97-160
l
CITY OF CAMPBELL
~l\' DEPT. OF PUBLIC WORKS
". 70 North First St.
,,)}' ~/ Campbell, CA 95008
'? - -Il, (408) 866-2150
G '-0J. ~. Fax (408) 376-0958
(" X v: (1
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APPUCATION - Application is hereby made for a Public Works Permit in accordance wim Campbell Municipal Code. Section 11.04.
if the permit is not issued. Application Fee is non-refundable
ENCROACHMENT PERMIT
(for working within the
public right-of-way)
~,,:~( .t!~t 1n~
i Permit No.
X-Ref. file
f? 7/L5tf
-
Application Date /~ -y 7 - f1 7
Application expires in 6 months
(Application expires in 6 months
A. W orll: address or tract #
-cc/ A
Utility trench location
A-7~/rC:/
/0/;7 .nPZ~~r/:72r'
B. NalUIl: of work
C. Attach four (4) copies of an engineered plans showing me location and extent of me work, and four (4) copies of me preliminary Engineer's Estimate of work. The
plans shall show me relation of me proposed work to existing surface and underground improvements. When approved by me City Engineer, said plan becomes a pan of
this permit.
D. All work shall conform to me City of Campbell Standard Specifications and Details for Public Works Construction; me General Permit Conditions listed on me reverse
side; and me Special Provisions for mis permit. listed below. Failure to abide by mese conditions and provisions may result in job shut-down and/or forfeiwre of Faimful
Performance Sureties and cash deposits. (See General Permit Conditions 1 and 2.)
E. THE CONTRACTOR MUST HAVE THIS PERMIT AND APPROVED PLANS AT THE SITE AND MUST NOTIFY THE PUBLIC WORKS DEPARTMENT AT
LEAST TWO DAYS BEFORE ARTING WORK. NOTICE MUST BE GIVEN TO PUBLIC WORKS AT LEAST 24 HOURS BEFORE RESTARTING ANY WORK.
~
Telephone
:!J7g~~~
Name of Applicant
Address 3'~ / ~nh-3'nam~e
--
24 HOUR EMERGENCY TELEPHONE NO. :::?
Is this work being done by me property owner at meir own residence?
Yes
/No
The Applicant/Permittee hereby agrees by affixing meir signawre to mis permit to hold me City of Campbell. its officers. agents and employees free. safe and harmless from
any claim or demand for damages resulting from me work covered by mis permit.
The Applicant/Permittee hereby acknowledges that mey have read and understand bom me front and back of mis permit. and mey will inform meir contractOr(s) of me
information.
x
(sign)
<6
SPECIAL PROVISIONS
_1. Street shall not be open cut for underground installations. Minimum cuts ~be allowedforcollllections or exploration holes. Such cuts maybe soecificallv
approved bv the Inspector prior to cutting.. . ... . . . ... . . ... .. .... . . .. . .
Pavement may be cut for underground installations and must be restored in accordance ",im meUtility Trench Restoration Standard Details. Memod 'A'BlICkfin,
unless olherwise 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 me Public Works Department before starting wort_
Per Section 4215 of the Government Code this permit is not valid for excaVations until. Underground Service Alert (USA). has been notified and the inquiry
identifICation number has been entered hereon. USA Pbone 1-800-227c2600. USA TICKET.NO.
vi
~
V'""4.
_5.
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES
TYPE
AMOUNT
RECEIPT NO.
APPROVED FOR ISSUAN
n.:z..~. ~b'"2..,.Q~~
~.ao\~20t~'"
$ ~.~.. -
<-:.> . ~ .CJl ~G.
$\a>.&>e..o -80 ~c.-,\. ~
PERMIT APPLICATION FEE
PLAN CHECK DEPOSIT
SECURITY FOR FAITHFUL PERFORMANCE/LABOR &. MATERIALS
CONSTRUCTION CASH DEPOSIT
PLAN CHECK &. INSPECTION FEE
~ ~\<..,. '-.J.....\ ~~
City of Campbell - Refundable Deposit Check Request
Interim Check Required:
To: Finance Director
Return Check to:
Please Issue Check
Payable to:
Address - Line I:
Department:
B & C Homes
54 N. Central Avenue
Line 2:
City:
Campbell
State: CA Zip: 95008
Finance Use Onlv
Description:
Monumentation security
Amount Payable:
$ 1,500.00
(Exact Amount)
Interest Earned
Account Number:
101.540.7448
Purpose:
Monumentations have been placed as confirmed by engineer.
OK to release monumentation security.
Approved by:
Voucher #: Permit #: 97-160
Date: 12/4/97
Title: Land Dev. Eng. Date: 10/7/99
Title: Land Dev. Mgr. Date: 10/7/99
Title: Account Clerk II Date:
Title: Date:
Verified by:
Approved by:
Special Instructions For Handling Check
Mail As Is:
x
Mail in Attached Envelope:
Other:
fin: S:lexceVchkreq . Revised 1/98
City of Campbell - Refundable Deposit Check Request
Interim Check Required:
To: Finance Director
Return Check to:
Please Issue Check
Payable to:
Department :
B & C Homes, Inc.
Address - Line 1:
Line 2:
54 North Central
City:
Campbell
State: CA
95008
Finance Use Onlv
Description:
Refundable Cash Deposits
Amount Payable:
$5,340.00
(Exact Amount)
Interest Earned
Account Number:
101.2203
101.540.7448
Purpose:
Refund of Construction Cash Deposit of $3,560.00 and Plan Check Deposit of $1,780.00.
Voucher #:
Receipt #:
107136 $3,560.00
056 $1,780.00
Permit #: 97-160
Date: JUlt/9?--/z/4.Jn..
5/9/97 05k4199
Title: PW Inspector Date:
Title: Acting City Engineer Date: 05tMf99
Title: Account Clerk II Date:
Title: Date:
Requested by:
Approved by:
Verified by:
Approved by:
Special Instructions For Handling Check
Mail As Is:
x
Mail in Attached Envelope:
Other: PLEASE NOTE - $10,680.00 (Receipt#107136-1214/97) is to be
moved from refundable deposits to ACCOIlDt #4722 as it is not be
refunded.
fin: S:/excellchkreq - Revised 1198
PUBUCWORKS DEPARTMENT RECEIPT
Effcc:ti\lc July I, 1996
TO: City Clerk PUBLIC WORKS FILE NO. D Y/~/
PROPERTY ADDRESS ~~h'.-V ~~... ,~r ~~
Pleasc collect &: receipt for the iollowinl monics:
ACCT, ITEM .d <.: ......,
I ......
43S.S3H921 Project Revenue (specify projcc:t) S
ENCROACHME:'oIT PERMIT
4722 Application Fec . -? 3'.~ c;d
~ Non-Utility Enc:roac:hmcnt Permit (S22')
R.I First Permit (No fcc), Subsequent PennitIYr (S1OU)
Utility Encroachment Permit
Arterial/Collector Street (S32S)
/ Residential Street/Other Areas (S22S)
V 2203 Plan Check Deposit - 2% of ENGR. EST. ($5IKI min) . / ",.-'1
22n3 F.ithful Penorm.nee SecurilV (FPS) (lOO%ofENGREST.) .
2203 Labol" and Materials Security (100%ofENGR EST.)
2203 Monumcntalion Security (l01~/' ofENGREST) .
22113 Cash Deposit (41'. of ENGREST)(S'(XI minIS 10.000 maxI .
Plan Check &. Inspection Fee (Non-Utility)
4722 En!lJ'.Est < $250,000 (121'. ofENGR EST,)
.. 2203 Engr.Esc.>S250,OOO (Deposit S./. of ENGR. EST./SJO.OOO min.).. .
.722 Utility < SIOH.OOCl
Minimum Charge Per Location (SI20)
ConduitslPipclines up to 500 Feet: (SL60/fi)
Above SOO feet (SI.IO/I\.)
ManholcsIVaultstEtc. (51OS/eo)
Pole SetlRemoval (S IUS/eo)
Street Tree PlantingIRcmov31 (SIOSItreo)
.. 2203 Utility> SIOB.UOO ActuDl Cost + 20"/. .. .
.722 Street Tree Planting/Rcmo"ll Pennit (SIO')
.7611 Project Plans & Specifications Proiect No.
.760 Standard Specifications &: Details (SllPg S12lBook)
4760 Copics of Engineering Maps &: Pllll\s IS.SO/'q,l\.)
4722 Penalties: Failure to restore public improvements (SIOU/CJlcndar Day)
(Muni Code Section 11.34.010)
.722 Penalties: Failure to correct unsafe conditions (SinO/Calendar Day)
UNO DEVELOPMENT
-~22 Lot Line Adjustment (S,1I0)
V .722 Parcel Map (4 Lots or Less) (S1.060 + S2S/Lotl // /-',/} r .M/
4121 Final Trncl Map (S or More Lots) (SI,3811 + S2S/Lo.)
4722 Certificate of Compliance (SlIX))
.722 Certificate of Correction (S301l)
.722 V 3c.ltion of Public Streets &: Easements (Sllll)
.722 A!lScssment Segregation or Reapportionment
First Split (Sllll)
~ch Additio~1 Lot (SI711)
.721 Stonn Drninagc Area Fee Per Acre (R.1. S2.lIIX))
(Multi-Res. $2.250)
(All Other. S2..s00)
4920 Parkland Dedication Fee
, .96J Postage
TRA FFIC
472f1 Intersection Turn Counts (Two-Hour Count) (S6U)
.728 Intersection Turn Counts (a.m. or p.m. peaKs) (SI2')
H28 Traffic Flow Map (Daily Traffic Volumes) (S27)
4728 COlmpbcll Tmffic Model (Full Scope Assessment) (S2.2SU)
.728 C.1mpbell Trallie Model (Reduced Scope Assessment) (S7.U)
.271 Truck Pennits (SJS/trip)
H28 No Parking Signs (SI/cOlch or S2j:/IO())
OTHER /
~C/ t!'~J/ ~.d E~~a'~ TOTAL S 5g:5: aJ
Q g/W'//~/?
NAME OF APPLICANT
- e d~PHONE
/7 ./7 ..-1 t3cr :17 A;/-;2 ::7C ,;
NAME OF PA YOR ,--
~.!/ AI. - /!/'/. / ?/ ~HJ/":' " S;/# z 9:~M
ADDRESS '/8 ZIP
, "
"Actual Cost Plus 20% Q"crnc:Jd (Non.lnterest bearing deposit)
I
FOR /f--" .1' ... l\~ ..
CITY CLERK RECEIVED BY 'J . ...
ONLY 5"!c/i:;"1> Receint' .. 1{J~b5Yf"-r Z .0)\0
D.te
......... ... ...... .. ; m
-For Pt:1D Check and Cash Deposits, scnd>'ellow copy ta
Daacr lniti,J!s
~ 1~7
,;JTY CLERK'S OffiCE ?
h:\recfnn4(cxc)mp(rev 1/2/97)
CIT'Y
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CHANGE;
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fVBUC WORKS DEfARTMENT KEellYf
EfTccti,.c July I, 1996
TO: Cily Clerk PUBLIC WORKS FILE NO. /P 97-/~ /) ~
PROPERTY ADDRESS /'~L~~ -:c'T
Please collect & receipt for the following monies: .... ...... .. .......
ACCT ITElIl ..AMOUNT
43l.l3l.4921 I Project Revenue (specify project) 5
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encroachment Permit (S22l)
R-l First Penuit (No Fee), Subsequent PcrmitIYr(SIOO)
Utility Encroachment Permit
ArtcriaVCollcctor Street ($l2l)
Residential SlreelIOther A=. (S22l) rO//Y
2203 Plan Check Deposit . 2~. of ENGR EST. (SSUClmin) . 'r'hd'
2203 Faithful Performance Security (FPS) (I_.ofENGR.EST.) .
2203 Labor and MalCriall Security (HH"'.ofENGR. EST.)
2203 Monumcntation Security (100';' of ENGR.EST.) . /"~ /.11?
2203 Cash Deposit (4% of ENGR.EST.)(SlOO miolS 10,000 max) .
Plan Check & Inspection Fee (Non-Utility) "/
4722 Engr.Esl < S2l0,OlMl (I211.ofENGR. EST.) /~;',#t1
.. 2203 Engr.Est.>S2S0,OOO (Deposit SOY. of ENGR. EST .IS30,OOCl min.)" .
4722 Utility < SIOO,OOO
Minimum Charge Per Location (S120)
ConduitslPipclines up 10 SOO Feet (SL60/fi)
Above lOO Feel (SI.IO/fi.)
Manholes/VaultsIEtc. (5lOl/ea)
Pole SetlRcmoval (SlOl/ea)
Street Tree PlantingIRcmoval (SllIlltrec)
.. 2203 Utility> Slno.ooo Actual Cost + 2a-/. .. .
4722 Street Tree PlantinglRcmoval Permit (SlOl) .
47611 Project Plans &: Specifications Project No.
4760 Standard Specifications & Details (SIIPv S12/Book)
47611 Copics of Engineering Maps & Plans (S.lO/.q.fi.)
4722 Penalties: Failure to restore public improvements (SI00/Calendar Day)
(Muni Code Section 11.34.(HO)
4722 Penalties: Failure 10 correct unsafe conditions (SIOO/Calendar Day)
LAND DEVELOPMENT
4722 Lot Line Adjustmcnt (SlIlO) VA./I
4722 Parccl Map (4 Lots or Less) (SI.0611 + S2l/Lo.) ~/.d
4722 Final Tract Map (~ or More Lots) (SI.3811 + S2l/Lol)
4722 Certificate of Compliance (S5(1O)
4722 CertifICate of Correction ($lOO)
4722 Vacation of Public Sb'ccts & Easements (S5SII)
4722 Assessment Segregation or Reapportionment
First Split (SllO)
Each Additional Lot (S I 711) -/ /) 'l '2.
4721 Storm Drainage Area Fee Per Acre (R.!. S2.lKIO)
(Multi-Re.. S2.2l0)
(All Other. S2.50ll)
4920 Parkland Dedication Fee
4%l Postalile
TRAFFIC
4728 Intersection Turn Counls (Two-Hour Count) (S60)
4728 Intersection Turn Counts (a.m. or D.m. peaks) (SI2l)
4728 Traffic Flow Map (Daily Traffic Volumes) (527)
4728 Campbell Trnffic Model (Full Scope Assessment) (S2.2l0)
4728 Campbell Traffic Model (Reduced Scope Assessment) (S740)
4271 Truck Pennits ($ll/lrip)
4728 No Parking Signs (S I/each or S2l/1 (HI)
OTIIER
~ ~/dYff ~~ / TOTAL S //'.1'6/1
/f~/! ~ ~- ,
NAME OF APPLICANT
// // #~/~3pf~
NAME OF PAYOR PHONE
ADDRESS ~9'" /J/ /'r?//'/~/?'/ ZIP ~~~/<t
.. Acmal Cost Plus 2'''/. Overhead (Non-Interest bearing deposit)
FOR
crrv CLERK
ONLY
CITY CLERK'S OFFICE
RECEIVED BY
Dale I
RECEIVED
DEe - 41997 /j
.Far Plan Chcck. and Cash. Dc:p()'sits, scnd.~.ellow,copY,IDf'mance.
h:I=fnn4(exc)mp(rev 112197)
c;.
. -- .
........""'I:'P\ ..",. 0"1:1. ';''''.M::'.I
~tLVil Dr; jHHKUNn
l"l r-r'", .~r r. .......r.T.r". ;
t",1 i I Ui LtHlir ~l:.~L.:: :"'H
PArOR; B & C HOMES,
TODAY~S DATE~ 12/04/97
...-,...."'...-- ......-. 4'" In, .""...
!it.blbi t.K iiHl t; j // d~/ ".' ~
DESCRIPTIO~
~....- ~""~"~T~~ ~~~
Ktr iltrUbl!b -iVl:~~V~
~~. nr~~~T7~ ~A~ ~~^~
ru:.r .u~i'UO.l i:O -l.\l~..::..::.\,:~
ENGR & SUBDIV FILING ~
~-- ~-~~_..~ 4~. ~_n_
~tr btrubi~b -iVl:.:'..~V~
TnT6i n!j~:
t \0: ~ 1110. ....~...._
{"'fl'-,-';i ...4"iT,.
i.,r1t.i..t\ rHJ.ii.
CHECK NO: 0615
....-'I.....oa~._..._
i t.r~i;tr( t.ii;
1..:HANL~ :
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V1V~JUlt} f!.Jb
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ilf1t;
4. .~", _, 0\
ll;Jt);~V
~MOUNT
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... ~,'\ i ".... r.....
~ iV;rCav. ".F.)
$2 ~ i)22:t {)O
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PUBLIC WORKS DEPARTMENT RECEIYT C r //'/b'd
Effective July l, 1996
TO: City Clerk PUBLIC WORKS ALE NO. /? /Y ~ /-~.:J,r A
4~~ // 4. . r'/r::' hYe
PROPERTY ADDRESS
Please collect & receipt for the followina monies: ... .. .....
ACeTo I ITEM ..... .........
43l.l3H921 Project Revenue (specify project) S
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encroachment Permit (S22l)
R.I Fint Pennit (No Fcc), Subsequent PcnnitlYr(SIlKI)
Utility Encroachment Pcrmil
ArtcriaUColleclOr Street (S32l)
Residential SIrectIOthcr Areas (Snl)
22113 Plan Check Deposit - 2.y. of ENGR. EST. (Slllllmin) 0
22113 Faithful Perfonnance Security (FPS) (llIlI'/.ofENGREST.) 0
22113 Labor and Malerials Security (I()()l1.of ENGR EST.)
22113 Monumcntation Security (1lI0%ofENGREST.) 0
22113 Cash Deposit (4". of ENGR.EST. )(S~H)O minJ11 0,000 mIx) 0
Plan Check & Inspection Fee (Non-Utility)
4722 Engr.Est < S2lll,OOO (12l'oofENGR EST.)
.. 22113 Engr.Est>S2lll,lIlIlI (Deposit KY. of ENGR. EST./SJOJH)() min.).. 0
4722 Utility < SIlIII,tKKI
Minimum Charge Per Location (SI211)
ConduitslPipelines up to .soo Feet (SI.60/8)
Above 500 Feet (51.11111\.)
ManholesNaultsIEtc. (SllIl/co)
Pole Sct/Rcmoval (SllIl/co)
Street Tree PlantinglRcmoval (5llIlltree)
.. 22113 Utility> SIlK),IKllI Actual COlt + 20-;' .. 0
4722 Street Tree Planting/Rcmoval Pcnnit (SllIl)
4160 Project Plans & Specifications Projece No.
4760 Scandard Specificaeions & Deeails (SlIP. S12IBook)
4760 Copies of Engineering Maps & Plans (S.lll/sn.ft.)
4722 Penalties: Failure to rescore public improvemenes (SIOU/Calcadar Day)
(Muni Code Section 11.34.01lJ)
4722 Penalties: Failure CO correce unsafe conditions (SIlIO/Calendar Day)
LANO DEVELOPMENT
4722 Lot Line AdjuSbnene (SlllO)
4722 Parcel Map (4 Loes or Less) (Sl.Il611 + S2l/Lot)
4722 Final Tract Map (~ or More Loes) (S1.3.11 + S2l/Lot)
4722 Certificate of Compliance (5lllO)
4722 Certificate of Correction (S300)
4722 Vacation of Public Streets & Easements (Sllll)
4722 Assessment Segregation or Reapportionment
Firse Split (SllO)
Each Additional Loe (SI70)
4721 Stomt Drainage Area Fee Per Acre (R.I, S2,IKK))
(Multi, Res. S2.2lll)
~ (All Other. S2.llltl) ,/
( 49211 harkland Dedication Fee J'17 -::z -Y' '/ .z 'l
~ Postage 7
TRAFFIC
472. Intersection Turn Counts (Two--Hour Coune) (S60)
472. Intersection Turn CounlS (a.m. or p.m, neaks) (SI2l)
472. Traffic Row Map (Daily Traffic Volumes) (S27)
472. Campbell Traffic Model (Full Scope Asseumentl (S2.2lll)
472. Campbell TraffIC Model (Reduced Scope Assessment) (S740)
4271 Truck PemtilS (S3l/lrip)
4728 No Parking Signs (SI/coch or S2l/1l1ll)
OTHER
~:2% /<~~f/;:& -- ~~;:7..:2? TOTAL 5 3/?d:?
/nl". '/
A~'/! c.// ~
NAME OF APPLICANT ., . '/./I!? .
~
// ,- ,/ q7~-2~~~
NAME OF PAYOR /} A PHONE
.--5 cd .-4/ /.(e./7../ ~ /'./ / I/rr: --.- .-" - - I
ADDRESS ZIP 7"
"Actual Cost Plus 21.-1. Overhead (Non-Interest bearing deposit)
.
FOR
CITY CLERK
ONLY
~'moy ~ uk:.
/;JsI 'Receipt, JOI/9D
OaCCI".lilitials
RECEIVED P
DEe - 5 1997 .
C\TY CLERK'S OFFiCE
.For Plan Check-and Cash Deposies;:scnd )'cllowcopy to Fmancc;
h;\rc<;fnn4(cxclmp(rcv 1/2/97)
_/./,,~.._->-_.-. ..
CITY OF CAMPBELL CA
RECVll BY: SHARuH~ Oi000i01iYO
FAYOR: B & G HG"ES~ INC
TCDAY~S DA1E: 12J05J97
REGIS1ER D~TE: i2J05jj? TlhE: 15:43:2:
DESCRIPT!ON
AMOUN1
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;::.)~. Tr{ f!P
,.;,., I" ;...: a ~.~
?ARKL~Nl!
Tli:'iI'i'i'ATiillJ ~:
.l.:~:,l:..:ni..~n
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'T...TJo~
iUini...
r.l1f'" .
lii..iC.
..",;. '1""" 1\r,
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CHE~~ FAIn;
*24 ~727:: OQ
\),
A;" ..
VOlu
CHECK NO:
1ENDERED:
CHANGE:
.. .... .,. ....
-.:.:...,.:0: i ~I' .'v\;
~ ..
~11.J'-1
TO: C"lly Clerk
2203
49201
49651
TRAFFIC
47281
47281
47281
47281
4728
4271
4728
OTHER
NAME OF APPUCANT
NAME OF PAYOR
ADDRESS
l'UBLIC WORKS DEPARTMENT RECEIPT
Eft'eelive July I, 1996
PUBUC WORKS FILENO. C/./ 7'/- / L ~
\~ F,~ \..1.-
PR~P'tifY~WS'-t2.t2-L~
2:03
22031
2:031
22031
2203
22031
4722
4722
4721
Parkland Dedication Fee
POSWl.e
intersection Tum Counts (Two-Hour Count)
Intersection Tum Counts (a.m. or D.m. oeaks)
Traffic Flow Mao (Dailv Traffic Volumes)
CamDbell Traffic ModeliFull Scooe Assessment)
Camobell Traffic Model (Jl.educed Scooe Assessment)
Truck Permits
No Parkin~ Signs
r~.{;7)11
........... ... ... ..... ......... .:-: .:-:-::::-:.:-AMOtlNr::
S
$325)
S225)
S500 min)
100"/.ofENGR.EST.)
100"10 ofENGR. EST.)
100"10 of ENGR.EST.)
(4% ofENGR.EST.)(SsOO mi~IO.OOO maxI
(J 00"10 ofENGR. EST.!
(12"/. ofENGR. EST)
(Decosit 8~. of ENGR. EST.1S30,OOO min.)"
(8"10)
(SI20)
(SI.60/ft)
(S 1.1 0Ifl)
(SI05/ea)
(SI05/ea)
(S lOS/tree)
Actual Cost ..p. 20-/. ..
Project No.
(Slil'q Sl2IBook)
(S.SO/SQ.ft. )
(SIOO/Calendar Dav)
~
Please collect &: receipt for the fo1lowina monies:
ACCT. ITEM. ..... .......ddddd..ddd
435.535.4921 I. Proiect Revenue (specifv project)
ENCROACHMENT PERMIT
4722 Application Fee
Non-Utility Encroachment Permit ($225)
R-I First Permit (No Fee). SubseQuent PermitlYr (SIOO)
Utility Encroachment Permit
ArteriaUCollector Street
Residential Street/Oth... Areas
Plan Check Deposit - 2~/. ofENGR. EST.
Faithful Pe,fonnance Security (FPS)
Labor and Material. Security
Monumentarion Securirv
Cash Deoo,it
Labor and Material Security
Plan Check &: !nspection Fee (Non-Utility)
EnI!t.Est. < S2S0.000
Enl!t.Est.>S2S0.000
Utility < Sloo.OOO
Minimum Charge Per Location
ConduitsfPipelines up to 500 Feet
Above 500 Feet
Manhole.tV aultsIElC.
Pole SetlRemoval
Street Tree PlantinlllRemoval
2203 Utilitv > Sloo.OOO
47601 Proiect Plans &: Specilicalion.
47601 Standard Specification. &: Details
47601 Cooie. oiEn~,"eering Mags &: Plans
472: Penalties: Failun: to restore Dublic imOfovements
I (Muni Code Section 11.34.010)
47221 Penalties. Failure to cornet unsafe condition.
LAND DEVELOPMENT
4722 Lot Line ....djustment
47221 Parcel Mao (4 Lots or Less)
47221 Final Tract Mag (5 or More Lots)
47221 Certificate ofComDliance
4722! Certificate of Correction
47221 V 3C8lion of Public Streets &: Easements
4;::1 Assessment S~ion or Reapportionment
First Soli'
Each Additional Lot
Stonn Draina;e Area Fee P... Acre
(Sloo/Calendat Dav)
(SSOO)
(SI.06O'" $2slLol)
(SI.380... S2slLot)
ISsOO)
IS3oo)
ISs50)
.-" C>
(SS50)
(SI70)
(R-I. $2.(00)
(Multi.Res. $2.250)
(All Oth.... S2,sOO)
($60)
(SI25)
(S27)
(S2.2S0)
(S74O)
(S3sItriD)
(SlIeach or S2S/loo)
TOTAL
S ~, c::.L:>
ZVIQ~ \ 10 EFQ., .Qt.
.~t:::>j..f ~ C~"""'-l.....L
.;::) I ~ 0 A-I .11/\ /I .r.. - -)
.. Actual Cost Plus 20% Overhead rNon-lnt= beatinR deoosit)
FOR
OTY CLERK
ONLY
PHONE
9.M" '0
'5c.. c.A-
C(,IC(
IV<:
ZIP
RECEIVED BY
Dale
'For Plan Check and Cash Deposits, send yellow copy to Finance.
h:'recirm4. wk3( mp )rev7/1/96
RECEIVED
JUL 3 0 1997 LJ
CITY CLERK'S OFFICE
Dale! Initial.
.....
1
/.
/,
CITY OF CAMF'BELL, CA
REC!JD BY; .JANH
'.
I
01000104145
PAYOR: BRYCE E. CARROLL
TODAY~S DATE; 07/10/97
~r~T~T~~ ~AT~. ^~;~n;n~ TT~r. 4..^"_An
I\1:.0i'::;ll:.l\ Unl!:' V/I.iV/1i linr.- ii-li/-Vu
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!.Ii:.bi..riilr"! iUf1
AnuUNT
16""" ... ,.,.""..,
r:.ltur~ {or ~UDii.i V r .iLl. HU r
1"~"T'';;:
lll....1
......::a..
~.::r-.
iHJt, ::
CHECK PAIH:
CHECK NO; 2877
TENDEREIi:
CHANGE:
it::lV\ roti
",__I v\t" = v~;
>PC' A^ AI".
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$5'XI = 00
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,-'
BOND FOR FAITHFUL PERFORMANCE
We, the undersigned B & C HOIvlES. INC.. (hereinafter "Contractor ") and
FAR WEST INSURANCE COMPANY , a corporation organized under the laws of the State of
NEBRASKA ' and authorized to transact business in the State of California, as Surety, are obligated
to the City of Campbell, (hereinafter "City") a municipal corporation under the laws of the State of California, in the sum of
EIGHfY-NINE TIIOUSAND Dollars ($ 89.000.00 ) 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 . 19-, entered into written Contract
with the City for the Project, a copy of which contract is attached and made a part of this bond, for construction of Project
"Agreement (Identified as No. PM 97-02)" for 1365 Harriet Avenue. Encroachment Permit No. 97-160 .
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 shal1lie 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, the parties have executed this agreement as of NOVF.MBF.R ?f)
.19 q7
(principal) B & C HOIvlES, INC.
~~51
Title PRESIDENT
(Surety) FAR WEST INSURANCE COMPANY
By
(Attach Acknowledgements)
SAN JOSE, CA 95112
Surety's Bond Number 006009532
(Accompany this bond with Attomey-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)
NOTARY ACKNOWLEDGMENT
Slate of ~Ar.TF'ORNTA
:ounty of SAN'T'A ~r.ARA
/ /0
In / /.} & ,: -/ J before me.
/
l.Jotary Public. personally appeared
JUDITH S. ROBERTSON
JOHN J. DALEY
(here insert name)
Jersonally known to me (or proved to me on the basis of satisfactory evidence) to be the person~s) whose name(s) is/are
iubscribed to the within instrument and acknowledged to me all that he/she/they executed the same in his/her/their
luthorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of
'.'hich the person(s) acted. executed the instrument.
VITNESS my hand and official seaL
(Seal)
:ignature
~jJ~
CAPACITY CLAIMED BY SIGNER SIGNER REPRESENTING
NAME OF PERSON(S) OR E~7i';'YIIESl
- - - FAR WEST INSURANCE C
_ INDIVIDUAL/S) _ PARTNEAIS) ~ GUARDIAN/CONSERVATOR
_ CORPORATE XXATTORNEY IN FACT _ OTHER
OFFiCERS _ TRUSTEE(S)
- SUBSCRIBING WITNESS
ATTENTION NOTARY: Allhough the Information reQuested below IS OPTIONAL. it could orevent frauoulent anaCl1ment of this cenltlcate.
THIS CERTIFICATE MUST Document Tille or Type:
BE ATTACHED TO THE
DOCUMENT DESCRIBED Number of Pages: Document Date:
HEREiN:
Signens) other man "amed above:
State of California
Tide or Type ofDocum.
~'1~C\
~ SSe
County of~\~\. ~ \~ ~
On ~\;J\- 2-0 \C\. C(" before me ~ ~. ~\\ \--
Notary Public;personally appeared ~.'JC'"--9 ~G~
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 that he/she/they executed the
same in hisf.1er/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.
Nwnber ofPages__
of Docwnent
Signer(s) Other than lW1\ed below
WITNESS my hand and official seal.
~I
Signature
(Seal)
0,.. A. $. MILLER ~
Comm #1024093 G)
Cl NOT ARV PUBLIC CALIFORNIAn
:E SANTA CLARA COUNTY ,
J ~ c.:;: .: '~ ~c~m~ ~P.;.,.M~ ~. ~99~ t
FD-l (Revised 1/93)
BOND FOR LABOR AND MATERIAL
We, the undersigned B & C HOMES. INC.. (hereinafter "Principal") mi
F' A R WEST INSURANCE COMPANY , a corporation organized under the laws of the
State of NRRR I!. ~J( I!. , mi authorized to transact business in the State of California, as
Surety, are obligated to the City of Campbell (hereinafter "City"), a mtmicipal corporation under the laws of the State of
California, in the sum of EIGHTY-NINE THOUSAND Dollars ($ 89.000,00 ) 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 a certain written Contract
with the City dated , 19 , ,
a true ani 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. The contract is entitled: "Agreement (Identified as No. PM CJ7..(Jl)"
for 1365 Harriet Avenue, Encroachment Permit No, 97-160.
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 kim, or for amoUnts due illlder 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 booo, mi also, in case
suit is brought upon the bond, a reasonable attorney's fee to be fixed by the court.
Now, therefore, we, B & C HOMES. INC. ,as Principal, ANIfAR WEST INSURANCE COf;1PANY
as Surety, are obligated to the City of Campbell, in the sum of $ EIGHTY-NINE THOUSAND DOLLARS
($89,000.00) 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 perfonnance 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 booo will pay for them, in an amount not exceeding the sum specified in this bond, mi 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 ani specifications referred to herein, ani 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 ~~ 8\..0 . 19~
~IJ~~
C~R~
Title PRESIDENT
(Surety) FAR WEST INSURANCE COMPANY
(Attach Acknowledgments)
(Both Principal's and
Surety's Attorney in Fact)
By
JO
Addre 0 urety: 152 N. THIRD
SAN JOSE, CA 95008
Surety's Bond Number 00600 g l) i 2
(Accompany this bond with Attorney-in-fact's
authority from Surety to execute the bonq.
certified to include the date of the bond,)
NOTARY ACKNOWLEDGMENT
3tate of ~AT.TFORNTA
:ounty of SANTA ~T,ARA
)n / / ..) t. It 7 before me,
,
I
. !
lotary Public, personally appeared
JUDITH S. ROBERTSON
JOHN J. DALEY
{here insert name.l
ersonally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
ubscribed to the within instrument and acknowledged to me all that he/she/they executed the same in his/her/their
uthorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf at
rhich the person(s) acted. executed the instrument.
fiTNESS my hand and official seaL
ignature
~-J
~
(Seal)
CAPACITY CLAIMED BY SIGNER SIGNER REPRESENTING
NAME OF PERSON(SI OR E?-m;YIIESI
- - - FAR WEST INSURANCE C(
_ INDlVIOUAl/5) _ PARTNEA(5) _ GUARDIAN/CONSERVATOR
_ CORPORATE XXATTORNEY IN FACT _ OTHER
OFFICERS _ TRUSTEE(S)
- SUBSCRIBING WITNESS
ATTENTION NOTARY: Although the InformatIOn reauested below IS OPTIONAL. it could crevent frauaulent anacnment of this cenrftcare.
THIS CERTIFICATE MUST Document Tille or Type:
BE ATTACHED TO THE
DOCUMENT DESCRIBED Numoer of Pages: Document Date:
HEREIN:
Signensl other than ~amea above:
. State-of California
County of ~{\~ C\c"----.
O~~ d.9 \ C\.C\.1. before me, ~ ~-.Y ('(\ \.\ \ ~'-
Notary P blic, personally appeared ~C'-D ~-r-- ,
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 that helshe/they executed the
same in hislher/their authorized capacity(ies), and that by hislher/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
t 55.
TIde or Type of I)ocwn,
Nwnber of Pages_
_Date ofDocwnent
Signel(s) Other tIwt named below
WITNESS my hand and official seal.
Signature ~ .-==-,- -
(Seal)
A. S. MILLER
Comm '1024093 ~
CJ -. NOTARY PUBLIC CALlFORNIAllJ
~ r 'SANTA CLARA COUNTY, 0
J ""OR"' Comm. Exp. May 16. 1998 ...
....,......,..~"""""""""'"""""''''---....,----....,.~
FD-l (Revised 1/93)
READ CAREFULLY
This document is printed on white paper containing me artificial watermarked logo (~ ) 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 omer POA. No representations or warranties regarding mis 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 me Company. Any party concerned about the validity of this POA or an accompanying Company bond should
call your local branch office at (401(1971-3694
KNOW ALL BY THESE PRESENT,. that Far West Insurance Company. a Nebraska corporation (the "Company"). does hereby make.
constitute and appoint:
ROY G. FLETCHER
JOHN J. DALEY
AS EMPLOYEES 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 Millerc~ perfo~ce
the nature thereof as follow: ~
ALL BONDS $**5,000,000.00 ~
Small Business Administration Guaranteed Bonds up to $**1,250,000.00
........ c-........._" """'t) 0....,..,.000.00 ~ ~~
Md'" blM "" <om"", """by Th" .,,,.,I'''''m;, "'" """' Md by "..,~.,,'^~~'" "" oow;, fuI] f,= "" off",
I, me undersigned secretary of Far West Insurance Company, a Nebras~~on~DO ~}'ip(Y\at this Power of Attorney remains in full force and
effect and has not been revoked and furthermore, that the resolutions 'l ~ ofDir ; ~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. 00600ql)~2 Signed&sealedthi~O ~~.J ~-i/ P ~
- , ~ Karen G. Cohen, Secretary
· · · · · · · · · · · RES IONS;S; O~ F DIRECTORS . . . . . . . . . . .
Article II. Section 7 of the By-Laws of Far West~rance Compan . is sign d sealed by facsimile under and by the authority of the following
resolutions adopted by the Board ofDirectors-o est Insu e om y at.lllin~f g duly held on July 28, 1983:
RESOLVED. that the President or any IC es ent, in~cti wi:!e 1\t retary or any Assistant Secretary, may appoint attorneys-in-fact or agents with
authority as defined or limited in me ins nte den~in ent in c case, for and on behalf of the Company, to execute and deliver and affix the seal
of the Company to bonds. undertakin ces, ty Ip o~o s of all kinds; and said officers may remove any such attorney-in-fact or agent and
revoke any POA previously granted to c persone;] ~V
RESOLVED FURTHER, that any bo ,unde . g. r gni suretyship obligation shall be valid and bind upon the Company:
(i) when signed by the President or any Vi res t an~s and sealed (if a seal be required) by any Secretary or Assistant Secretary; or
(ii) when signed by the President or any s' 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 \.,
(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 me power of attorney issued by e ompany to such person or persons.
RESOLVED FURTHER, that me signa re of any authorized officer and the seal of the Company may be affixed by facsimile to any POA or certification
thereofaumorizing 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 me same force and effect as mough manually affixed.
IN WITNESS WHEREOF, Far West Insurance Company has caused mese presents to be signed by its proper officers, and its corporate seal to be hereunto affixed
."]40.",",",,=,,".]995. ./ ~ 1/ ~
~ ~ .pq Q4A '-L .x:/: ~
}A J,hn E. S".g.. ,% "'= G. eo"", S"'"""
State of Cali fomi a
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 me basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to me within instrument and acknowledged to me all mat
helshe/they executed the same In hislher/their authorized capacity(ies). and that by hislher/their signature(s) 1 :;:. nen.l.lhe~rs..ll..n~ o~e~t~ u.m>n ~hl
of which t!lfi,\Wrn8~( s) acted. executed the instrument. .
"","'" \J RA 1111111", WITNESS hand and offiCial seal. . PEGGY.. LORaf
","'~s."""""""./!'O""" ~ eom-'IfDn#lCU)11 ~
$' "......~POJy ..... ~"::. 2: NoIaIrNllc-CaIbnIa ~
! "......CP "'I j:...... \ Signature · (Sea\)j 1.01 AnoM CcMIy 1-
g CI) .: ~ <6 " 0 ~ Mv Comm. ExpRe Aug 6. 199t
~wi- DEC.14. !O~ __ ~ ~ __ ~ _ _ ~ ~ _ __ _
i~\. 1995 j~g "Car\V lest
\ ./"'" ~~ *,'" ./ ~ j r; Wt
% V"'/..... I!J R ,,<b ..~~,~
'~ Ii1JI" ...... 1"...... ~~..
;''''''''.:::1 ........... ~ ...",........
""'11' * ,\,\\"
"".unll''''''
Insurance Company
2
ACORD~ CERTIFIC~ TE OF LIABILITY INSURANC~~gH~l DATE (MMIDDIYY)
08/03/98
PRODUCER THIS CERTIFICA T~ ISSUED AS A MA ITER OF INFORMATION
Suhr /Ma thias Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
servi~ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O..P' ox 9098 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Jose CA 95157-9098 COMPANIES AFFORDING COVERAGE
Phil Baker COMPANY
A NIC Insurance Compan~ ,.... _ _
Phone No. 408-246-7887 Fax No. 408-246-4919
INSURED COMPANY IlL;;:\",., t: I Vr= 0
B
B & C Homes, Inc & Ramsey COMPANY .P!'}G 04 1998
Corporation C ...
54 Central Avenue, #2 A '-'I... '"
COMPANY OM/N/ST'.OIlKS
Campbell CA 95008 0 RATION
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDIYY) DATE (MM/DDIYYJ
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000
- 06/26/98 06/26/99
A X COMMERCIAL GENERAL LIABILITY 98Gll0771 PRODUCTS - COMP/OP AGG $ 1,000,000
I CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
-
FIRE DAMAGE (Anyone fire) $ 50,000
f--
MED EXP (Anyone person) $ 5,000
AUTOMOBILE LIABILITY
- COMBINED SINGLE LIMIT $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-QWNED AUTOS
R PROPERTY DAMAGE $
~., ~.,~ AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
f=r '_UTI EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
I WORKERS COMPENSATION AND I WC STATU- I rOTH-I
TORY LIMITS ER I
EMPLOYERS' LIABILITY EL EACH ACCIDENT $1,000,000
B THE PROPRIETOR! RINCL 74597 09/01/97 09/01/98 EL DISEASE - POLICY LIMIT $ 1,000,000
PARTNER~EXECUTlVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE $ 1,000,000
OTHER
DESCRIPTION OF OPERA TlONS/LOCA TlONSNEHICLE~SPECIAL ITEMS (q 7--/ (, 0)
RE: 1142-1154 Smith Ave. , Tract 8959, Permit #97-108 and Harriet Ave.
project.
CERTIFICATE HOLDER CANCELLA liON
CITYC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City of Campbell ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
Attn: Public Works Dept. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
70 North First Street OF ANY KIND UPON THI!'~PANY, Its AGEN,TS OR REPRESENTATIVES.
Campbell CA 95008 AUTHORIZED REPRES~FrlJl !JLluc
Phil Baker , ( y
ACORD 25-S (1/95) . .. ACORD CORPORATION 1988
AUslimr
CERTIFICATE OF INSURANCE
ALLSTATE INSURANCE COMPANY
HOME OFFICE - NORTHBROOK, IL 60062
hereby certifies that the following insurance is in force:
POLICYHOLDER POLICY NUMBER
DAVID LURSEN 050535929 BAP
2015 MCCLOSKEY RD
HOLLISTER, CA 95023
The person or organization designated below is described in the policy as:
CITY OF CAMPBELL
PUBLIC WORKS DEPT
70 N 1ST ST
CAMPBELL, CA 95008
Coverages designated are afforded as stated below:
LIABILITY: $1,000,000 EACH ACCIDENT
I .)', I\.. ~7 f
A ,r , . /;:, I I . / (,..'t.J
,; 91.-7 - I D 8
EFFECTIVE DATE
OF CERTIFICATE
07/24/98
POLICY PERIOD
07/24/98 TO 07/24/99
AT 12:01 A.M. STANDARD TIME
~ LIENHOLDER (Loss Payable Clause)
ADDITIONAL INTERESTED PARTY
ADDITIONAL INSURED
X CERTIFICATE HOLDER
''/20
( /998
"rli "'iiI(
'11"10:
--..
hECCIVED
JUN 0 8 1998
Pl,llJLIC WORKS
ADMINISTRATION
To the person or organization stated above:
This policy, as respects the interest of the loss payee, additional interested party, additional insured or certificate holder
named herein, may be cancelled by the Company during the policy period by giving such person or organization 10 days
written notice at its last address known to the Company.
Proof of such mailing is deemed sufficient proof of such notice.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy
referred to above.
BU1380-1
III
BU114-2
PAGE 1 OF 1
YOU'RE IN GOOD HANDS WITH ALLSTATE@
INSURANCE REQUIREMENTS CHECKLIST
Pennit # q 7 -( (~ · . elF Project #
/3 ~5 ./\-1.~-j-
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
~ercial General Liability for bodily, personal injury and property damage:
~ $1,000,000 per occurrence, and
~ $1,000,000 general aggregate limit applying separately to the project, and
EJ. $2,000,000 general aggrregfte limit. /) ft /\ ~ . r ~ .
'fi(. Policy expiration date _~..r20 A",q IUllr.t.(,A./(\(~""- \~
Automotive Liability - "any auto" . U~e.... pD tLGj -f}-vn--. <:'1/---, O~
r$ $1,000,000 per accident for bodily injury and property damage
';t Policy expiration date 7 12.4-1 , '0\ 9
Worker's Compensation and Employer's Liability ~-b;Ci ~ U/+- nl>\.4J v-. f..lQ...
.1id $1,000,000 per accident for bodily injury or disease
~ Policy expiration date ~
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
~ditional Insured Endorsement
~ The City, the City of Campbell Redevelopment Agency, its officers,
employees and volunteers are named as additional insured.
)t The insurance coverage afforded to the Additional Insured is primary
insurance.
Workers' Compensation Insurance Sheet Submitted
o For General Contractor
)lJ Subrogation Clause
W~
Insurance Certificate Reviewed ~ t
o Initials
Copy of Insurance Certificate placed in tickler file one month prior to expiration.
o
5}/15
,
Date
-rt
j:\forms\inscklst 4/96 (rev 6/96)
-Ibo
STATE
COMPENSATION
INSURANCE
F=UND
P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
FEBRUARY 13,.. 1998 POLlCY NUMBER:
CERTIFICATE EXPIRES:
745-97 UNIT 0000106
9-1-98
I
CITY OF CAMPBELL
JOANN - PUBLICWORKS<DEPARTMENT
70 NORTH FIRST STREET
CAMPBELL CA 95006
RECEIVED
FES1 7 1998
PUBl.fC WORKS
ADMINISTRATION
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
I 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 th.8 terms, exclusions and conditions of such policies.
;7~~~
AUTHORIZED REPRESENTATIVE
K~
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE
02/06/98 IS ATTACHED TO AND FORMS A PART OF THIS POLICY.
THIRD PARTY NAME: CITY OF CAMPBELL
EMPLOYER
I
B &- C HOMES INC
54 CENTRAL AVE NO. 2
CAMPBELL CA 95008
fR~M allst~te
488842 Ul19
07-24-97 18:88AM TO
Allstate@
3760958
. P.1
(,) fLt) W""e. i Vl" q 1 - IO€>
~QPllcant: DAVID LURSEN
AppllJ;~nt Nal"le
BU31ne~5 Addre5~
tilJ"lnesel Phone
HOl"le Phone
Type of 8u5iness
Business EntIty
#. El'lployee5
Years 1n Business:
lJ,k firL 97/bo
i4/a-v
ALLSTATE INSURANCE BUSINESS AUTO APPLICATION
....BUSINESS INFORM~TION.**.
DAVIa LURSEN
~015 MCCLOSKEY RO
HOLLISTER, CA 95023
< ~08 I 636-1974
(408) 62;6-1974
contr"actor
I
20
*.*.INSURANCE INFORMATION....
CIJrrent I nl!lLlran~e Carr.'lCI':
POliCy Nu...ber
EXplnttlon O.,l"
allstate
067558831
11/25/1997
Date coverage will begin with All~t4t~:
Date coverage IS accepted/bound
Other All!tate Pollcie~: 067558831
06'7468693
004141435
i)~I'1l cl e J \;
VII~
TerrItory
Coll1510n
Mileage
Indul5try
Vehlclt! U~e
Conlr'M;tcr.
07/2;'/1997
07/23/1997
AUTO"VOL
PlUTO-SPEC
HOMEOWNERS
1991 FORD/FI00 SERlE
.*..VEH1CLE INFORMATION....
IFTEF14Y4HLA33954
024
500 Oed
o '- 50 "Illes
Contractor - cO~MerClal
6t\t'IlQed
Cost New
COMP
IJe 1\~" t
No.: 34359697205S74J
jJ2.3P1 uUL
---nv.ffuj).L
C- c ~--tn-.O
O--ru-j-D v0 Ur?f\ t...L--
~LrJi' . ~C-L-
cI~. f:..a-/ r (f1,JY
~. -JIu:;r
"f (4 /WI-
C- (J-~.-P J?k. ~ .
.,.- ~,......,;.:....;.",,;..
Rl'lS1dence
SI5,625
250 Oed
,uQ to 10,000
GVW
3e~vlce O~ repaIr OD~ratlon~ dr1vinQ to ~ Job ~lte
JR'l/1 allstate
40BB42H1l9
07-,4-97 10:0BAM TO
3750958
P.,
Allstate@
PaQe 1 of MOl""e
ALLSTATE INSURANCE BUSINESS AUTO APPLICATION
ApplIcant: OAV10 LURSEN
No.: 343596972055741
. ....ORIVER INFORMAllONltHe
DrIver # 1: DAVID LURSF.N
2015 MCCl05KEY RO
HOLLISTER, CA 95023
Llcense ;:
008
U~e5 Veh ,;
r0068997
05/03/1949
I
Stete
Sex
CA
Male
ACCldent&/Vlol~tl0n$ for Orlv~r # 1:
NQNE
*...COVERAGE INFORMATION-...
Coverfttle
Lll'\d
PreMIUM
U",bIl !ty
V~ln9ur~d/Vnderln5ured Motor1st
Hired Auto LIabIlIty
ColliSIon
COl"lprehen51\le
I ,fll00.000
1 ,000,900
I .000,00<11
~ee Ven
See Veh
491
137
40
266
116
Total PrerllulI'1
$
1,050
~RLINE SILVA;
EXClU';:IVt:: Armr
DOl #06t9J~17
AL.L.STATE IN:';URA:,~r:c: co.-
7591 EIGl~SUUY '.,f.
GILROY, CA, .,,5~~O
"HONE * 4(J8fl'l42.5608
Allstate
CERTIFICATE OF INSURANCE
EFFECTIVE DATE
OF CERTIFICATE
12/03/97
ALLSTATE INSURANCE COMPANY
HOME OFFICE - NORTHBROOK, IL 60062
hereby certifies that the following insurance is in force:
POLICYHOLDER POLICY NUMBER
DAVID LURSEN 050535929 BAP
POLICY PERIOD
07/24/97 TO 07/24/98
AT 12:01 A.M. STANDARD TIME
2015 MCCLOSKEY RD
HOLLISTER, CA 95023
The person or organization designated below is described in the policy as:
CITY OF CAMPBELL
PUBLIC WORKS DEPT
70 N 1ST ST
CAMPBELL, CA 95008
~ LIENHOLDER (Loss Payable Clause)
ADDITIONAL INTERESTED PARTY
ADDITIONAL INSURED
X CERTIFICATE HOLDER
Coverages designated are afforded as stated below:
LIABILITY: $1,000,000 EACH ACCIDENT
, ~ 1"'\
po ~ \.~ '.'"
~ r Jf, .
,,;e ....".
'I> .
ill ~ '\no.1
~jf2~ \J f~"
:, __ ~ I ,. --<!" 1""'1\ ,....
,'~ -~'",\Rp..\\U
:..Dr~,\N\.
To the person or organization stated above:
This policy, as respects the interest of the loss payee, additional interested party, additional insured or certificate holder
named herein, may be cancelled by the Company during the policy period by giving such person or organization 10 days
written notice at its last address known to the Company.
Proof of such mailing is deemed sufficient proof of such notice.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy
referred to above.
BU13So-1
PAGE 1 OF 1
I II
BU114-2
YOU'RE IN GOOD HANDS WITH ALLSTATEE>
97- '{flo
JjCORD.. CERTIFICJ 'E OF LIABILITY INSU"" \NC~~gHI6~1 DATE (MM/DDIYY)
05/01/98
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Suhr/Mathias Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Services HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 9098 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
San Jose CA 95157-9098 COMPANIES AFFORDING COVERAGE
Phil Baker COMPANY
A NIC Insurance Company
Phone No. 408-246-7887 Fax No. 408-246-4919
INSURED COMPANY
B
B & C Homes, Inc. & Ramsey COMPANY
Corp. C
54 Central Avenue, #2 COMPANY
Campbell CA 95008 0
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDIYY) DATE (MM/DDIYY)
GENERAL LIABILITY GENERAL AGGREGATE $2,000,000
-
A ~ COMMERCIAL GENERAL LIABILITY 97Gll0405 06/26/97 06/26/98 PRODUCTS.COM~OPAGG $ 1,000,000
=:J CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ 1,000,000
f--
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
f--
f-- FIRE DAMAGE (Anyone fire) $ 50,000
M ED EXP (Anyone person) $ 5,000
AUTOMOBILE LIABILITY
f-- COMBINED SINGLE LIMIT $
ANY AUTO
f--
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
r--
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
f--
c---- PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $
r--
ANY AUTO OTHER THAN AUTO ONLY:
r--
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND IWCSTATU. I 10TH-
TORY LIMITS ER
EMPLOYERS' LIABILITY EL EACH ACCIDENT $
THE PROPRIETOR! RINCL EL DISEASE. POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Project: 1365 Harriet, Cam~bell and all work in ~ublic ri~ht-of-way.
Add~tional Insured: The Ci y, the Ci~ of C~be I Redeve o~ment Agency, its
officersi employees and volunteers. otice 0 cancellation or non-payment
will be 0 days. Primary workding and additional insured endorsements
included.
CERTIFICATE HOLDER CANCELLATION
CITYC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL
City of Campbell ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ATTN: Public Works Dept. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
70 North First Street
Campbell CA 95008 OF ANY KIND UP - NY, ITS AGENTS ( R REPRESE~ATlVES.
A~"""""O ...."'~,An"i :fli ,V ~QL);~,
ACORD 25-S (1/95) Phil Baker /~ rut.( \ cQ. / C!.
V . ACORD CORPO I N 1988
I
5-01-1998 9:46AM
POLlCY NUMSEFI:
FRO-l CAt-PBELL PlBL Ie WKS 408 376l2l958
P.5
...oMMEAcIAI. GeNERAL.1..IA8JLJTY
nlls ENDORSeMENT CHANGES TH~ POUCY. PL9S1! READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES or
CONTRACTORS [Form A]
this endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL. UASIUTY COVERAGE PART
SCHmULE
. I taUon of
Cover1Id 0perJdb.
HI!: &l1 1IIDd: ill pal)I.1c :dght;-of-wil!' _ a 1::r ~ "."...u.
Ci1:y or .~.l1 !It--"--l~",,: ~qe'ftey'. :1ta offl~.
-.pl.oyeQ aDd ~lazateeJ:. are Da-.cI AS add! 1:.ioaal.
~ as respeC't8 liablli q per cc: :Z009_
Advance PnHnium
Name of Person or Organization (AddJtionaI Jnaand):
crrv OF CAMPBELL.
AnN: DEPT. OF PUauc WORKS
70 NORTH FIRST &nlEET
CAMP.1iLL. CA IIGOI
Bodily Injury and
Property Damage UabIUty
PnHnium Basis
Cost
Rates
(Per
$1000 of cost)
$
Total Advanc. Pramium $
(If no entry appears above, Intom1atlon naquired to c:ompJere this enc10mement will be Shawn in the Declarations .
as applicable to this endorsement)
1. WHO IS AN INSURED (Section II) is amended to
include as an Insured the pen;on or organization
(called ".,;1ditional insuntd. shown in the Sc:twd-
ule but'only with respect to IabUily arising out of:
A. "Your Work" fOr the additionaJ fns&rid(s) at
the location d~nated above. or
B. Acts or omissions ot the additional instnd(s)
In connectiOn with their generaJ SUPervision
of "your work. at the location shoWn in the
Schedule.
2. WIth respect to the ~rance domed these
addItional insulWCfs. the . following asitionaI
proviSions apply:
A. None at the e=usions under Coverage A.
except exdusions (a), (d). (e). (1), (h2), (i).
and (m), app4y ta. this insurance.
S. Additional EXcfulrions. This insurance dOH
not apply to:
(1) -Bcx.Oly Injury- or -pro~ ~.
for whiCh the additional insuntd(s) are
obIiga~ to pay damages by r&ason of
the U$Um~on of 1i.abWty", a contr.ICt Or
ag~ement. This exdusioii does I"IOt apl'ty
to llabhity fOr damagQ that the additional
in&ured(s) would have in the absence of
the contract or agrHl'hent.
(2) -Bodily injury- or .property dartage-
occuning attar:
CG 20 091185
(a) All wcrk on the ptDject (other than
service. maintel1ance. or ~) to
be rxtlfonned by or on behd at the
additJonaf inSured(s) at the Site ~ the
covered cper.ilUori:i has beQn com-
pleted; or
(b) That POrtion of "your ~ out of
~ infury or ....--..e arises has
been put to itS ~ UN by any
P8lBOn or ~n alherthan an-
0Ih... contractor or IUbc;Qlllr~
engag.a In peIforning ~ tor
a Prinap.l .. . pIUt 01 1M Amlt
pt\)ject.
(3) "B,o~ Injury- or "property damage-
~ out of any act or atr'Iis&ion 01 the .
additiOnal instnd(s) or any of 1heir em-
pIoyHs other than the genend ~M-
sion 01 'NOne PBlfonned (or the 8dditionaI
lnsur&d(s) bY you.
(4) .Propeny daniage-to:
(a) Property Owned. used or accupied by
01' rented to the adc:ItionaJ in8ured(s):
(b) Property in the care. ~ or can-
tra 01 the. additional Insured(s) or
OYer vmich the additional insurea(s)
.... for any PUJ'POH excerising phyS-
ical control; or
(c) "Your \Voric" far !he additicnal in-
surec:I(S).
COPyright, Insurance Service Office, Inc.. 1984
5-01-1998 9:46AM
FRGI CAt-PBELL Pl.BL Ie WKS 408 3760958
P.6
Insured Name B & C Homes, Inc. & Ramsey Corp.
Poficy# 97GII0405
PRIMARY WORDING:
SUBJECTTO AlL OTHER TBWS AND PROVISIONS OF THE POUCY, SUCH INSURANCEAS
PROVIDED BY THIS ENDORSEMENT SHALL BE DEEMED PRIMARY, BUT ONLy WITH
RESPECT TO WORKPERFORMEC BY OR FOR THE NAMED INSURED IN CONNECTION WITH
THE ABOVE DesCRlBEO CONTMCT.
WORKER'S COMPENSATION INSURANCE INFORMATION
The following worker's compensation insurance information is required for all Applicants and
Contractors, One of the following items for each Applicant and Contractor must be submitted
prior to working under a Public Works permit or contract. R E eEl V E D
JAN 0 2 1990
WORKERS' COMPENSATION INFORMATION:
Public WorQ/Engineerin~
\S~L- ~~ ~'^--C~.
Name of Contractor! Applicant
o A Certificate of Consent to Self-Insure issued by the Director of Industrial Relations; OR
/ A Certificate of Workers' Compensation Insurance
Insurance Co. ~TC---\"e.. ~~d.
Policy No. J4Lo nLf '2>6 ~ Expiration Date I' \ . <97 ; OR
o A signed Certificate of Exemption from the Workers' Compensation laws as printed
below.
CERTIFICA TE OF EXE:MPTION
I certify that in the performance of the work for this contract, I shall not employ any
person in a manner so as to become subject to the Workers' Compensation Laws' of
California.
Signed
Date
Title
NOTICE TO APPLICANT/CONTRACTOR: If after signing this Certificate of
Exemption, you should become subject to the Workers' Cpmpensation pr.ovision of the
Labor Code, you must forthwith comply with such provisions or the Permit or Contract
will be cancelled or revoked.
j: \forms\ workcomp(rev6/96)
O\,'CA'4
. A
... ~
.... ~
- r'"
:;..; r-
~~
-
,
.:..
r)
kCHA\lO
CITY OF CAMPBELL
Public Works Department
January 3, 2001
Mr. Bruce Bowen
B&C Homes, Inc.
54 North Central A venue
Campbell, CA 95008
SUBJECT: PERMIT NO. 97-160
LOCATION: 1365 Harriet Avenue
ONE YEAR MAINTENANCE INSPECTION - ACCEPTANCE
Dear Mr. Bowen:
The City of Campbell has made the fInal 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.
Please fInd attached your original Faithful Performance and Labor/Material Bonds which we
are returning to you.
Sincea~
Alan Horn
Public Works Inspector
MQ
Enclosure
cc: Permit 97-160
Public Worlcs/Maintenance Division
Far West Insurance Company, 425 California Street, Suite 350, San Francisco, CA 94104
H: \ word\permits\97160accGd)
70 North First Street. Campbell, California 95008-1423 . TEL 408.866.2150 . FAX 408376.0958 . TDD 408.866.2790
r....
~
~<\::
...s>
.to
o \'. C"A.t
f...4,'~A~(I'>
... t'"
U !""
. .
... ...
<$. "-
~. c.,'
oJ/ C H A y.1l.
112 Ccp
r:f) 7
0!
CITY OF CAMPBELL
Public Works Department
June 9, 1999
Mr. Bruce Bowen ::5tJ .-;;t!i:1f;
B & C Homes, Inc.
54 North Central Avenue
Campbell, CA 95008
Re: 1365 Harriet Avenue
EP #97-160, Parcel Map
Monumentation Cash Security
Dear Mr. Bowen:
According to the City's records, a $1,500 cash security bond is still being retained for setting the
survey monuments for the above-referenced Parcel Map, Please provide us with a letter from
your engineer/surveyor that all monumentation has been completed in accordance with the
recorded parcel map and that he/she has been paid. Upon written request, City staff will arrange
to have your security released.
The monuments should have been set on or before January 20, 1999.
Please respond by July 12, 1999, and thank you very much for your cooperation.
cc: LD Fi1e/1365 Harriet Ave.
EP Fi1e/97-160
H:\ WORD\LANDDEV\ I 365HAR2(JD)
70 North First Street. Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TOD 408.866.2790
~$ /PX 57/;;:Z~t17 #2/99
Of'c'-t'4
;"~'~/.)~(t'>
... !'"
U !'"
. .
-" ..
-$0 '"
~. c..'
o<tc Ii A \1.0.
CITY OF CAMPBELL
Public Works Department
May 20, 1999
B & C Homes, Inc.
54 North Central Avenue
Campbell, CA 95008
SUBJECT:
PERMIT NO. 97-160
LOCATION: 1365 Harriet Avenue
FINAL INSPECTION AND ACCEPTANCE
Dear Mr. Bowen:
The City of Campbell has made a final inspection of subject Public Works 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.
The City will continue to hold your Faithful Performance Bond until a Maintenance Bond in the amount
of $22,250.00 has been received, as your Maintenance Surety. Additionally, refunds of your
Construction Cash Deposit of $3,560.00 and Plan Check Deposit of $1,780.00, plus any interest due,
are now being processed and will be sent to you under separate cover. Enclosed is a copy of the City
standard maintenance bond for your use.
If you have any questions, please call me at (408) 866-2168.
t?u~
Alan Horn
Public Works Inspector
MQ
cc: Suspense - 11 months
Permit #97-160
Inspector File
Far West Insurance, 425 California Street, Suite 350, San Francisco, CA 94104
H:\ WORD\PERMITS\97l60FIN(JD)
70 North First Street . Campbell, California 95008.1423 . TEL 408.866.2150 . FAX 408.376.0958 . TDD408.866.2790
~ARROll
4IE~:~~~~d~urveyors
Tel: 40X-261-9XOO
Fax: 408-261-0595
E-mail: carcngl@aol.com
1101 So. WiEchester Blvd.. Suite H-184. San Jose. CA 95128-3903
August 20, 1999
RECEIVED
AUG 2 3 1999
PUBLIC WORKS
ADMINISTRATION
Mr. 1. Harold Housley, P.E.
Land Development Engineer
City of Campbell
Public Works Department
70 North First Street
Campbell, CA 95008-1423
RE: 1365 Harriet Avenue
EP #97-160, Parcel Map
Monumentation
Dear Mr. Housley,
On behalf of our client, Bruce Bowen at B&C Homes, Inc., we hereby inform you that all
monumentation has been completed as of this date in accordance with the recorded parcel map.
We have been paid in full for completion ofthis project and we would request that the Cash
Security be released.
If you have any questions, please do not hesitate to contact our office.
Very truly yours,
t[3iJGiiWC.
Timothy 1. Redd
Surveyor
TJR/lm
cc: Bruce Bowen, B&C Homes, Inc.
Far West
'"".flj;~,'t" No. q., -l~o
Insurance Company
AUG 29, 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 N. 1ST STREET
CAMPBELL, CA 95008
RECEIVED
SfP a 8 1998
P/";c::iliC
ADMIN/STV:R'ORKS
AT/ON
Bond No.: 006009532
Subdivider: B & C HOMES, INC.
Amount: $89,000.00
Description: SUBDIVISION OFF-SITE PUBLIC IMPROVEMENTS PERMIT NO.#97-160
Location: 1365 HARRIET AVENUE, CAMPBELL, CA
Effective Date: 11-26-97
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 ~ No
2. If not, what percent has been completed? i5 %
3. Is the work progressing satisfactorily? IZI Yes D No
4. Has this work been accepted? DYes I2J No
5. If so, what is the date of acceptance?
6. If not, what is the anticipated date of acceptance?
COMMENTS:
Signed by:
~~
Name:
tt IA~ He ......
~lo' - -Zl~B
Date:
~~L IIp ~ \ ~~g
Phone: (4<J~
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 NO.
0'< . CA/lt/-> PROJECT: PERMIT 97-160 REPORT NO.
~~ DATE: J1Md 1/
f::: t'"" 1365 HARRIET AVENUE If~
u r-
o 0 ~.A .. .-,1-
..... -'- WEATHER:
'So ....
<'" '-'.... INSPECTOR: ~
.oRCH^\I."'. CONTRACTOR: B&C HOMES, INC.
,
ITEM DESCRIPTION
~ IZtmd. ~ ~ ,I/~~ ~.~ dtrr/~/ ~~ A~
~A#\ -I. /',/- ~?~-L~ ck-d- . / ,
CC: PAGE OF
FIELD ENGINEER'S DAILY REPORT
t\AcGlZ-t ~
CONTRACTOR:
ITEM
DES CRI Pl'I ON
~t\ ,. ~c.vl.-.k ~1
~ \ tNUek
cc:
CITY OF CAHPBEt.L
PROJECT HO.
REPORT HO:
DATE:~fU? 4- 3er'le
WEATHER: br.ee:
INSPECTOR:
PAGE: I
OF I
CITY OF CAMPBEL'L
FIELD ENGINEER'S DAILY REPORT
ITEM
cc:
~~Ie.'-
CONTRACTOR:
DESCRIPTION
...;..wb
- I
t'
I'
'Z.
PROJECT HO.
REPORT NO:
DATE: I)JJ . -z..1. t;g
WEATHER: 'Vo.V'M
INSPECTOR:
PAGE: I
OF I
l' ~"',-\- ~, q(p - I ~ 1-
Far West
Insurance Company
CITY OF CAMPBELL
70 N. 1 ST STREET
CAMPBELL, CA 95008
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FINAl'"''
rt..c DE?r.
Far West Insurance Company
152 NORTH THIRD STREET
SUITE 550
SAN JOSE, CA 95112
TEL (408) 971-3694 FAX (408) 971-3698
RECE"V~D
MAR 1 8 1998
PUBL./C
AOMINIS/'ORK8
RATION
FEB 28, 1998
Bond No.: 006009532
Subdivider: B & C HOMES, INC.
Amount: $89,000.00
Description: SUBDIVISION OFF-SITE PUBLIC IMPROVEMENTS PERMIT NO.#97-160
Location: 1365 HARRIET AVENUE, CAMPBELL, CA
Effective Date: 11-26-97
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
Z.r; %
IZI Yes
DYes
[ZJ No
D No
D No
COMMENTS:
Signed by:
a~
,
Name:
IIlan ft~
Date:
3- 20- <jg
Phone: (~8) &6' - ?-I b 8
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.
f ROACHMENT PERMIT ISSUANCE CH :: LIST
City of Campbell
Department of Public Works
Encroachment Permit No. C:::r\ .- l G:O
Tract No. ~ Y'-> PfiP' ,>:7:"V'::(;)
Address: \ '=?..~" l~2.1~T
I~MS REOUlRED FOR PERMIT APPLICATION:
/:1.-/ z.:i2. Applicant section complete
It-/l-? 1 Applicant signature and date (front and back)
. .
'S:'- Cf-q, Permit Application Fee $225.00 paid - Receipt Number \C:>'-b~
c:I. \, cex:::.. c 0
"S-=t.-<:::t,Plan Check Deposit Paid (2% of Engineer's Estimate, $500 min) Receipt Number \ D.""L€:>~<.a
~- q..q, , Engineer , s Estimate Submitted
~~9.-9:'lFive Sets of Improvement Plans Submitted
ITEMS REOUlRED PRIOR TO PUBLIC WORK CLEARANCE FOR BUILDING PERMITS
/;2., ::!tJ1Plan 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 Estimate required; $30,000 minimum
deposit), Amount $ \ e:>\ t::.~c>. (.:<:::J Receipt No. /?' 7 / ~ ~
/;l -t.::L.l- Security for Faithful Performance and Labor and MJterials, 100% each of Engineer's Estimate, supplied or paid.
Amount $ ~I ~. e:.o Form ~~ J.D. # ~d/?.5~;t..,
/:l-:L:.ti Security for Monumentation
Amount $ t SDC:>. e:; C)
Receipt No. /t'7/~~
/:t~ Construction Emergency Cash Deposit: 4% of Engineer's Estimate, ($500 minimum, $10,000 maximum)
Amount $~~~. oC) Receipt No. /tt'? / '!}1/7
!j.::.i::U Storm Drainage Area Fee
Amount ~.2..L. eo Receipt No. /b'7 / ~?
l.- 2 -c'l~Worker's Compensation Insurance Information Sheet Received for Applicant.
. ~ All oth~P)lblic Works re~uirements listed in the Conditions of Approval of the development.
'f!f/77. ~ /.//4///79 #//r~J/a/
/t"'f:f.L Other Fees, Payments, ~oSits Amount $~ 6 '7..:t 7' Receipt No. / ,tJ 7 /~cJ
h';'~ //7 "e/,,(/ ;:rteef.
ITEMS REQUIRED PRIOR TO ISSUANCE OF ENCROACHMENT PERMIT:
_ Contractor's signature added to the permit application (front and back)
~- ""4l:Worker's Compensation Insurance Information Sheet received from Contractor.
~- t-~~ Certificate of Insurance with Additional Insured's Endorsement received from Applicant or Contractor.
.0:;: - { -1t:>One mylar set and four blue line 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 MAY BE ISSUED.
Issuer: Initial
and date
and file with permit.
UPON ISSUANCE, INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND
j:\word\fonns\pmtcklst rev. 4/97
To: City Cler'L-
Please c( and receipt
for the fouv wing monies.
PJar 'g File No.:
Ai.
ITEM
I. MijQ[;.
A. 1 + acres - General Plan Amendment
Zone Change
Planned Development Permit
EIR Review
AMOUNr
$4,425
4,425
4,425
4,425
3,225
3,225
3,225
3,225
B. 0-1 acre General Plan Amendment
Zone Change
Planned Development Permit
EIR Review
II. Min2ri
A. Subdivision Map (5+ lots)
Site and Architectural 10+ K S,F,
Tentative Parcel Map (4<Lots)
3,225
2,150
2,150
B, Site and Architectural 0-10 K S.F.
Variance (Non-residential)
Text Amendments
Use Permit
1,550
1,550
1,550
1,550
III. Miscellaneous:
A. Variance (Residential)
Modifications of Approval
Modification PO Permit
Reinstatements
Revised Development Schedule
Extensions of Time
960
960
960
960
960
960
B. Lot Line Adjustments 500
Site and Architectural (Res,) (Each House) 120
Signs (Each Sign) 120
Fence Exception 120
Promotional Events 120
C. Appeals 0
Downtown Development Permit 0
Historic Preservation Zone, Use Permit, HP Permit 0
IV,
~
Maps
General Plan Text
Zoning Ordinance
Copies (per page)
Refundable Deposit - Account 2203
Fire Department Review - Account 01.303.3322
Architectural Approval
Project Plan Review
50
150
100+ 10 per lot/unit
6.25
18.00
22
1
r Impact Fee - Account 295.535.4920
For City Clerk Only: Receipt No.:
Amount Paid:
Rereived by;
Olte:
/~
!~~U-'
S~
--
Exception for Major Projects: It is anticipated that the application processing costs of
selected major projects will significantly exceed the above fees. In these cases, the
Community Development Director may collect a deposit and charge actual time spent to
process the application based upon current hourly rates.
N~. ~e!\9opted by R:~:on NO,. ~~ a~~l, <;ity of ~bell, 6/20/95, .
~~/ ~-Z-<<- :0 ~??~/ ~~. /z;/~ 7
PUBLIC WORKS DEPARTMENT
ENGINEER'S ESTIMATE
Address:
1365 HARRIET
Date:
9/23/97
ENCROACHMENT PERMIT NO. 97-160 ADDlication No. PM97..(}2
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. DESCRIPTION UNIT QTY <$30K $30 K to S150 K > $150 K $ AMOUNT
I, SURFACE CONSTRUCfION
MOBILIZATION 1 LS $ 1.750.00 $ 1.750.00
CONSTRUCTION TRAFFIC
CONTROUPHASING 1 LS $ 1,000.00 $ 1,500.00 $ 1.500.00
CONSTRUCTION STAKING t LS $ 750.00 $ 400.00 $ 400.00
CONSTRUCTION TESTING I LS $ 600.00 $ 600.00
II. DEMOLmON/CLEARING
1. CLEARING & GRUBBING 1 LS $2,000.00 $ 2.000.00
2. SAWCUT P.C.C.lA.C.(UP TO 6") 255 LF $4.50 $3.00 $2.00 S 765.00
3. P.C.C. REMOVAL (1.095 S.F.) 122 SY $30.00 $23.00 $10.00 $ 2.806.00
4. CURB AND GUTIER REMOVAL 160 LF $6.00 $3.00 $2.00 $ 480.00
4.5. AC, AB REMOVAL 4150 SF $ 2.50 $ 10,375.00
5. MEDIAN REMOVAL SF $4.50 $2.25 S1.25
6. DEMOLISH EXISTING INLET/PLUG RCP'S EA $300.00
7 REMOVE INLET, CONDUITS LS $750.00
III. STORM DRAINAGE
1. 12" R.C.P. (CLASS V) LF $60.00 $40.00 $20.00
1a. 8" PVC LF $15.00
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 IIn LF $90.00 $75.00 $65.00
6. T.V. INSPECTION (12") LF $1.20 $0.75 $0.60
7. STD. DRAINAGE INLET EA $1.600.00 $1,300.00 $1,000.00
(C.C. DETAIL 5)
8. FLAT GRATE INLET EA $1,400.00 SI.I00.00 S900.00
(C.C. DETAIL 6)
9. STANDARD MANHOLE EA $2,000.00 $1,600.00 $1,300.00
(C.S.J. DETAIL D-ll)
(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 <$30K $30 K to $150 K > $150 K $ AMOUNT
11 THRU-CURB DRAIN 2 EA $ 500.00 $1.000.00
IV. CONCRETE IMPROVEMENTS
1. SIDEWALK (321)(5) 1605 SF $6.50 $4.50 $2.75 $7,222.50
2. DRIVEWAY APPROACH 600 SF $7.50 $5.50 $3.75 $ 3.300.00
2.5 PRIVATE PCC DRIVEWAY 552 SF $5.50 $ 3,036.00
2.7 PRIVATE AC DRIVEWAY 312 SF $3.75 $ 1,170.00
3. CURB AND GUTIER, TYPE A2 441 LF $22.00 $18.00 $15.00 $ 7.938.00
4. V ALLEY GUTTER SF $12.50 $10.00 $8.25
4.5 SPECIAL V ALLEY GUTTER 123 LF $5.00 $ 615.00
5. CURB RAMP EA $1.200.00 $800.00 $700.00
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
10.5 AC CONFORM OVERLAY 800 SF $2.00 $ 1.600.00
v. PAVEMENT
1. ASPHALT DIGOUT AND REPLACE CF $2.00 $3.50 $2.50
2. PAVEMENT WEDGE CUT (6') 76 LF $5.00 $2.50 $1.50 $ 190.00
3. PAVEMENT GRINDING 195 SF $0.80 $0.50 $0.35 $ 97.50
4. PAVEMENT FABRIC (PETRO-MAT) 33 SY $2.00 $1.85 $1.50 $ 61.05
5. ASPHALT CONCRETE (TYPE A) 251.3 T $80.00 $50.00 $35.00 $ 12,565.00
(9827 SF)(0.33')(0.0775)
6. AGGREGATE BASE (CLASS 2) 433.4 T $40.00 $20.00 $12.00 $ 8.668.00
(7271 SF)(0.50')(0.070)
(2556 SF)(I.00')(0.070)
7. SLURRY SEAL (TYPE II) SF SO.07 SO.06 SO.05
8. SLURRY SEAL (TYPE III) SF SO.t1 SO.09 SO.07
VI. TRAFFIC SIGNALSILIGHTS
1. 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 3 EA $2,600.00 $2,200.00 $1,800.00 $ 6,600.00
5. 1 112" RIGID CONDUIT 180 LF $9.00 $7.00 $5.00 $ 1,260.00
Page 2
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. DESCRIPTION UNIT QTY < $30 K $30 K to $150 K > $t50 K $ AMOUNT
6 2" RIGID TRAFFIC SIGNAL CONDUIT LF $ 17.00 $ t3.00 $ 10.00
7 CONDUCTOR 540 LF $ 0.70 $ 055 $ 0.45 $297 .00
8 PULL BOX (NO.3 1/2) 5 EA $300.00 $240.00 $185.00 $1,200.00
9 TRAFFIC SIGNAL PULL BOX (NO.5) EA $400.00 $350.00 $300.00
10 PULL ROPE LF $055
VII. STRIPING AND SIGNS
1. REMOVE PVMT. MARKINGS (PAINT) SF $250 $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 $t.35 $0.85 $0.35
5. STRIPING DETAIL 29 LF $2.2.5 $1.65 $1.20
6. STRIPING DETAIL 32 LF $2.40 $1.75 $ 1. 2.5
7. STRIPING DETAIL 37 (THERMO) LF $1.85 $1.50 $1.00
8. STRIPING DETAIL 38 (THERMO) LF $2.50 $1.85 $1.15
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 LF $t.35 $1.05 $0.90
12. CROSSWALK, 12' WHITE LF $t.35 $1.05 $0.90
13. PAVEMENT MARKINGS (PAINT) SF $250 $3.80 $1.60
14. PAVEMENT MARKINGS (THERMO) SF $5.50 $3.80 $2.60
TYPE IV ARROWS
15. PAVEMENT MARKER (NON-REFL.) EA $4.50 $3.00 $2.20
16. PAVEMENT MARKER (REFLECTIVE) EA $6.00 $4.t5 $3.15
17. TYPE K MARKER EA $95.00 $80.00 $70.00
18. TYPE N MARKER EA $95.00 $80.00 $70.00
19. SALVAGE ROAD SIGN EA $85.00 $75.00 $65.00
20. RELOCATE ROAD SIGN (W81 ON NEW POST) EA $tOO.OO $85.00
21. INST. RD. SIGN ON EXIST. POLE 2 EA $200.00 $145.00 $110.00 $290.00
22. ROAD SIGN WITH POST 2 EA $300.00 $240.00 $195.00 $480.00
23 INSTALL 1226S SIGN WITH POST EA $240.00
24 STANDARD BARRICADE LF $15.00
Pag~ '3
ITEM UNIT PRICES FOR PROJECT AMOUNT
NO. DESCRIPTION UNIT QTY < $30K $30 K to $150 K > $150 K $ AMOUNT
VIII. LANDSCAPING
1. IRRIGATION. PLANTING WORK LS $1,000.00 $1,000.00
2 PRUNE TREE ROOTS EA $125.00 $100.00 $85.00
3 TREE REMOVAL EA $650.00 $500.00 $400.00
4. ROOT BARRIER (12") LF $20.00 $10.00 $6.00
5. ROOT BARRIER (18") LF $25.00 $t5.00 $10.00
6. STREET TREE (15 GAL) EA $450.00 $325.00 $250.00
7. STREET TREE (36" BOX) EA $700.00 $550.00 $400.00
8. TOP SOIL BACKFILL t5 CY $15.00 $225 .00
9 IRRIGATION LS $675.00
IX. MISCELLANEOUS
I. PEDESTRIAN BARRIER LF $75.00 $60.00 S50.00
2. CHAIN LINK FENCE (6') LF SI5.00 $11.50 S9.25
3. RAISE MISC. BOX TO GRADE 2 EA $300.00 $200.00 $175.00 $400.00
4. RAISE MANHOLE TO GRADE EA $400.00 $275.00 $200.00 $275.00
5. INSTALL MONUMENT BOX 2 EA $450.00 $350.00 $300.00 $700.00
6. MEDIAN BACKFILL CY $19.00 $17.00 $15.50
7 RESET BENCH MARK LS St50.00
SUBTOTAL $ 80,866.05
PREPARED BY: CRUZ S. GOMEZ
10% SECURITY ENFORCEMENT FEE $ 8.086.61
REVIEWED BY: I. HAROLD HOUSLEY
TOTAL ESTIMATE FOR FAITHFUL $88,952.66
APPROVED BY: MICHELLE QUINNEY 1f PERFORMANCE SECURITY S89,OOO.00
.See Section 66499.4 of me Map Act.
h: \excel\landdev\ 1365harr(mp)
Page 4
/MaY-03-97 06:00P Du~~ea/Carroll
/' .
<{ .
408_265 4772
P.02
ESTIMATE OF PROBABLE
CONSTRUCTION COST
CITY PORTION ONLY
HARRIET/ROBNICK PROJECT
av 5
III eM UNIT TOTAL
NO. ITEM DESCRIPTION bUANTln UNITS COST COST
1 Mobilization 1 LS 2500.00 2500
2 rrraffie Control 1 LS 1000,00 1000
3 ~Iearina RIW 1 LS 2500.00 2500
4 Saweut AC, S/W 225 LF 3.00 675
5 Remove AC 4150 SF 2.50 10375
6 Remove pce S/W & DIW 850 SF 2.50 2125
7 Remove Curb and Gutter 160 LF 3.00 480
8 12" RCP 115 LF v 40.00 4600
9 Std Stnn Inlet 2 EA 1300.00 2600
10 Strm Manhole 1 EA 1600.00 /1600
11 Break & enter Strm MH 1 EA 550.00 550
12 Thru-curb Drain 2 EA 500.00 1000
13 PCC Sidewalk 1902 SF 4.50 '/8559
14 PCC Drivewav 288 SF 5.50 1584
15 Curb & Gutter 438 LF 18.00 7884
16 AC DIW Confonn 293 SF 3,75 1099
17 AC Pavina (3- on 8" AS) 9715 SF 1.50 14573
18 AC Conform Overlav 1350 SF 1.00 1350
19 Electrolier 2 EA 2200.00 4400
20 Electrolier Conduit and Cable 180 LF 7.50 1350
21 #3-1/2 Pull Box 2 EA 240.00 480
22 Street Tree 4 EA 325.00 1300
23 Raise Mise Box to Grade 2 EA 200,00 400
24 Raise Manhole to Grade 1 EA 275.00 275
25 Street Monument 1 EA 350.00 350
26 0
27 0
28 0
29 0
30 0
GRAND TOTAL 1$73.608
M 1997
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JiCHA-V."
MEMORANDUM
CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT
TO:
Tim Haley, Project Planner DATE: February 27, 1997
Michelle Quinney, City Engineer ~V~ , I
Harold Housley, Land Development Enginee~..........
FROM:
SUBJECT: Development Review Committee - Formal Conditions of Approval
APPLICATION NO:
ADDRESS:
APPLICANT:
PROPERTY OWNER:
PM 97-02
1365 Harriet Avenue
Bruce Bowen
Dorothy A. Patton and Central California Conference Association of the
Seventh Day Adventists
Subdivide One Lot into Four Lots for Residential Development
PROJECT DESCRIPTION:
SUBJECT: Public Works Department's Conditions of Approval
DISCUSSION: We have reviewed the applicant's tentative parcel map which generally depicts the
development plan. The salient issue of the proposal is that the applicant only plans to dedicate a portion
of the required right-of-way and construct a portion of the standard improvements pursuant to STANP.
Therefore, it will be necessary to record a "Plan Line" and require the property owner to the west to
complete the dedication and improvements upon further development of their property,
1. Parcel Map:
Prior to issuance of any building permits for the site, the applicant shall prepare and submit a
parcel map for review by the City Engineer and recordation upon City approval. All dedications
shall be shown on the parcel map by letter designation. Dedications shall include additional
right-of-way to provide for a 30 foot half street on Harriet Avenue and additional right-of-way
for the extension of Robnick Court and the cul-de-sac as both are shown on the tentative parcel
map. Ten foot public utility easement shall be included on all property frontages. The City fee
to process the parcel map is currently $1,160. The applicant shall also provide a current
preliminary title report.
1365 Harriet Avenue
.. February 27, 1997
Page 2
2. Standard Street Improvements:
Prior to issuance of any building permits for the site, the applicant shall prepare plans, pay fees,
post securities, and provide insurance as required to obtain an encroachment permit to construct
public street improvements as required by the City Engineer, Public street improvement plans
shall be prepared by a registered Civil Engineer licensed in the State of California, and shall
include the following:
Harriet A venue
A. New curb, gutter, sidewalk, and street lighting to match the eXlstmg predominant
improvements northerly and southerly of the site on the west side.
B, New pavement from centerline to lip of gutter, plus pavement conforms to existing
pavement, based on a Traffic Index provided by the City and R-value provided by the
applicant's soils engineer (4" minimum A.C, thickness).
C. Undergrounding of existing and proposed off-site power poles and related improvements
in accordance with Section 20.36.150 of the Municipal Code.
D. Signing and striping as determined by the City EngLlleer.
Robnick Court Extension
A. New curb, gutter, sidewalk, and street lighting to match the predominant existing
improvements on Robnick Court.
B. New pavement plus conforms to existing pavement based on a Traffic Index provided by
the City and R-value provided by the applicant's soils engineer (4" minimum AC
thickness) .
C. New improvements for the full cul-de-sac as shown on the Tentative Tract Map.
Improvements to be constructed with the future development shall be designed and
included on the plans as "future construction".
D. New storm drain as determined by the City Engineer.
E. Signing and striping as determined by the City Engineer.
F, Removal of existing street improvements within the existing cul-de-sac of Tract No. 8132
and reconstruction of new improvements without the cul-de-sac bulb as required to match
existing improvements to the south.
1365 Harriet Avenue
.. February 27, 1997
Page 3
3. Easement Abandonment:
Prepare all documents, legal descriptions and plats needed to abandon existing easements for
ingress and egress across the subject property and easements "c" and "D" as shown on Tract
No. 8132,
Construction of private improvements on abandoned easements "C" and "D" to match existing
private improvements.
4, Plan Line:
Prior to recordation of the final map, a Plan Line for completion of the Robnick Court cul-de-
sac showing future right-of-way dedication must be approved by the City Council. Before
agendizing the Plan Line for consideration by the City Council the applicant shall submit all
documents, legal descriptions, and plats required for processing, approval, and recording of the
Plan Line.
5. Completion of Public Street Improvements:
Prior to issuance of occupancy for the site, all public street improvements as required by the
encroachment permit must be completed and accepted by the City Engineer and the applicant
must provide the one-year maintenance security,
6. Storm Drain Area Fee:
Prior to issuance of any building permits for the site, the applicant shall pay the required current
storm drain area fee of $2,OOO/acre.
7, Grading and Drainage Plan:
Prior to issuance of any building permits for the site, the applicant shall conduct hydrology
studies as necessary, prepare grading and drainage plans, and pay fees required to obtain
necessary grading permits. The study shall be based on a 10 year storm frequency, The study
shall include runoff from adjacent properties. Off-site storm drain may be required as
determined by the City Engineer.
8. Storm Water Management:
Comply with California Storm Water Best Management Practices Handbook, prepared by Storm
Water Quality Task Force, Santa Clara Valley Water District.
9. Monumentation:
Prior to recording parcel map, applicant shall provide security guaranteeing the cost of setting
all monuments as shown on the parcel map.
1365 Harriet Avenue
. February 27, 1997
Page 4
10. Street Improvement Agreement:
Execute a street improvement agreement and post securities to guarantee the installation of the
required street improvements.
11. Underground Utilities:
All new and existing on-site utilities shall be installed underground per Section 20.36.150 of the
Campbell Municipal Code for any new or remodeled buildings or additions,
Applicant shall submit a Utility Coordination Plan and Schedule for approval by the City
Engineer for installation of all utilities. The plan shall minimize the damage to all public
facilities. The plan shall include appropriate provisions for development of the parcel to the
west (APN 403-19-013).
H: 1365HARR.COAGd)(wp)