HomeMy WebLinkAbout20190628_ApplicationPA2019-130 . . .. ' . . . . PA~6\ ~-130
Community Development D. epart. ment~ cnv oF Ncvurofn ssAcH" . . • . it) am._ 100 Civic Center Drive Planning Permit Apphcatlo ~ Newport Beach , California 92660
949 644-3200
newportbeachca.gov/communitydevelopmerit
1. Check Permits Requested:
D Approval-in-Concept -AIC #
D Coastal Development Permit
0 Waiver for De Minim is Development
D Coastal Residential Development
D Condominium Conversion
D Comprehensive Sign Program
D Development Agreement
D Development Plan
D Lot Line Adjustment
2. Project Address(es)/Asses
D Lot Merger
D Limited Term Permit -
D Seasonal O < 90 day 0>90 days
D Modification Permit
D Off-$ite Parking Agreement
D Planned Community Development Plan
D Planned Development Permit
D Site Development Review -D Major D Minor
0 Parcel Map
's Parcel (s)
0 Staff Approval
0 Tract Map
D Traffic Study
D Use Permit -OMinor 0Conditional
0 Amendment to existing Use Permit
D Variance
0 Amendment -OCode OPC OGP OLCP
0 Other:
__ J
3. Project Desc~ and Justification (Attach additional sheets if necessary):
~Jlt/' r'U4ilAM. 71' .;J~/ftl.HPW ~ ~
1 4r .7Jlt~ e~ ~42-'~ -,,..,,,. "1511/LlrAlos ..
· I lil/Alll111re . •/-• . · ·· · I 4. Applicant/Company Name . . . .. ... ~ 4W ..
Mailing Address I 1Pft, e ~ Z111!: .. ~ -. · ' Sultf/Unit 1 . . ... ··-.. J
City L ~ ~ -----State I ~ ,J Zip[j,thv I
Phone~.!?fz1J?>J Fax Email! __ ···----~--·-----------I
5. ~n~Compa-r;i~ ~~ L. __ .~
Mailing Address _ ~-· · ~·-··-·'--· . . '/!ff rtt::' . .. ... Suite/Unit ~ ___________ _J
I
City' e~~ . J·. Statel e.;,.. I .zip,. 'Ji141"I
PhonelJa~~J Fax . ___ J EmauV4'1~~~'7t6Ui#+Afer
6. Owner Name I 3q ~()~'.:\_.:\/_\t,U_l }(_ \Q9, LL.e__ ___ . ___ ]
Mailing Address L~,_~ :::iu 1--.._ .. _______ Suite/Unit ';:=::====-·=·······::::::J,
City kn~~\ .M~ . .J State L __ .C~~----J Zip I 0'2.
Phone I ( q4~) 1'2.:~::?::~~-J Fax J Email -~~b.£..~~\L_~~
7. Property Owner's Affidavit*: (I) {JVe) l_ ~\furj ...\:;Ll\b.\t -----·--·--__ ]
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) {JVe)
certify, under penalty of perjury, that the foregoing statements and answers herein contained and JJ,e info
herewith submitted are in all respects true and correct to the best of (my) (our) knowledge and belief. ·
Signature(s):\l(j\u~ . Title: I ~(.(J\Jn~ I Date: l.P~~I,.
Signature(s): ---.,------------Title:----.-------
*May be signed by the lessee or by an authorized agent if written aulhortzation from the owner of record is filed concurrently ith the
application. Please note, the · owner(s)' signat.ure for Parcelrrract Map and Lot Line Adjustment Applltation must be notarized.
F:\Users1COD\Shared\Admin\Plannlng_Olvlslon\AppHcalions\Application_Goldellnes\Plaoolng Permit Appllcallon . CDP addad;doox Rev: 01/24117
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