3555 S. Bascom Ave. (77-55)
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CITY OF CAMPBELL ~
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Su1iect: PUBLIC WORKS DEPARTMENT REQUIREMENTS c: ,J ~
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The requirements of the Public Works Department have been satisfied for ~ ~'~
the following development: ~- .
APPLI CANT Ld ; L U A M ~ oc.,r- tl.l ~ .,~
BUILDING ADDRESS ~~<;s S. BA::COM AvE., 1- ~ )0
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COUNTY ASSESSOR I S ~ <~ ~
PARCEL NUMBER 4-1 ~ -I ~, ! o'?> 'Z.) ~ J
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APPROVAL NUMBER "L," -"7 -C::;C{' ~ ~ ~
PUBLIC WORKS FILE NUMBER W.O. (oz/) \ 5'~ t'
~~~~~/JfjD.~L6~o~~BLIC WOR.".~ ~ LiI>~
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By: l.j7Q..._..\,( -''L/ r C;,..A.-i C-l ~ ;"I(
Dater t. '.];i(J;) -7 P , , ~
To
DING DEPARTMENT
Date: );,) n c,...
Fr m:
PUBLIC WORKS DEPARTMENT
RECEIPT
CITY OF CAMPBELL
CAMPBELL, CALIFORNIA
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NAME
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ADDRESS
FOR~.AAA_
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crJ.-CHECK
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REVENUE ACCOUNT NO,
FUND NUMBER
o MONEY ORDER
o CASH
DATE
AMOUNT
THIS RECEIPT
MUST BE MACHINE
VALIDATED AND
SIGNED BELOW.
JUL -3-78
006 ***1,742.00
65 o06A **1,7~2.00
JUL -]-78
16793
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Thank Yau
CITY OF CAMPBELL
CITY CLERK
CITIZEN COPY
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AGENDA DATE JAN. l7
APPLlCANT~05E/'J
ADDRESS 355'5" S. BAsCOM A\JE.
TYPE OF DEV. ~O - UN 'T A F'T: c.o~ {.)LE)(
RECOMMENDED CONDITIONS
liS" NUMBER 17-S'S'
A.P.N. 4-1'3- GS-I05
"':,.Y;;;;~'.."8.ftd ':file' a
map,
<T'lodiC:8i'-=-r;;'~;b.+:-'of ~~y
~>< Pay Storm Drainage Area Fee
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~w,i:Ae"eopy'oi Preliminary Title-Report
( ~p1&l77 )
ED~er: intu agreement:: for const::ruction of street'
i~ovemen~s
Pay,jees'asnot::ed in aqt'eement
pr~/~xaminationand cons~u~tion inspe~fi
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~, / c. ffiP,9i ell Municipal Lighting District pro-rata
/ flr/ h:i"~t rental
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.~Q$.,Mnd......,. ,noted in agreement,~
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Provide grading and drainage plan
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