11, 2(XX)
! CAPACITY CLAIMED BY SIGNER SIGNER-REPRESENTING
NAME OF PERSON(SI OR ENTlTY(IESl
- o PARTNER(S) o GUARDIAN/CONSERVATOR
_ INDIVIDUAUS)
_ CORPORATE []! ATTORNEY IN FACT o OTHER FAR WEST INSURANCE
OFFICERS n TRUSTEE(S) COMPANY
o SUBSCRIBING WITNESS
ATTENTION NOTARY: Although the inlonnallon reQUested below is OPTlONAL it could pl'BY8l1t fraudulent attachment of this certi1lcale.
THIS CERTlFICA TE MUST Document Tille or Type: {J()M /V'Ji,;,1 r (?)CjICC
BE ATTACHED TO THE j,l I
DOCUMENT DESCRIBED ....i fa
Number ot Pages: Document Date:~ (~/~, 7
HEREIN:
Signerls) other than named above:
B( ) FOR FAITHFUL PERFORMAl' .::. BOND NO.006008530
PREMIUM: $760.00
We, the undersigned JOHN S.. NICOLI , (hereinafter
"Contractor") and FAR WEST INSURANCE COMPANY , a corporation
organized under the laws of the State of NEBRASKA , and authorized to transact business
in the State of California, as Surety, are obligated to the City of Campbell, (hereinafter "City") a municipal corporation
under the laws of the State of California, in the sum of THIRTY-EIGHT THOUSAND SIX HUNDRED
DOLLARS ($ 38.600.00 ) for the payment of which sum we obligate ourselves and our successors and assigns, jointly
and severally by the following provisions:
The condition of this obligation is:
Because the obligated Contractor has, on
Contract with the City for the Project entitled TRACT NO. 8922. EP 96-246
and made a part of this bond, for construction of Project.
, 19 , entered into written
, a copy of which is attached
Now, therefore, if the Contractor shall faithfully perform the work in accordance with the plans, specifications
and contract documents during the original term, and any extensions of the contract which may be granted by the City,
with or without notice to the surety, and if it shall satisfy all claims and demands incurred under the contract, and shall
fully indemnify and save harmless the City from all costs and damages which it may suffer by reason of failure to do so,
and shall reimburse and repay the City all outlay and expense which the City may incur in making any default, then this
obligation shall be void; otherwise to remain in full force and effect.
If any legal action be filed upon this bond, it shall be filed within one year after final payment has been made
under the Contract excluding the warranty period, if any, provided for in the Contract, and venue shall lie in the County
of Santa Clara, State of California, and that surety, for value received stipulates and agrees that no change, extension of
time, alteration or addition to the terms of the Contract or to the work to be performed under it or the specifications
accompanying it shall in any way affect its obligation on this bond, and it does by this means waive notice of any
change, extension of time, alteration or addition to the terms of the Contract or to the work or to the specifications, and
thereby waives the provisions of Section 2819 of the Civil Code of the State of California.
In witness, contractor and surety have executed this agreement as of MARCH 1 ~
, 19....<lL.
Title
CAMPBELL, CA 95008
(Attach Acknowledgments)
Surety's Bond Number 006008530
(Accompany this bond with Attorney-in-fact's
authority from Surety to execute the bond,
certified to include the date of the bond.)
(Both Principal's and
Surety's Attorney in Fact)
h: \landdev\buckbond(mp )wd
NOTARY ACKNOWLEDGMENT
Slate of CALIFORNIA
County of SANT A CLARA
On 3/13/97 before me, VERONICA RAMIREZ
Notary Public, personally appeared ROY G. FLETCHER
(here insert namel
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me all that he/she/they executed the same in hisiher/thelr
authorized capacity(ies), and that by hisiher/their signature(s) on the instrument the person(s), or the entity upon behalf at
which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
101M U,}
(Seal)
J .- .- ~ ~ ~ ~;;; ~ J
~ a Commission' 1l>>4210 ;;
~ .... Notay PubIc - CaIfomIa ~
~ Santa Clara Colllty -
j _ _ ~,_M~C::~:~l:~l
Signature
(
\Jli~ .;10:tl
,L ~I I
'\
CAPACITY CLAIMED BY SIGNER SIGNER. REPRESENTING
NAME OF PERSON(SI OR EHTITY(IESI
= INDIVIDUAUS) C PARTNERIS) o GUARDIAN/CONSERVATOR
_ CORPORATE []l ATTORNEY IN FACT OO'T1-lER FAR WEST INSURANCE
OFFICERS Ii TRUSTEE(S) COMPANY
n SUBSCRIBING WITNESS
ATTENTlON NOTARY: Although the information requested below is OPTIONAL it could pmvent fraUdulent attacnment of this cel1ltlcate.
,i /""'\
THIS CERTlFICA TE MUST -f!.Qj':f. I~ 1 \ ~ lie ~01{L
Document TIlle or Type: I II ( ~I U (\.....
BE ATTACHED TO THE 1- Document Date:.3 /1 3/? 7
DOCUMENT DESCRIBED Number of Pages:
HEREIN:
Signefls) other than named above:
~ t
, _''')unty 0
'~
J
On
before ...d.
CATE
IWIE. fllLE 01 OIFICEA" E G. '.lANE :lOE. NOTARY pUlue'
personally appeared
NAMEIS' OF SIGHEAISI
o personally known to me . OR . 0 proved 10 me on the basis 01 salislactory evidence
to be the person(s) whose name(s) islare
subscribed to the within instrument and ac-
knowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s),
orthe entity upon behalf of which the person(s)
acted, executed the instrument.
Witness my hand and oHicial seal.
o INDIVIDUAl(S)
o CORPORATE
OFFICER(S)
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CITY OF CAMPBELL
Public Works Department
August 21, 2000
Bucknall Development
c/o John Nicoli
496 South Murphy Avenue
Sunnyvale, CA 94086-6114
Re: Project Address: 1681 Bucknall Road
EP 96-246, Tract No. 8922
Monumentation Cash Security
Dear Mr. Nicoli:
According to the City's records, a $2,500,00 cash security bond is still being retained for setting
the survey monuments for the above-referenced Tract No, 8922. Please provide us with a letter
from your civil engineer/land surveyor that all monumentation has been completed in accordance
with the Subdivision Map Act Section 66495, and the recorded Tract Map No. 8922, and that
he/she has been paid for hislher services. Upon written request for refund of the security by the
party who posted it, the staff will check the site to verify that the monuments have been set.
When the monumentation has been completed, the staff will arrange to have your security
released by the City Council.
According to recorded Tract Map No. 8922 monuments should have been set on or before
February 1, 1998.
Please respond within two (2) weeks of receiving this letter. Contact David Corona or me at
(408) 866-2158 if you have any questions.
I. arold Housley, P.E
Land Development Engineer
cc: LD File/1681 Bucknall Road
EP File/96-246
Alan Horn, Public Works Inspector
Michelle Quinney, City Engineer
Ted L. Wilson, Kier & Wright, 3350 Scott Blvd, Bldg. #22, Santa Clara, CA 95054
j:\ld\monuments due
70 North First Street. Campbell, California 95008-1423 . TEL 408.866.2150 . FAX 408376.0958 . IDD 408.866.2790
/o.,4."~O f" C.4AtA-d>(I'I
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O~CHA\lQ'
CITY OF CAMPBELL
Public Works Department
September 24, 1998
John Nicoli
181 Tan Oak Drive
Scotts Valley, CA 95066
SUBJECT: PERMIT NO. 96-246
LOCATION: 1681 Bucknall Road
FINAL INSPECTION AND ACCEPTANCE
Dear Mr. Nicoli:
The City of Campbell has made a [mal inspection of subject Public W orIes improvements and
finds the work to be acceptable and in conformance with City standards, Accordingly, the City
Engineer accepts the improvements.
The one year maintenance period stated in the permit begins as of the date of this acceptance
letter, The permittee is responsible for the repair and/or replacement of any defective work or
failures that occur within one year. The City will inspect the improvements within one year
and notify you, in writing, whether or not any repairs are required,
Your Faithful Performance Bond will be kept in force for the duration of the one year
maintenance period or until a Maintenance Surety equal to 25 % of the Faithful Performance
Bond is received.
If you have any questions, please call me at (408) 866-2168,
S~n dtL-
Alan~
Public W orIes Inspector
MQ
cc: Suspense - 11 months
Permit #96-246
Inspector File
Far West Insurance Company, ATTN: Roy G. Fletcher, 152 North Third St. #550, San Jose, CA 95112
H:\ WORD\LANDDEV\96246FIN(JD)
70 North First Street. Campbell. California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TOO 408.866.2790
.....1IIcOII, ..... c......
496 South Murphy Avenue
Sunnyvale, CA 94086
Phme 650 968-9706
Fax 650 968-9721
Email JNICOLI@AOL.COM
June 29, 1998
,-- "'ED
L.. I J
JUN 2 9 1998
Mr. Allen Hon, Public Works Dept.
City of Campbell
70 North First Street
Campbell, CA 95008
," u,~l..IC "tlunKS
ADMINISTRATION
Re: Permit #96-246, Tract 8922 Bucknal1 Estates
Dear Mr. Hon:
Attached you will find vellums and one blue-line set of "As-Built" Improvement Plans for tl\e above project for
your files. Also enclosed is a copy of the June 2, 1998 letter from Kier & Wright, Civil Engineers, confirming that
they have set the street monuments, property corners, and have been paid in full for all services on the project.
Per our telephone conversation of this morning, I believe these are the items needed by the City of Campbell in
order to complete the project. Please review this information submitted today. I trust you will then release all
bonds on file with the City for the project. Please supply me with documentation of the release at your earliest
convenience.
Regards,
"~\
~~"--- ;;
John Nicoli
Owner/General Contractor
JLN:jn
Attachments
JUN. 3.1g98 9:10AM
KIER & WRIGHT
NO,25T
P.2/c
WRIGHT
Civil Engineer. Survevors. Inc.
June 2,,1998 .
, Robert Kass
ublic Works Director
ity of Campbell
70 North First Street
Campbell, CA 95008
T,lIct No.. 8922
Bucknall RDad, Campbell
This letter is to confirm that Kier & Wright Civil Engineers & Surveyors, me, has set the
street monuments and the property comers for the referenced tract and have been paid in
full for our services to date on the project.
lease call me if you have any questions.
Sincerely,
KlER & WRIGHT
rp:~
Ted L. Wilson, LS
Principal
Tt W/jc
\\server I \admin\word\led\OS 19l1r.doc
3350 Scott Boulevard. Building 22 · Santa Clar.. California 9S064 . ("08) 727-6885 . FAX (401) 727--"
'-1 j (...
'fI it/t I.d'--"
KIER WRIGHT
RECEIVED
MAY 2 1 1998
PU8llc WORKS
ADMINISTRATION
May 19, 1998
Civi I Engi neers Su rveyors, Inc.
Mr. Robert Kass
Public Works Director
City of Campbell
70 North First Street
Campbell, CA 95008
Re: Tract No. 8922
Bucknall Road, Campbell
Dear Mr. Kass:
This letter is to confirm that Kier & Wright Civil Engineers & Surveyors, Inc. have set
the street monuments for the referenced tract and have been paid in full for our services
to date on the project.
Please call me if you have any questions.
Sincerely,
KIER & WRIGHT
Ted L. Wilson, LS
Principal
\ \server 1 \admin\word\ted\05191tr.doc
3350 Scott Boulevard, Building 22 . Santa Clara, California 95054 . (408) 727-6665 . FAX (408) 727-5641
Far West
April 30, 1999
Far West InSLlfance Company
425 California Street
Suite 350
San Francisco, CA 94104-2105
(415)362-1188 RECEIVED
MAY 1 n 1999
PU8L.,c
AD"'HI'T:~~~~
Insurance Company
West Valley Sanitation District of Santa Clara Cou
70 North First Street
Campbell, CA 95008
Bond
Subdivider:
Amount:
Description:
Location:
Effective Date:
006008529
John S. Nicoli
$15,703.00
STREET IMPROVEMENTS TO TRACT #8922.EP96-246
"SANITARY SEWER IMPROVEMENT BOND" - CAMP
3/13/99
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your
cooperation in providing the information requested below. Receipt of this information allows us to monitor
our contractor's progress on this job and total work program. Thank you for your assistance.
1.
2.
3.
4.
5.
6.
Have the improvements been completed?
If not, what percent has been completed?
Is the work progressing satisfactorily?
Has this work been accepted?
If so, what is the date of acceptance?
If not, what is the anticipated date of acceptance?
~Yes
UNo
%
Yes
b< . Yes
Awr~"t ZI,I'I'S
[J No
LNo
COMMENTS:
"I~ l ~ tM4~~('. ~\.d ~1- ~ -\-\i......
Signed by:
Date:
C1LdJ.--
5.'o.1~
Name: A l...M . ~o ""
Phone: -.fjo e ) 8''0. oz.1 c.g
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR CONVENIENCE.
PLEASE FOLD ON THE DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
BM-F9023
Far West
9t-.2f?
Insurance Company
Far West Insurance Company
425 CALIFORNIA STREET
SUITE 350
SAN FRANCISCO, CA 94104
TEL (415) 362-1188 FAX (415) 362-1599
OCT 24, 1998
WEST VALLEY SANITATION DISTRICT OF SANTA CLARA COUNTY
70 NORTH FIRST STREET
CAMPBELL, CA 95008
Bond No.: 006008529
Subdivider: JOHN S. NICOLI
Amount: $15,703.00
Description: STREET IMPROVEMENTS TO TRACT #8922.EP96-246
Location: "SANITARY SEWER IMPROVEMENT BOND" - CAMPBELL CA
,
Effective Date: 3-13-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
rnves
1. Have the improvements been completed?
2. If not, what percent has been completed?
3. Is the work progressing satisfactorily?
4.
5.
Has this work been accepted?
If so, what is the date of acceptance?
~ %
Yes
~~.,l.4-9% Yes
o No
o No
o No
6. If not, what is the anticipated date of acceptance?
COMMENTS: C""'~ ,;. t:ML '"h~ ~/.4...A>>1U, te/'f,t. A #{I/'.r!. &J
I I '
..j;, i/7t)() C()uU /y/~ ~ ;tWM.~a/l;Y df .r3~060,
Date:
Name:
K~ /J:d;;I/
(IJtf ) f&6-,;2/&,)./
Signed by:
Phone:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
Far West
Insurance Company
JUL 25, 1998
Far West Insurance Company
425 CALIFORNIA STREET
SUITE 350
SAN FRANCISCO, CA 94104
TEL (415)362-1188 FAX (415)362-1599
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
RECE/\IED
AUG 0 6 199a
PUBL.IC \"1(.)")
AOMINlsTnAil~~
Bond No.: 006008530
Subdivider: JOHN S. NICOLI
Amount: $38,000.00
Description: STREET IMPROVEMENTS TO TRACT #8922.EP96-246
Location: CAMPBELL, CA
Effective Date: 3-13-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
1. Have the improvements been completed? IZl Yes 0 No
2. If not, what percent has been completed? %
3. Is the work progressing satisfactorily? I3ZI Yes 0 No
4. Has this work been accepted? [2] Yes 0 No
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance? ~7f '2..1 I 1'17'8
COMMENTS:
at /5L
"1;-. 7 I t'l18
Name:
1l4H #m
( log) 1;6' -Z/bf3
Signed by:
Date:
Phone:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
Far West
Insurance Company
APR 21,1998
Far West Insurance Company
425 CALIFORNIA STREET
SUITE 350
SAN FRANCISCO, CA 94104
TEL (415) 362-1188 FAX (415) 362-1599
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
<?' 4f:~ \"r 't G. - "Z.4ec.
RECEiveD
APR 2. 7 1998
PUBLIC WORKS
ADMINISTRATION
Bond No.: 006008530
Subdivider: JOHN S. NICOLI
Amount: $38,000.00
Description: STREET IMPROVEMENTS TO TRACT #8922. EP96-246
Location: CAMPBELL, CA
Effective Date: 3-13-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
1. Have the improvements been completed?
2. If not, what percent has been completed?
3. Is the work progressing satisfactorily?
4. Has this work been accepted?
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
DYes
I %
r2:I Yes
DYes
~ No
D No
D No
COMMENTS:
?~~
Name:
A!a;t 1I(j;IA.
( (01) qG b - ::x15"o
Signed by:
Date:
s- - tf- e;!;
Phone:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
(
\
\,
CITY OF CAHPBET,T,
FIELD ENGINEER'S DAILY REPORT
PROJECT HO.
REPORT HO:
ITEM
DESCRIPTION
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CONTRACTOR: ~k AJ,~ko l ~
INSPECTOR:
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FIELD ENGINEER'S DAILY REPORT
CITY OF CAMPBET,T.
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PAGE: I
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C,ITY OF CAlllPBEl1
Public Works Department
70 North First street
Campbell, CA 95008
Date: '(rift
TO:
FACSIMILE COVER SHEET
l 11'tv\. ,-~rwj5
~vJJ MVIIJb
FROM:
Fax Telephone No. (t -)0) ~5 4 --- 9?7'(J
/( ~ Uesf-G-II
MESSAGE:
Number of Pages Transmitted (including this page) J-
P.,:rJ''''J /!-f/ tu~. -r:/..- t/p.{~ );51: &/J--' i< ?tt/:.d
ojM ~ LeI/II.. -I~ 1111-1u-.d b~tt. A A/wilt d/rl ;"'S
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Transmitted from Fax Phone # (408) 376-0958
If there are any problems with this transmission, please call (fd 1 ~ Rt t . Jj b S-
ept. Phone No,
a: \admindisk(#2)fax
CITY OF CA1\IPBEll
Public Works Department
70 North First Street
Campbell, CA 95008
Date:
4/1/9F
, f
FACSIMILE COVER SHEET
TO: s.J IlVL O()/IJ~ $.
~VI So () Av1 N(--?
FROM:
Fax Telephone No. (&5'0 ) fi54- 9Piv
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Number of Pages Transmitted (including this page)
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Transmitted from Fax Phone # (408) 376-0958
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Dept. Phone No.
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,"
FIELD ENGINEER I S DAILY It JRT
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DATE: 5 I tctt:t 6
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DESCRIPTION
u! l()~ ,J\fllJeuJ ~ leD LF Cu( b ~ .
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FIELD ENGINEER' S DAILY REPORT
PROJECT HO.
REPORT NO:
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WEATHER: elu.v
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PAGE:
OF
Far West
Insurance Company
JAN 13, 1998
FarWestmsuranceCompany
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
REce'VED
,j~N 2,~ '/QO<;:,
, - I ~ J.{ ~
Bond No.: 006008530
Subdivider: JOHN S. NICOLI
Amount: $38,000.00 8
Description: STREET IMPROVEMENTS TO TRACT #8922 P96-246
Location: CAMPBELL, CA
Effective Date: 3-13-97
,.Jlh.'>I..i( VI,_",
ADMINISTRATla~1\,
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
~nror:v:::~:p:::::n:P::::::~:d:en5' Th~O~e:r your ass~rNO
2. If not, what percent has been completed? ~ %
3. Is the work progressing satisfactorily? ' Yes 0 . No
4. Has this work been accepted? 0 Yes g No
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance? I~ 2...k J f\Ilot1 tI..~ .
COMMENTS: tI~/1vU ('(i;J /Mtlk- ;; /~L ~ud' :sf/Oj- 1';vv.Jlr"r-~T 1tttA/J,/ I/1r-r
~ /
k ,..-huUl. M..J ,~ (Co. ''''/ JU.!~.~ n.R". t f.wd ,.."",,;ti, J rr;
J:r f+/act- ,Aio/l.
Signed by:
<-3J~d/
1b.,f9P
/ '
Name:
aNIJY I1/6frr~
(/fap) 9 ~ , -' J-/ )()
Date:
Phone:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
CITY OF CAMPBELl'.
FIELD ENGINEER' S DAILY REPORT
PROJECT HO.
(~I ~~LL.-gP
REPORT HO:
DATE: 1'Z."23 ICl-r
WEATHER: c.le~(" - c.s l~
INSPECTOR:
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CONTRACTOR:
ITEM
DESCRIPTION
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CITY OF CAMPBELL
FIELD ENGINEER I S DAILY REPORT
PROJECT NO.
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REPORT NO: Z.
DATE :
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WEATHER: /7
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CONTRACTOR:
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DESCRIPTION
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Far \Xest
Insurance Company
OCT 11, 1997
FarWestmsuranceCompany
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
) .""
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'AII/tv/s;'" \...0,(,\ .
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Bond No.: 006008530
Subdivider: JOHN S. NICOLI
Amount: $38,000.00
Description: STREET IMPROVEMENTS TO TRACT #8922.EP96-246
Location: CAMPBELL, CA
Effective Date: 3-13-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistaje.
1. Have the improvements been completed? 0 Yes [zJ No
2. If not, what percent has been completed? --e- %
3. Is the work progressing satisfactorily? 0 Yes
4. Has this work been accepted? 0 Yes
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
rn: No
[Z] No
COMMENTS tJ{f-$;./e- ".;0;1< h"-i rirf p:+ ~j/fA^.-) ~ap- -b/ rcwVaJ/:'1,J'
Signed by:
Name:
j)1jN~'f We)T.ftft.0
( ttcJ f ) J:'b ~ - dI b ~--'
Date:
Phone:
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
CITY OF CAMPBELL
/ bel ~1Il~41 N .
PROJECT NO. 96.;M/&
REPORT NO: I
DATE: 9jjr ~I
WEATHER: PAIR.
INSPECTOR: K. wG:-51fALL
FIELD ENGINEER'S DAILY REPORT
CONTRACTOR:
ITEM
DESCRIPTION
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PAGE: I
OF I
Far West
Insurance Company
JUL 12,1997
FarWestmsuranceCompany
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
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Bond No.: OCSC08~30
Subdivider: JOHN S. NICOLI
Amount: $38,000.00
Description: STREET IMPROVEMENTS TO TRACT #8922.EP96-246
Location: CAMPBELL, CA
Effective Date: 3-13-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistance.
1. Have the improvements been completed? DYes G No
2. If not, what percent has been completed? 0 %
3. Is the work progressing satisfactorily? 0] Yes 0 No
4. Has this work been accepted? DYes G2I No
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance? 7
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COMMENTS:
Date:
p~
.7/26/17
Name:
12013 If!; r? -r
rn.~;u. ~s
I
Signed by:
Phone:
(Llc ~I) ~~~ - 2..{C g
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
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Santa Clara Valley Water Dishict
6
5750 ALMADEN EXPRESSWAY
SAN JOSE, CA 95118-3686
TELEPHONE (408) 265-2600
FACSIMILE (408) 266-0271
AN AFFIRMATIVE ACTION EMPLOYER
Me. John Nicoli
1681 Bucknall Road
Campbell, CA 95008
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.APR 171997
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4DMINIST ....."
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April 14, 1997
Dear Me. Nicoli:
Subject:
Permit and Construction of 6-inch Water Main for Tract Number 8922
This letter is inform you that a permit will be issued to the San Jose Water Company (SJWC) for the
construction of the 6-inch water main for Tract Number 8922. The permit that was recently issued to
you (Number 97920) originally covered this construction, however, it has since been determined that
SJWC will be installing the water main. The permit that has been issued to you will remain valid for
the construction of the 6-inch sanitary lateral and the 12-inch storm drain for the Tract.
Please reference Santa Clara Valley Water District File Number 24425 on further correspondence
regarding this matter.
If you have any questions, or need further information, you can reach me at (408) 265-2607,
extension 2253.
Sincerely,
.J.foRIGINAL SIGNED BY
Sue A. Tippets, P.E.
Supervising Engineer
Community Projects Review Unit
cc: Me. Edwin Mello, P.E.
San Jose Water Company
374 West Santa Clara Street
San Jose, CA 95196
Jg. Chuck Gomes
Department of Public Works
City of Campbell
70 North First Street
Campbell, CA 95008
Me. Ken Olcott
Kier and Wright
3350 Scott Boulevard, Building 22
Santa Clara, CA 95054
o recycled paper
SenkQ a'llQ Valley WcJ.81 r:Ashid6
'750 AlMADEN EXPRESSWAY, SAN JOSE. CA 951 (40BI 265.2600
PERMIT
Facility:
Campbell Distributary
Date Issued: Apfil 14, 1997
Permit No,:
97924
Permittee: San Jose Water Company
Attn: Mr, Edwin Mello
374 West Santa Clara Street
San Jose, CA 95196-0001
Telephone:
(408) 279-7808
File:
24425
Campbell Distfibutary
Bucknall Road at
Weston Drive
Re: 1681 Bucknall Road
Track 8922
Purpose of Permit
181 Encroachment
181 Construction
o Temporary
Installation of a 6-inch water main overcrossing the District's Campbell Distributary.
Construction Expiration Date:
Amil 14. 1998
Encroachment Expiration Date:
.PER....,.,.............'M'....Hle.E......."'.M....',....'U,..,,...'S'.....,.X.......::::.N..:':..:O'.....'.'T.............:F......y..."...::''?A'''.....;:N....:...:.O....'.::":F.......'U..."..'.R....:.'.N..:':..'I...S.'.....'.a..:::...:':'S'......"C.'...'8..',....e...,..'O.......'.U.."'....[E..""....."':O.:...."'F.......":W...;..."'...O'...."'.e.....:.K..'...'''''T.......'O'...,
. .. . .. .". ....... .. - - ", ,', . . .-. .. - ... . ...
.. .. .. -. ,-. . . . .. . . . . .... . . . . . . , - . - - .. -.,.. . -, . . ... . . .. . . . . . . . . . - .
;. .:.:..: -. ..':':' ::.. '-: ".:.:.: '-: -::. .... .:.:.:. - ::- ;.; ,':- . . :.:.', .;,".: .,':-:. -:- ..-;.: -:' -.':':- . -: . "-:.:-:.: >: :-: .
...:;:;.....-....:-..:..-........./...;:;:;...;:......:...:.:.;:;:...:.......:;......:;.......;:....;:;:;:...:....;..-:-..;:;:...:;.......::;:;:....;;:::...;:;.,.....;....:......;.;:::....;:;::.....;:...;;......::...;...:.......;...;:...:;:;.......:::.....;:...::....-....::.....-:::.......;....-:.....:-;:::;...:...;....:;:;:::;;...::...;::.......;:...:;-.....;;...::;:;:...::::....-.-:"
District's Construction Unit, c/o Mr. Dean Arroyo, (408) 265-2607, extension 2801, at least 2 normal working days before
starting any work under this permit. Failure to notify is cause for revocation of oermit and removal of work. Exercise of this
permit shall indicate acceptance of and agreement to comply with all provisions included herein. This permit is subject to
the General Provisions listed on the reverse side hereof or as expressly modified in the additional Special Provisions listed
below, Violation of any provision shall be cause for immediate revocation of permit.
SPECIAL PROVISIONS
1. All backfill within District right of way shall be compacted to at least 90 percent relative compaction in accordance with
California Test Method 216 or 231 or ASTM Test Designations 01556, 01557, or 02922 except as modified herein.
2. Permittee shall use only nonpotable or reclaimed water for completion of activities under this permit, unless the District
approves another source.
3. Measures must be taken to prevent or minimize disturbances to the District's pipeline.
4. Permittee must maintain a minimum clearance of 1 foot between the District's pipeline and the 6-inch water main being
installed.
Approval:
~d 1 Wt-e,h
Sue A. Tippets, ..
Supervising Engineer
Community Projects Review Unit
cc: Mr. Chuck Gomes
-iJepartment of Public Works
City of Campbell
70 North First Street
Campbell, CA 95008
D. Arroyo, S. Tippets, V. Stephens, D. Ely, C. Summers, File (2)
VS:clf
FeE 60.. 112/8/96)
Far West
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72jrJ
Insurance Company
APR 12, 1997
Far West Insurance Company
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CA 95008
RECE'VED
APR B 11991
;JULlL,'L v
ADM 'y~,,,,\,
INISTRA nON
Bond No.: 006008530
Subdivider: JOHN S. NICOLI
Amount: $38,000.00
Description: STREET IMPROVEMENTS TO TRACT #8922.EP96-246
Location: CAMPBELL CA
,
Effective Date: 3-13-97
FAR WEST INSURANCE COMPANY is the Surety on the above bond. We would appreciate your cooperation
in providing the information requested below. Please return the form to us so that we may have current status
information on the above captioned improvements. Thank you for your assistaje.
1. Have the improvements been completed? D, _ Ves EJ No
2. If not, what percent has been completed? -4 % ,....,{
3. Is the work progressing satisfactorily? 0 Yes ~/ No
4. Has this work been accepted? 0 Yes lZI No
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
COMMENTS: f}~ j)",dl/c [J.;/ts &crGt,;(tJ'YiJ-;/,-f A.r/Vl/~
I
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I 511/21. .
Date:
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4- "L..-t_o q l
Name: C:{2t -)'7- cs...,(;';cJ/,"-1~
Signed by:
Phone: E!Qb) b.~ .....'Z...\,.c....~
A POSTAGE PAID REPLY HAS BEEN PRINTED ON THE REVERSE SIDE OF THIS FORM FOR YOUR
CONVENIENCE. PLEASE FOLD ON DOTTED LINES AND USE TAPE TO SEAL; DO NOT STAPLE.
1.
2.
3.
4.
CITY OF CAMPBELL
ENGINEERING DIVISION
LAND DEVELOPMENT SECTION
DEVELOPMENT CHECKLIST
APPLICATION NO:
TRACT NO.
ENCROACHMENT PERMIT NO:
ADDRESS:
APPLICANT NAME AND PHONE:
CONSULTANT NAME AND PHONE:
-z..e_ C1C,,--C;" 2 i\-Sqb--C::~ l, ~t'~9.'='.l4
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\C-\..E:-r2.. ~'.A..)t2'~~l \~JJ (3 \...,c.c;.tT\
.~~{ - (.::;>(,-., &:;, s:..
REQUIRED RECEIVED
i..c> --'\C:>~. ~,
5.
6.
7.
ENCROACHMENT PERMIT ISSUANCE CHECKUST
ENCROACHMENT PERMIT APPUCATION
ENCROACHMENT PERMIT INSURANCE CERTIFICATES
FEES, SECURITY AND CONSTRUCTION ESTIMATES / f f' /". ..
a. Engineering Plan Check and Inspection Deposit <:1\, 0 s. c~ e> ..\c, - lo """'1<'.- ...
b. Engineering Plan Check and Inspection Fees. ,....... <l.4 b'~-z.. ~c:: '~ - i.4--<>i'1 ;//
c. Faithful Performance Security ...................~ce..,,\t.?C;O.<fW ~- \" -~~i -I t
d. Labor and Material Security ,................... ~,~~ ~ ~.c..o:I. e.o ....-:, - - \.~ .c". " '
e, Maintenance Security . . .... . . .. . . . . . . . . . . . <\\. Ctc... ~p .i....e-
f. Emergency Cash Deposit . . . . .. ... , . . . . . , . . . . . ~ \~:::A-4.ao -"'::, -- \ 4-':.>1 J /
g. Storm Drain Area Fee ......... ,........... <\t \ D\.l. e ~ """'..) - t,~ """1", v
h. Record Map Fee .......,..,..,....... <\\. \~"--::"S ,C,O \'--<~--=l'-- -
1. Traffic Engineering Fee . . . . . ... . . . . . .. . .. .. . ~..1"'h-.
J. Monumentation Security .............,....... ~l.~~~').CD ~- l<4-~-, v y
k P k 1m t F ~'J "" ~ ~ - -:L"'" r;71?Jtf= ,P/..
. ar pac ees ,.................... - -;.~ .",\. :.. ;-:;e i..=5,e~.tI
1. Miscellaneous Fees ........... ....... ..' Lt-b.-.
m. Constroctl'on Cost Estuna' te ~c:.... , 'v. ec:::. "'t, _'7 l -=.-
..................... '~tu=" c.-. -" 'I
STANDARD AGREEMENT AND ATTACHMENTS"...... ""3 - \ 4- - .ct-I
SPECIAL AGREEMENT AND ATTACHMENTS.,.......... t--t~---.,
RECORD MAP
a. Easements and Dedication c:J,':-:-;:. .~~V,:...
b. Taxes and Assessments Letter ,.............,....
c. Non-Interference Letters (NILS) ,....,.............
d. Signed Check List by Engineer/Surveyors ......"..
e. Current Preliminary Title Report . . . . . . . . . . .. . . . . . . ,
f. Subdivision Guarantee . . , . .. .. .. . . .. . . . . .
g. Fictitious Name Certificate ....,...,..........
h, HOA Management Agreement ,...",.............
1. CC&R's ,..,.....,.........
j. Mylar Copies After Recording ,.............,....
-\0- 10 -LiL
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RIGHT-OF-WAY BY SEPARATE INSTR..,................
SOILS REPORT ..................,
PLANS
a. Street Improvements . . .. .. . . . . .. , . . .. . ..
b. Grading and Drainage ,...................
c, Landscape . . . , . . . . .. . . . . . .. .. ,
d. Traffic Control ,...................
e. Other ,................... i_ "~
CLEARANCE LETTERS OR PERMITS FROM OTHER AGENCIES
a. SCVWD PROP. EASEMENT LTRS..,............... ~ 1'---.=
b, WVSD II II II II "...................
c. SJWC "II II II ".......,...........
d. PG&E II II II II ",..................
e. Pacific Bell II II II ", . . . . . . . . . . . . . . . . . .
f. TCI "" " II ".................,.
g. SCCFPD (Central Fire) ....,...............
h. Cal Trans ..........,......,..
1. City of San Jose =:::::; '.(;qt.', '~3:..... ..r~.'tot')~""~--'
J. Town of Los Gatos ....................
k. Private ....................
1. Other ~ ~:" v-t r .':::., pc-::..tc? ~-Y~JT. . . . . . . . . . . . . .
SOILS REPORT ,...................
LETTER FROM DEVELOPER TO PAY ADDITIONAL
PLAN CHECK EXPENSES
UTIliTY COORDINATION PLAN ......................
APPliCANT LEITER STATING COMPUANCE wrm
CONDITIONS OF APPROVAL
SPECIAL SUBMI'ITALS PER CONDITIONS OF..........
APPROV AL
PLANNING DIVISION APPROVAL '...................
BUILDING DIVISION APPROVAL ....................
TRAFFIC DIVISION APPRO V AL . .. . . . .. .. .. . .. . .. . .
SER'lICE CEN~ APPROV~ ......,.............
ESCROW LETTER WITH RECORDING INSTRUCTIONS
CITY COUNCIL AND PLANNING COMM.RES...........
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20,
21.
22.
23,
24.
COMMENTS:
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t-'~':,.(41 1~-1
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Date:
Prepared by:
h: checklist. hh
1/4/96
Approved by:
2
Date:
~~O~'CA~JO<S>
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.ORCH-'''O.
City of Campbell -- Community Development Department
70 N. First Street, Campbell, CA 95008
MEMORANDUM
To:
Harold Houseley, Land Development Engineer
Date: April 4, 1997
From: Barbara Schoetz Ryan, Planner I
Subject: Park Fees for Tentative Tract TS 96-01 and Planned Development Permit PD 96-02 at 1681 Bucknall Road
SUBDIVISION PARK FEE based on 3 acres/lOOO population
5 new lots x $5,276.25 (6-13 density range) = $26.381.25 DUE PRIOR TO TRACT RECORDATION
DEVELOPMENT PARK FEE based on 4 acres/lOOO population
6 units x $7,035.00 (6-13 density range) - credit for 2 units x $10,990 ($21,980) (at density under 6 acres) = $20.230
DUE PRIOR TO OCCUPANCY PERMIT
Per Section 13.08.110 of the Municipal Code (Credits against the park dedication requirements),
"Existing legally constructed units shall be counted as a credit against the fee or dedication
requirements applicable to developments at the density rate of the existing dwellings, up to a
maximum of one hundred percent of the park land oblieation."
Because the subdivision fee exceeds the development fee in this case due to the credits, there shall
be no development park fee due prior to occupancy.
cc. Jackie Nicoli
.Of'CA.4t.,o
-l. ~
Io...~..~. ~
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U_~i!:'r"
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1- "-
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.O~CH'\lO
CITY OF CAMPBELL
Public Works Department
March 11, 1997
Ralph QuaIis
Public Works Director
City of San Jose
801 North First Street
San Jose, CA 95110
Re: 1681 Bucknall Road, Campbell, CA
Tract No. 8922
Connection to the City of San Jose Storm Drain System
Dear Ralph:
The City of Campbell is currently reviewing the storm drain improvement plans for the above-
referenced development. Kier and Wright, engineer for the owner/developer John Nicoli, has
prepared grading and drainage and street improvement plans (copies attached) which include a
storm drain lateral from the property in the City of Campbell to the City of San Jose's storm
drain in Bucknall Road. We understand that a representative of Kier and Wright has
previously discussed these matters with Jim Tanner of the City of San Jose Public Works
Department.
The developer will be requesting approval to connect to the City of San Jose's storm drain
lateral as shown on the plans, Based on similar situations in the past, we suggest that the City
of Campbell and the City of San Jose proceed as follows:
1. Kier and Wright will prepare the plans for approval first by the City of San Jose and
then by the City of Campbell.
2. The developer will obtain appropriate encroachment permits from both cities and shall
notify each City prior to construction within the city.
3. Both cities will inspect the construction work within their respective jurisdictions,
If you are in agreement, we will continue to follow this process in all future minor storm drain
connections between our jurisdictions, If you have any comments, questions, or concerns,
please contact me at 866-2150 or our City Engineer, Michelle Quinney, at 866-2159.
70 North First Street, Campbell, California 95008.1423 . TEL 408.866.2150 N' ~.4QS.wc:37.9.,2J7?i. . TOO 408.866.2790
.t..W l' r.n....:l.. 1t
i:lQ8-37 6-09 53
Ralph Qualls
March 11, 1997
Page 2
Thank you for your cooperation and assistance.
-~
Robert Kass
Public Works Director
cc: John Nicoli, Owner/Developer of 1681 Bucknall Road
Jim Tanner, City of San Jose Public Works Department
Ken Olcott, Kier & Wright
File: 1681 Bucknall Road
h: \Ianddev\csjltr(mp )wd
San~a COla Vall"Il Wale, Ilis!tid 6
5750 ALMADEN EXPRESSWAY. SAN JOSE. CA
18 (4081 265-2600
PERMIT
Facility:
Campbell Distributary
Date Issued: April 3, 1997
Permit No.:
97920
Pennittee: Mr. John Nicoli
1681 Bucknall Road
Campbell, CA 95008
Telephone: (408) 245-7210
File:
24425
Campbell Distributary
Bucknall Road
at Weston Drive
Applicant: Kier and Wright
Attention Mr, Ken Olcott
3350 Scott Boulevard, Building 22
Santa Clara, CA 95054
(408) 727-6665 Re:
1681 Bucknall Road
Tract 8922
Purpose of Permit
R!Cl;lVED
A~n4'fS1
181 Encroachment
181 Construction
o Temporary
. .'K~
loIU...i.ll. v.. ..,"","
Installation of a 6-inch sanitary sewer lateral, ~~t&lM1lQM, and a 12-inch storm sewer line crossing
District's Campbell Distributary
Construction Expiration Date: Anril 3. 1998
Encroachment Expiration Date:
.....................:.....:......................................::::.....::.......::...:.......:.......:::::...::..::.....:,........:..:.p.........:....::::::....:::N....:...:.......:::::...........:...:.R......:...:::.....:::.....:.R..:::...:::.S:.....;::.......:...:,....e.......O.....:.:.U..:::....t..:::e......::::.O:.....:::......::::.W..:....::..::.....:::.....:.:...:...:::::.......:::.....::
. ..... . .... . .. . .. . . . .. ..... ... .
.. :.::.;.:." ";':' :-.. .:. .:-:-: .;. .:. -:: "" ,,:.;.: ,': '-: :.;.....-: " :.'.' ':':,' :..... ',::- ::::-: '":.:.:> '.":':'.' -:- .:.:.:.:. :>. ..: ,
peBMI:Jme.e.:JY.lU$l1:Ng;:rt:/YhR..:.J~l:f:U...::.Nl$....:....::::...J~H...::..:::t;Q~mg.
District's Construction Unit, c/o Mr. Dean Arroyo, (408) 265-2607, extension 2801, at least 2 normal working days before
starting any work under this permit, Failure to notifv is cause for revocation of oermit and removal of work. Exercise of this
permit shall indicate acceptance of and agreement to comply with all provisions included herein, This permit is subject to
the General Provisions listed on the reverse side hereof or as expressly modified in the additional Special Provisions listed
below. Violation of any provision shall be cause for immediate revocation of permit.
SPECIAL PROVISIONS
1, All backfill within District right of way shall be compacted to at least 90 percent relative compaction in accordance with
California Test Method 216 or 231 or ASTM Test Designations 01556,01557, or 02922 except as modified herein.
2, Permittee shall use only nonpotable or reclaimed water for completion of activities under this permit, unless the District
approves another source.
3, Measures must be taken to prevent or minimize disturbances to the District's pipeline.
4, Permittee must maintain a minimum clearance of 1 foot between District's pipeline and the lines being installed.
5, The sanitary lateral MU.SI not have less than 4 inches of clearance below the District's existing pipeline.
6, Permit 97920 is being issued to replace Permit 97916 which has been VOIDED.
Approval:
tLda CLdua#v/ i P;..
~y Sue A. Tippets, P,E.
Supervising Engineer
Community Projects Review Unit
cc: Mr, Chuck Gomes, Department of Public Works, City of Campbell, 70 North First Street, Campbell, CA 95008
FeE 60. 112/8/96)
CITY OF CAMPBELL
PUBLIC WORKS DEPARTMENT
ENGINEER'S ESTIMATE
Address:
1681 BUCKNALL ROAD (TR 8922)
Date:
2/25/97
Encroachment Permit No. 96-246 Application No. TS 96-01
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. DESCRIPTION UNIT QTY < $30 K $30 K to $150 K > $150 K $ AMOUNT
I. SURFACE CONSTRUCTION
MOBILIZATION 1 LS $ 1.500.00 $ 4,000.00 $ 4.000,00
CONSTRUCTION TRAFFIC
CONTROLCONTROLlPHASING 1 LS $ 1,000.00 $ 2,000.00 $ 2,000.00
CONSTRUCTION STAKING 1 LS $ 750.00 $ 1,000.00 $ 1,000.00
CONSTRUCTION TESTING 1 LS $ 750.00 $ 1,000.00 $ 1,000.00
II. DEMOLITION/CLEARING
I. CLEARING & GRUBBING 1 LS $1,750.00 $ 1,750.00
2. SAWCUT P.C.C./A.C.(UP TO 6") 167 LF $4.50 $3.00 $2.00 $ 501.00
3. P.C.C. REMOVAL SY $30.00 $23.00 $10.00
4. CURB AND GUTIER REMOVAL LF $6.00 $3.00 $2.00
5. MEDIAN REMOVAL SF $4.50 $2.25 $1.25
6. DEMOLISH EXISTING INLET/PLUG RCP'S EA $300.00
III. STORM DRAINAGE
I. 12' R.C.P. (CLASS V) 33 LF $60.00 $40.00 $20.00 $ 1,320.00
2. 15" R.C.P. (CLASS III) LF $65.00 $48.00 $38.00
3. 18" R.C.P. (CLASS III) LF $70.00 $60.00 $52.00
4. 24" R.C.P. (CLASS III) LF $80.00 $68.00 $59.00
5. 30" R.C.P. (CLASS III) LF $90.00 $75.00 $65.00
6. T.V. INSPECTION (12") 33 LF $1.20 $0.75 $0.60 $ 24.75
7. STD. DRAINAGE INLET EA $1,600.00 $1,300.00 $1,000.00
(C.C.DETAIL5)
8. FLAT GRATE INLET EA $1,400.00 $1,100.00 $900.00
(C.C. DETAIL 6)
9. STANDARD MANHOLE 2 EA $2,000.00 $1.600.00 $1,300.00 $ 3,200.00
(C.SJ. DETAIL 0-11)
(INCLUDES FRAME & LID)
10. BREAK AND ENTER M.H.lD.I. EA $700.00 $550.00 $450.00
Page 1
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. DESCRIPTION UNIT QTY < $30 K $30 K to $150 K > $150 K $ AMOUNT
IV. CONCRETE IMPROVEMENTS
I. SIDEWALK 355.5 SF $6.50 $4.50 $2.75 $ 1,599.75
2. DRIVEWAY APPROACH 294.5 SF $7.50 $5.50 $3.75 $ 1,6t9.75
3. CURB AND GUTTER 112 LF $22.00 $18.00 $15.00 $ 2,016.00
4. V ALLEY GUTTER SF $12.50 $10.00 $8.25
5. HANDICAP RAMP I EA $1,200.00 $800.00 $700.00 $ 800.00
6. TYPE B-1 CURB LF $12.00 $9.50 $7.50
7. TYPE AI-B3 CURB LF $15.00 $12.00 $10.00
8. COBBLESTONE MEDIAN SURFACE SF $12.00 $8.00 $5.00
9. P.C.C. DRIVEWAY CONFORM SF $7.00 $5.50 $4.50
10. A.C. DRIVEWAY CONFORM SF $4 .50 $3.75 $3.00
V.
PAVEMENT
I. ASPHALT DIGOUT AND REPLACE CF $2.00 $3.50 $2.50
(IO"XI2"XI15' PCC SLURRY)
2. PAVEMENT WEDGE CUT (6') LF $5.00 $2.50 $1.50
3. PAVEMENT GRINDING SF $0.80 $0.50 $0.35
4. PAVEMENT FABRIC (PETRO-MAT) SY $2.00 $1.85 $1.50
5. ASPHALT CONCRETE (TYPE A) 51 T $80.00 $50.00 $35.00 $ 2,550.00
(I1O)(I8){0.33){0.0775)
6. AGGREGATE BASE (CLASS 2) 115 T $40.00 $20.00 $12.00 $ 2,300.00
(110){18)(0.83){0.070)
7. SLURRY SEAL (TYPE II) SF $0.07 $0.06 $0.05
8. SLURRY SEAL (TYPE III) SF $0.11 $0.09 $0.07
VI. TRAFFIC SIGNALS/LIGHTS
I. DETECTOR LOOP (6' ROUND) EA $450.00 $300.00 $250.00
2. DETECTOR LOOP (6' x 30') EA $650.00 $540.00 $440.00
3. DETECTOR LOOP (6' x 50') EA $900.00 $750.00 $640.00
4. ELECTROLIER I EA $2,600.00 $2,200.00 $1.800.00 $ 2,200.00
5. I 1/2" RIGID CONDUIT 110 LF $9.00 $7.00 $5.00 $ 770.00
6. 2" RIGID CONDUIT LF $17.00 $13.00 $10.00
7 CONDUCTOR 330 LF $0.70 $0.55 $0.45 $ 181.50
Page 2
ITEM UNIT PRICES FOR PROJECT AMOUNT $ AMOUNT
NO. DESCRIPTION UNIT QTY < $30K $30 K to $150 K > $150 K
8 PULL BOX (NO.3 1/2) 2 EA $300.00 $240.00 $185.00 $ 480.00
9 PULL BOX (NO.5) EA $400.00 $350.00 $300.00
VII. STRIPING AND SIGNS
I. REMOVE PVMT. MARKINGS (PAINT) SF $2.50 $1.50 $1.00
2. REMOVE PVMT. MARKINGS (THERMO) SF $3.00 $2.00 $1.40
3. REMOVE PVMT STRIPING LF $1.40 $0.80 $0.40
4. STRIPING DETAIL 9 LF $1.35 $0.85 $0.35
4A. STRIPING DETAIL 22 50 LF $UO $ 55.00
5. STRIPING DETAIL 29 LF $2.25 $1.65 $1.20
6. STRIPING DETAIL 32 LF $2.40 $1.75 $1.25
7. STRIPING DETAIL 37 (THERMO) LF $1.85 $1.50 $1.00
8. STRIPING DETAIL 38 (THERMO) LF $2.50 $1.85 $U5
9. STRIPING DETAIL 39 LF $1.50 $0.85 $0.45
10. STRIPING DETAIL 40 LF $2.20 $1.70 $1.00
II. LIMIT LINE 20 LF $1.35 $1.05 $0.90 $ 21.00
12. CROSSWALK LF $1.35 $1.05 $0.90
13. PAVEMENT MARKINGS (PAINT) SF $2.50 $1.90 $1.60
14. PAVEMENT MARKINGS (THERMO) 22 SF $5.50 $3.80 $2.60 $ 83.60
(STOP)
15. PAVEMENT MARKER (NON-REFL.) EA $4.50 $3.00 $2.20
16. PAVEMENT MARKER (REFLECTIVE) EA $6.00 $4.15 $3.15
17. TYPE K MARKER EA $95.00 $80.00 $70.00
18. TYPE N MARKER I EA $95.00 $80.00 $70.00 $ 80.00
19. SALVAGE ROAD SIGN EA $85.00 $75.00 $65.00
20. RELOCATE ROAD SIGN 3 EA $100.00 $85.00 $75.00 $ 255.00
21. INST. RD. SIGN ON EXIST. POLE EA $200.00 $145.00 $110.00
22. ROAD SIGN WITH POST 2 EA $300.00 $240.00 $195.00 $ 480.00
23 STANDARD BARRICADE 10 LF $15.00 $ 150.00
VIII. LANDSCAPING
I. IRRIGATION, PLANTING WORK t LS $2,835.00 $ 2,835.00
{90'){4.5 ')($7 .(0)
Page 3
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. DESCRIPTION UNIT QTY < $30 K $30 K to $t50 K > $150 K $ AMOUNT
2 PRUNE TREE ROOTS EA $125.00 $100.00 $85.00
3. TREE REMOVAL EA $650.00 $500.00 $400.00
4. ROOT BARRIER (l2") LF $20.00 $10.00 $6.00
5. ROOT BARRIER (l8") 32 LF $25.00 $15.00 $10.00 $ 480.00
6. STREET TREE (l5 GAL) EA $450.00 $325.00 $250.00
7. STREET TREE (36" BOX) 2 EA $700.00 $550.00 $400.00 $ 1,100.00
8. TOP SOIL BACKFILL 15 CY $t5.00 $ 225.00
(90')(4.5 '){l2 ")/27
IX. MISCELLANEOUS
I. PEDESTRIAN BARRIER LF $75.00 $60.00 $50.00
2. CHAIN LINK FENCE (6') LF $15.00 $11.50 $9.25
3. RAISE MISC. BOX TO GRADE EA $300.00 $200.00 $175.00
4. RAISE MANHOLE TO GRADE EA $400.00 $275.00 $200.00
5. INSTALL MONUMENT BOX EA $450.00 $350.00 $300.00
6. MEDIAN BACKFILL CY $19.00 $17.00 $15.50
SUBTOTAL $ 35,077.35
PREPARED BY: C-~~
\.N~ %-tH7 10% SECURITY ENFORCEMENT FEE $ 3,507.74
REVIEWED BY:
- ,
TOTAL ESTIMATE FOR FAITHFUL $ 38,585.09
APPROVED BY: ~ PERFORMANCE SECURITY $38.600.00
.See Section 66499.4 of the Map Act.
H:\1681BKNL(MP)EXC.
Page 4
34758 North First Street. #2L-.
San Jose. California 95134
PACIFICt:tBELL,
A Pacific Telesis Company
January 2, 1997
CBStoMB.R COP)
City of Campbell
Public Works Department
70 North First Street
Campbell, CA 95004
RECEIVED
JAM 0.61991
Re: Tract #8922
i"'uuLI~ 'Vyv......,'iI
AQM'~I$TR,ATION
Attn: Martha Kozera
Gentlemen:
The Public Service Easements/Public Utility Easements as shown on the final copy
of the parcel map presented prior to recording are adequate and satisfactory for the
installation of Pacific Bell's facilities.
The above mentioned project is located within the Pacific Bell service area and
Telephone service will be provided in accordance with our rate, rules and regulations.
Our engineering plans call for providing service to this site when service is required.
If you should have any questions, please call me on (408) 493-7229.
~kL~
R. L. McManus
Pacific Bell Engineer
cc: Keir & Wright
3350 Scott Blvd. Bldg. 22
Santa Clara, CA 95054
/~# efl?~??~1
.,
SANTA CLARA COUNTY
CENTRAL FIRE PROTECTION DISTRICT
14700 WINCHESTER BOULEVARD
LOS GATOS, CA 95030-1818
SINCE 1947
CONTROL NUMBER
BUILDING PERMIT NUMBER
(408) 378-4010
FAX (408) 378-9342
PLAN REVIEW NUMBER 9 7 - 0 4 3 4
FILE NUMBER
CODE/SEC. SHEET NO. REQUIREMENT
IlEC~,,,
Review of a Tract Map for a new six lot subdivision.
_cFr8 28199;
4DM-"'''' ~.
!"'!SiR - '.
4 rlC2~
1. Approved.
Copy to City of Campbell Public Works.
DISTRICT PLANS SPECS NEW RMDL AS OCCUPANCY CONST. TYPE PERMmEE DATE I PAGE
CBL 0 0 0 0 0 KIER & WRIGHT 02/27/97 ~OF~
SECJFLOOR I AREA LOAD DESCRIPTION BY
Residential Development Veargason, Chris
DEVELOPMENT REVIEW COMMENTS
EO
NAME OF PROJECT
I LOCATION
1681
Bucknall Rd
Proudly Serving Santa Clara County and the Communities of:
Campbell. Cupertino, Los Altos, Los Altos Hills, Los Gatos,
Monte Sereno, Morgan Hill and Saratoga
WEST VALLEY SANITATION DISTRICT
OF SANTA CLARA COUNTY
SERVING RESIDENTS OF
CITY OF CAMPBELL
TOWN OF LOS GA TOS
CITY OF MONTE SERENO
CITY OF SARA TOGA
UNINCORPORA TED AREA
100 East Sunnyoaks Avenue
Campbell, California 95008
Telephone (408) 378-2407
March 14, 1997
REC~IVt;"
MAR 141997
City of Campbell Planning Dept.
70 N. First St.
Campbell, CA 95008
~"l.Ij\rjJ.'C t::. I" ,.
RE: Tract 8922
1681 Bucknall Rd., Campbell
Please consider this letter as a conditional clearance to allow the developer of the above referenced tract to
have the tract map recorded. Improvement plans, inspection deposit, and plan check fees have been
submitted to this office. The improvement plans have not yet been given final approval by the district.
Please do not issue any building or plumbing permits until it has been verified that all remaining
requirements from WVSD have been met by the developer.
If you have any questions, please do not hesitate to call Don Toy at this office.
Very truly yours,
@
District Manager and Engineer
by Don Toy
Junior Civil Engineer
(FORMERLY COUNTY SANITATION DISTRICT NO.4)
I.lJJ
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)279-7874
March 14, 1997
City of Campbell
Public Works Department
Engineering Division
70 North 1st Street
Campbell, CA 95008
RECFEJV~~
MAR 1 41997
~(""r~.'U1"i'
Attention:
I. Harold Housley
REFERENCE:
Tract 8922
Bucknall Road
Gentlemen:
This letter is being written at
Development Company regarding the
referenced project.
the request of Nicoli-Pierce
Tract Map for the above-
Please be informed that upon review of the Final Map, the
PSE (Lot 7) to be granted appears adequate and satisfactory for
the installation of our proposed water facilities. We have no
objections to the recordation of the map. Furthermore, We do not
anticipate any conflicts occurring between any existing water
line easements or rights (if there are any) and those resulting
from the creation of this subdivision.
If you have any questions or require further information,
please contact this office at (408) 279-7874.
!91Y, _ _ _ . ,
y~~~ -6/""~--&'~
u_--'JAMES R. BARITEAU
New Business Representative
JRB:
NB96-327.doc
Letter picked by: John Nicoli of Nicoli-Pierce Development Company
Pacific Gas and Elt . COmpany
Land Rights Office
111 Almaden Boulevan.l
PO. Box 15005
San Jose, CA 95115-0005
March 18, 1996
m
Kier & Wright
Civil Engineers & Surveyors, Inc.,
3350 Scott Boulevard, Building 22
Santa Clara, Ca 95054
Attn: Marta Kozera
Re: Tentative Parcel Map Job# 96043
OUf File: 0541L6-4938
Dear Ms Kozera:
Thank you for submitting the proposed map for aUf review. This allows PG&E to
protect existing facilities and associated rights, and to request dedications of Public
Utility Easements (p.U.E.) as needed.
PG&E bas DO objection to tbe recording of tbis map provided it confonns with
the revised map submitted to this office.
With regard to future submissions:
I. All improvements within PG&E's transmission rights-of-way need to be approved by
PG&E's Land Rights Office.. Please submit four (4) copies of the improvement pJans
to this office, to the attention of Tom Zlatunich, Land Agent, at telephone (408) 282-
7106.
2. The existence and nature of any PG&E interests need to be shown on proposed
maps per Sec. 66436 of the Subdivision Map Act. PG&E has the option as to
signature.
3. Any existing overhead and/or underground facilities which are evident in the field
should be plotted on the proposed map from field data. If, in the opinion ofPG&E.
due to the nature of the facilities or due to the fact that the facilities cross proposed
bOlmdary lines, then dedication of a P. D.E. wi]) be requested by PG&E.
If you have any questions or need further assistance please contact me at the above
address or at telephone (408) 282-7564, E-mail JJT2@pge.com
tV~IY, I
w: J~es"
Senior Land Technician
S0Uth Coast Area-San J~se
We're taking television
iato tomorr~
.11
TCI Cablevision of
California
3/20/97
Marta Kozera
Kier & Wright 3350 Scott Blvd., Bldg. 22
Santa Clara, CA. 95054
Subject:
Tract 8922 - Campbell
Dear Ms. Kozera:
After reviewing yout' project, Tel has no objection to the recording of this map provided it
conforms with the revised map submitted to this office, showing a P,U,E., as shown upon said
Tentative Parcel Map.
With regard to future submissions:
1. All improvements within TCI's right-of-way need to be approved by Tel. Please submit 2
copies to this office, to the attention of Jerry Isbill, Construction Manager, at (408) 452-9100.
2, Any existing overhead and or underground facilities which are evident in the field should be
plotted on the proposed map from the field data. If, in the opinion of Tel, due to the nature of
the facilities or to the fact that the facilities cross proposed boundary lines, then dedication of a
P.D.E. will be requested by Tel.
If you have any questions, please call (408) 452-9100,
Sincerely,
~~~
Romeo Ulep
Engineering and Design
234 Easl Gish Road
F>.O. BOJll 14
San Jose. CA 95103-0114
(408)452.9100
FAX (408)452-5720
An EqUal Op~o"uniIY EmpJcYCf
RESOLUTION NO, 9135
BEING A RESOLUTION OF THE CI1Y COUNCIL OF
THE CITY OF CAMPBELL, APPROVING A
TENTATIVE SUBDIVISION MAP, FILE NO, TS 96-01,
LANDS OF MR. AND MRS. HORVATH, APN: 403-36-
089, ON PROPERlY LOCATED AT 1681 BUCKNALL
ROAD
After notification and public hearing as specified by law on the application for approval of
a Tentative Subdivision Map as referenced in the above heading and after presentation by
the Community Development Director, proponents and opponents, the hearing was
closed.
After due consideration of all evidence presented, the City Council did find as follows,
with respect to File No. TS 96-01.
1. The proposed subdivision of 6 residential lots, results in a density of 11. 9 units per
gross acre. This density, when averaged with the other Medium Density projects in the
area, results in a Medium Density area of 14.4 units per acre. This density is
consistent with the medium density residential land use shown on the Land Use
Element of the General Plan.
2. An initial study was prepare for this project and no significant impacts wen~ identified.
Based upon the foregoing findings offact, the City Council further finds and concludes
that:
1. The proposed subdivision is consistent with the General Plan.
2. The proposed subdivision does not impair the balance between the housing needs of
the region and the public service needs of its residents and available fiscal and
environmental resources,
3. The design of the subdivision provides, to the extent feaSlole, for future passive or
natural heating and cooling opportunities.
4, No substantial evidence has been presented which shows that the project, as currently
presented, and subject to the attached conditions, would have a significant effect upon
the environment.
THE FOREGOING INSTRUMENT IS A TRUE
AND CORRECT COpy OF THE ORIGINAL
ON FilE IN THIS OFFICE.
ATTEST: AN
OF CAMP LL,
BY
DATED
city Council Resolution No. 9135
TS 96-01 - 1681 Bucknall Road
Page 2
Based upon the above findings, the City Council does hereby approve this map subject to
the Conditions of Approval attached hereto as Exhibit A
PASSED AND ADOPTED this 17th day of Sept. 1996, by the following roll call
vote:
AYES:
NOES:
ABSENT:
ABSTAIN:
COUNClLMEMBERS:
COUNCILMEMBERS:
COUNClLMEMBERS:
COUNCILMEMBERS:
Burr, Conant, Watson, Furtado, Dougherty
None
None
None
APPROVED:
ArrEST: [~~
Aifue Bybee, City Clerk
EXHIBIT A
CONDmONS OF APPROVAL FOR FILE NO. TS 96-01
SITE ADDRESS: 1681 BUCKNALL ROAD
APPLICANTS: JOHN NICOll AND TOM SWEENEY
The applicants are hereby notified, as part of this application, that they are required to
meet the following conditions in accordance with the Ordinances of the City of Campbell
and the State of California, The lead department with which the applicant will work is
identified. Additionally, the applicants are hereby notified that they are required to comply
with all applicable Codes and Ordinances of the City of Campbell and the State of
California that pertain to this development and are not contained herein.
PUBLIC WORKS CONDITIONS:
1. Public Street Tmprovements: Prepare plans, pay fees, post securities and provide
insurance as required to obtain an encroachment permit to construct public street
improvements, in accordance with the City of Campbell's Standard Specifications and
details, on Bucknall Road at Weston Drive, as required by the City Engineer prior to
issuance of building permits for the site, Public street improvements shall be prepared
by a registered civil engineer licensed in the State of California, and shall include the
following:
A New curb and gutter with curb face at 20' from centerline,
B. New pavement to centerline of required right-of-way plus an additional
distance of about 2' to 4' to conform to existing pavement elevations based on
a Traffic Index of 7.5 and an R value provided by a qualified soils engineer.
C. New separated 5' sidewalk on the north side ofBucknall Road.
D. One new public street light.
E. New residential driveway approach.
F. Landscape and irrigation system for street trees and landscaping in the
parkway.
G. New centerline striping and stop sign for traffic exiting the private driveway
onto Bucknall Road.
2. Co:o:u>letion of Public Street Tmprovements: Prior to approval of occupancy for the
site, all public street improvements required by the encroachment permit must be
completed and accepted by the City Engineer.
3. Right - of - Way Dedication: Provide right-of-way dedications as needed for a 30' half
street prior to recordation of the Final Map.
Conditions of Approval for TS 96-91
1681 Bucknall Road
Page 2
4. Underground Utilities: Install new on-site utilities underground per Section 20.36.150
of the Campbell Municipal Code. Provide evidence from all utility companies that the
proposed houses can be served. Comply with the plan submittal, permit and fee
requirements of the utilities associated with new or modified service connections.
5. Grading and Drainage Plan: Prior to issuance of any building permits for the site, the
applicant shall prepare construction, grading and drainage plan~ for and conduct
hydrology studies, as necessary, to determine the adequacy of the site drainage.
Proposed plans and studies shall be submitted to the City Engineer for review. All
storm drain runoff shall be collected on-site and conveyed underground to the City's
existing storm drain system using 12" minimum pipe. The drainage study shall be
based upon a 10 year storm frequency.
6. Storm Drain Area Fee: Prior to issuance of any building permit, the applicant shall pay
all unpaid storm drain area fees. The current fee is $2,000 per acre.
7. Final Map: Prior to issuance of any building permit, the Final Tract Map shall have
been approved by the City Engineer and recorded. The Tentative and Final Maps
shall contain:
A. A Lot "A" for ingress, egress, drainage, Public Utility Easement, and related
improvements to serve the development; and
B. ''lot to lot" easements as necessary for drainage.
The submittal for City Engineer approval shall also contain:
A. A current Preliminary Title Report.
Conditions of Approval for TS 96-91
1681 Bucknall Road
Page 3
9. Management and Maintenance Agreement: Prior to recordation of the Final Map, the
applicants shall furnish and record an agreement for maintenance and management of
the project. The agreement shall demonstrate that the project will be maintained in
accordance with the intent and pwpose of the approvals, and shall provide for the
ongoing financial responSloility of the Homeowners Association for maintenance of the
common areas created by the Final Map for the life of the project. The agreement
shall include provisions for maintenance of the landscape and irrigation system in the
public right-of way. The agreement shall also contain a Consumer Price Index (CPI)
for fee adjustment, which shall be incorporated into the Covenants, Codes and
Restrictions for the project.
10. Utility Connections: Coordination shall be made with the City of San Jose for all
utility connections.
11. Soils Report: A soils report for the site shall be provided which has been prepared by
a qualified registered geotechnical or civil engineer.
PLANNING DEPARTMENT
12. Approved Proiect: Approval is granted to construct a 6 unit detached residential
planned development project. The building designs shall substantially conform to the
exhibits listed below, except as may be modified by the Conditions of Approv~.
A. Site and building plans prepared by Bruce Johnson, dated July 1, 1996 (w/July
23 modifications).
13. Landscaping: The applicant shall submit a landscape, paving and irrigation plan for
approval by the Site and Architectural Review Committee, prior to issuance of
building permits, addressing the following:
A Preparation of a landscape plan consistent with the Water Efficiency
Landscape Standards, including replacement for 51 trees.
B. Landscape Bond or Agreement
c. Driveway Pavement: Driveway pavement to be divided into distinct areas by
alternative pavement treatments.
D. Walkways, porch, planter boxes/edging and driveway to utilize brick to match
that shown on the houses' bay window foundations.
Conditions of Approval for TS 96-91
1681 Bucknall Road
Page 4
e. Ivy/fence Protection Plan: A plan for the protection of the ivy and chain link
fence along the west property line, from 15' back from the new front property
line to the beginning of the existing wood fencing" shall be submitted and
implemented. In the event that the ivy and/or fence is damaged, it shall be
replaced by a solid, wood fence of the design indicated on the approved plans,
and shall be landscaped with ivy or a vine.
14. Fencing: A fencing plan indicating location, height, and details of the fencing shall be
approved by the Planning Department prior to issuance of a building permit. Plan to
include a low, decorative fence (3'6") along the side property lines for the first 15',
and 6' tall decorative fences along the side and rear property lines. The location of the
protected area of the ivy-covered chain link fence shall be included.
15. Utility Boxes and Back-Flow Preventers: Applicant to submit a plan prior to
installation ofPG&E utility (transformer) boxes and San Jose Water Company back-
flow preventers, indicating the location of the boxes and screening (if the boxes are
above ground) for approval by the Planning Department.
16. Trash DisposaVRecycling: The applicant shall submit details regarding the design and
location of trash disposal/recycling facilities to the City for review and approval prior
to issuance of building permits.
17. Property Maintenance: The applicant is hereby notified that the property is to De
maintained free of any combustible trash, debris and weeds until the time construction
actually commences. All existing structures, when unoccupied, shall have its windows
boarded up and doors sealed shut or be demolished and removed from the property.
18. Park Impact Fees: Applicants to pay Park Impact In-Lieu Fee at the time of Final Map
recordation and building final Current fee is $7,035 per unit less a credit for legally
existing units or lots.
19. On-site Lighting: On-site lighting shall be shielded away from adjacent properties and
directed on site. All exterior lighting shall be installed prior to building final
20. Revised Elevations: Revised elevations for Lot 4 shall include a bay roof which
follows the angle of the gable above it. The material between the first and second
floor bays shall match the siding of the house (not rough-sawn plywood). Porch steps
and/or other element shall include brick to match the brick on the foundation of the
bay windows.
Conditions of Approval for TS 96-91
1681 Bucknall Road
Page 5
21. Garages: The garage for each of the units is to be equipped with automatic garage
door openers. Additionally, the developers will be required to add language to the
project's CC&Rs which mandates that garages be maintained at all times in such a way
that they are available for the parking of automobiles.
FIRE DISTRICT
22. Fire Flow: The required minimum fire flow for the project is 1000 Gallons Per Minute
at 20 pounds per square inch residual pressure.
23. Hydrant: One public fire hydrant shall be installed on site at a location to be
determined jointly by the San Jose Water Company and the Central Fire District.
ENCROACHMENT PERMIT ISSUANCE CHECK LIST
City of Campbell
Department of Public Works
Encroachment Permit No.
Ib-l6-q~
ITEMS REOUIRED FOR PERMIT APPLICATION:
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Applicant section complete
Applicant signature and date (front and back)
Permit Application Fee $225.00 paid - Receipt Number q~~,4'!:
Engineer's Estimate submitted
Plan Check Deposit paid (2% of Engineer's Estimate, $500 min) ~'"l~}":S .OC'
Receipt Number qC..~
Five sets of improvement plans submitted
ITEMS REOUIRED PRIOR TO PUBLIC WORK CLEARANCE FOR BUILDING PERMITS
:s --14 -~L Plan Check & Inspection Fee: If Engineer's Estimate < $250,000, then 12 % of Engineer's
Estimate. If Engineer's Estimate> $250,000, then Actual Cost + 20%. (Deposit of 8% of
Engineer..'s Est. imate. required; $.3.0,000 minimum deposit). '\\ 4- t.,,~3'-2.- eo
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"'!, -14- ~=.'" Security for Faithful Performance and Labor and Materials, 100% each of Engineer's Estimate,
supplied or paid. 1.9o-,.t2, ~.......__, l~.J..,),-;.;o,*.L: t"'_~ C-<':">.
Amount $3.'te--1 &.c..:.o. (>c Form 1.0. # c>>.-X--:)bOO ~S ~C1
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\0 -to ..etG, Contractor's signature added to the permit application (front and back)
:"S:"-9 -c:rl Worker's Compensation Insurance Information Sheet received from Contractor.
%:" ~~-7 Certificate of Insurance with Additional Insured's Endorsement received from Applicant or
Contractor.
One mylar set and four blueline sets of off-site plans signed by licensed engineer, stamped
APPROVED FOR CONSTRUCTION.
Permit signed by City Engineer.
WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE, PERMIT MAYBE ISSUED.
Issuer: Initial and date and file with permit.
j)ft, ~3J-6v'ilPUPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
<fU
j:\mq\ld\pmtcklst rev. 6/96
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John S. Nicoli
General Contractor
Rea I Estate Broker
496 S. Murphy Ave.
Sunnyvale,CA 94086
(408) 245-7210
FX (408) 245-6130
Oias Trenching Inc~
Underground Systems
Mario V. Dias
CELL (408) 859-8739
2367 Blandine Ave.
SanJOIe, CA 95121
PH. (408) 274-8625
FAX (408) 238..0703
B&K
LANDSCAPING INC.
FRITZ BRAUEN
President
1995 Bayshore
Redwood City. CA
415/365-5653
Cont. Lie. #4171 B6
(FAX) 415/36B-6753