97-127
CITY OF CAMPBELL
DEPT. OF PUBUC WORKS
70 North First St.
Campbell. CA 95008
(408) 866-2150
Fax (408) 376-0958
~
J.
r- 'tt No.
"f. File
97-/27
Application Date
Application expires in 6 mos.
r2/2 <8) q 7
APPUCATION - 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 #
Utility trench location
1:3t;;,S. flA~f<.Il:::r ~ C4t1I&:.L L.
tv€S:r I-IA~~/C.'" 40' -r (;) wA c... "'T"5e. oS A dE:.
B. Nature of work
C. Attach four (4) copies of engineered plans showing the location and extent of the work, and four (4) copies oRJ;rcC:4l~e&'sn
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approve!'ry
the City Engineer, said plans become a part of this permit. FEe B 8 f991
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Consuuction; thpOrn.W ~nditions
listed on the reverse side; and the Special Provisions for this pennit, listed below. Failure to abide by these conditions~!iAos^ esult in
job shut-down and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions 1 and 2.) 'I(~ N
t:.tA r. a~,c GAs ::!6e.v/( ~
S,D, # c611f:l952.5'l
E. TIlE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AT TIlE SITE AND MUST NOTIFY TIlE PUBUC WORKS
DEPARTMENT AT LEAST TWO DAYS BEFORE STARTING WORK. NOTICE MUST BE GIVEN TO PUBUC WORKS AT LEAST 24 HOURS
BEFORE RESTARTING ANY WORK.
Name of ApplicantlPermittee
Pacific Gas & Electric Company
Telephone (408) 725-2022
Address 10900 North Blaney Avenue. Cupertino, CA
Is this work being done by the property owner at their-own residence?
95014'
Yes
No
The Applicant/P~rmittee hereby agrees by affixing their signature to this permit to hold the City of Campbell, its officers, agents and employees free,
safe and harmless from any claim or demand for damages resulting from the work covered by this permit.
TIle Applicant/Permittee hereby acknowledges that they-have read and understand both the front and back of this permit, and they will inform their
contractor(s) 0 the infonnation:
'iI
,;2 -02.~-'1
~ ~pi(rL-~~;
1. .... ......- U -51. 'S....
~y '71 "!.
? / 'Z _1040 \-or- r'
4' KLJ! 8e:.LL HoLtE:. \ ~
(.)<) ~ t( 0 v It / ~
~o~ II ~ Cl'~~~ \0
:1~~ ~6~!"\\__ c:
~ l-'1) ~r 54 ~ --"",,-'
\~.\.- --- '- \ \
_ _ _ S '-- ...,,--\~- ~~ \\.-, \
\ \~r~". j \V ~
i t; ~\ ~~~~U .
Pei&rr S x..ac..W
_,..z-.,____....,......~ f'l~ ""l"r aI'(' BH' '!lit:. J.r J 1111 ~ L 1
GUT-OFF SERVICE AT MAIN
13~5* "ffAet/~ Ave:.
ADDRESS
cIa BY __
JOB NO.41f;JQS:2Sr
S.D. NO. "72. uJ
\"':?"~'~~l"}'
-'. .
~~ t~
~
~ ...---
l~
~(;. II c -uI":I ._.1
\ . - - .'
-...- .
... .0 {'
.. -
I-
~-'()
..... -I
-"
.Q~
1--
. -(f)
Z
0--,.
O. ,,)
0....
. '.. 0.\,..--
("''1 '. ;....... '
...."
u.....
0 r -.
lU ....,,/ -
r"'"
::::> ......1
"-:;..
0 :.>
~ ()
0.. --
D... ...0
<( ::J
(L
:.-
-DA TE
FOOTAGE
SIZE
\
)
. 1/2PL.___-
- -~ t~~
~~