1059 Audrey 99-658
.
MEMORANDUM
CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT
DATE: -, hRCf. -10 I?lcL~ '/7/~'l
Site Address:\OS9 ~UDt::L'-{ ~'i~
Plan Check Number: ~ _ ~~~
File No(s):
TO:
Bill Bruckart
Building Official
Harold Housley, L. D. Engineer/.--
Chuck Gomez, Assistant Engineer
G-:sc~
THIS DEPARTlVIENT HAS NO OBJECTION TO ISSUANCE OF GRADING,
DRAINAGE, OR BUILDING PERMITS FOR THE ABOVE REFERENCED PLAN
CHECK NUl\1BER.
BY: DATE:
FROM:
CONDITIONS OF APPROV AL ARE SUMMARIZED BELOW FOR CLEARANCE OF
BUILDING PERMIT(S) TO CONSTRUCT A NEW RESIDENTIAL STRUCTURE OR
AN ADDITION OR ALTERATION THAT ADDS 50% OR MORE SQUARE FEET OF
STRUCTURAL COVERAGE (SECTION 11.24.182).
fJ(j Street Improvements: Prior to issuance of any grading, drainage or building permits
for the site, the applicant shall cause plans for public Street Improvements to be
prepared by a registered civil engineer, pay fees, execute a street improvement
agreement, post security and provide insurance necessary to obtain an encroachment
permit for construction of the improvements, as required by the City Engineer. The
plans shall include the following:
'-t~Street Improvements an R-l/Minor Encroachment Permit: Prior to issuance of an
- encroachment permit for construction of any public street improvements in the public
Right-of- W ay the applicant shall cause plans to be prepared, post security, and provide
insurance, all as required by the City Engineer.
Page 1 of 3
PLAN CHECK NUMBER:
okl.o Unsecured Deferred Street Im~rovement Agreement: Prior to issuance of any grading,
drainage, or building permits for the site, the owner shall execute an unsecured street
improvement agreement for construction of street improvements.
.\....lu Right-of-Way for Public Street Purposes: Prior to issuance of any grading, drainage,
or building permits for the site, the applicant shall grant additional
Right-of-Way
for
Public
Street
Purposes
along
the
frontage(s) to accommodate
Applicant shall cause to be prepared all documents necessary to record dedication and
submit to the City for review
~ Public Service Easement: Prior to issuance of any grading, drainage, or building
permits for the site, the owner shall grant a
Public Service Easement on private property contiguous with the public right-of-way
along the
frontage. The applicant shall cause all documents to be prepared by a registered civil
engineer/surveyor and submitted to the City for review and recordation.
'-res Storm Drain Area Fee: Prior to issuance of any grading, drainage, or building pennits
for the site, the applicant shall pay the required Storm Drain Area fee. The current fee
is $~i <:;, DO. C, 0 per acre which is $ SO%. DO
l I.r;
f"-.1;L' Proof of Ownership: Prior to issuance of any grading, drainage, or building pennits
for the site, the applicant shall provide a current preliminary title report, grant deed, or
other proof of ownership.
No Utility Installation Plan: Prior to issuance of building permits, the applicant shall
submit a Utility Installation Plan and Schedule for approval by the City Engineer for
installation of any new utilities. Streets which have been resurfaced within the previous
5 years-may require installation beneath pavement by boring and jacking method and
will also require a pavement restoration plan for approval by the City Engineer prior to
any utility installation.
NO Legal Lot: The applicant shall provide documentation to ascertain that the lot was
legally created, or prepare a parcel map to create the parcel shown.
'~6 Site Plan: Prior to issuance of an encroachment permit, the applicant shall provide a
complete and accurate Site Plan in accordance with the Planning Division's checklist.
Page 2 of 3
~.
PLAN CHECK NUMBER:
lRECEIVED A COpy OF THESE CONDfflONS OF APPROVAL:
Owner's Signature
Print
Date
cc: Alan Horn, PWD Inspector
j: \forms\bldgapp
Rev. 3/18/99
Page 3 of 3
PUBLIC WORKS
PLAN REVIEW ROUTE SHEET
/ADDRESS,/t1S-<? Ao,tJ~GY rf't/c::;
IpLAN CHECK NUMBER: C1? ~ 03
IAPPROVED I NO COMMENTS:
DATE:
APPROVED ICONDDaONS BELOW:
DATE:
Rt=C~/l/I2.D
JUN 2
PUIiJI.. 8 199'9
-40"" Ie
IN/~t IIVOIlI('
Fl~ t,o:
~....
NOTES:
IRETURN TO DARLEEN BECKER, BUILDING DMSION
PERMIT APPLICATION
DATE:t:: /2 )/99
. ,
CITY OF CAMPBELL
BUILDING DIVISION PERMIT NO.:
..............................................................................................
PERMIT TYPE:
BUILDING ~ nEe,.4; MECH .k PLUMB~
DEMO ~ SIGN _ GRADING _ OIliER
.
BUILDING ADDRESS:
OWNER'S NAME:
ADDRESS:
APPUCANT'S NAME:
ADDRESS:
/0 /'9 4~dJ~Y ~/A7 SUITE
~~/5 .r?~~~
/p ..r 9 ~ e...J/ "'-157 ~v,$'.
~~~Jt:
58-~-
?t Hfl/q'7
PHONE '2 ~o - 4 Z/ Z,
DESCRIPTlO~ . n SIGN DEMO ~
~'i'. r7, 4tJ~/;7/,f)~
~~~~~~: O~".I /.L R~c~
CO!\"TACT PERSON: .lUN 2. 0
~lJe .9 ;~99
"0"" '-Ie
ADDRESS: lNI." ~rw~
If" 7'/0 8
PHONE NO.: () !!.
ARCHITECT /ENGINEER:
COMPANY NAME:
CONTACT PERSON:
ADDRESS:
PHONE NO.:
~~U!" vO H,J5~'--
.
f) cJ ~ 4L/'/u? </e/t!5-i
(
)
:;. 79,- 79 ?o
HAZARDOUS MATERIALS: STO~ YES NO USED ON SIn: YES NO
Use or storage of huardous materials requires a Hazardous Materials Information Statement
to be submitted to the Fire Department for review and (OllUllot at time of buDdin. permit
application. Failure to provide the HMIS will hold up buDdin. permit approval.
FIRE SPRINJ<LERED:
YES
NO