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Home My WebLink About20191028_ApplicationCommunity·Development Department Planning Permit plication 1. Check Permits Requested: ~Approval-in-Concept~ AIC # D Lot Merger M Coastal Development Permit O limited Term Permit~ 0 Wafllt!Jr for De Mln!mis DoV-Ofopmenl O Seasonal O < 90 day 0>90 d~ys D Coastal Residential Development O Modification Permit D Condominium Conversion D Ort...S!te Parking Agreement 0 Comprehensive Sign Program · D Planned Community Development Plan 0 Development Agreement D Planned Development Permit 0 Development Plan · 0 Sito Development Review-O Major O Minor 0 Lot Line Adjustment D Parcel Map 100 Civic Center Orlve Newport Beaon, Cafifomla 92660 949 644-3200 newportbeachca.govlrommunityct0volopment 0 Staff Approval 0 Tract Map 0 T raffle Study 0 Use Permit MOMlnor OConditlonat 0 Amendment to existing Use Permit 0 Varfance 0 Amendment *0Code OPC OGP OlCP D Other: 2.f. Project Address{es)/Asses~~el NoJ!>.,.-~ ,ww· ·-~--~·m-·-·---...-~ ..... -·-~·-------·----J "' ,~ LJ,~, , ~ ,• .,,,,0~13,AbLf\~ H:C _ _j ,_uAFttJ O 4 _ 9, -~ i-<b 2-., -31__,_.,.,.,._,.,.,_.,_,.,,."'"'"" ··,A"• •· 3 .. Project Description and Justification 'Attach additional sheets if necess~~ r;:~=o~~l~~~~i- ~ ~b•~~!~,= Malllng_Address L_ -··-____ ,,, _,_ .. :L. .... ,,, __ jv___J Stnte/Umt_j_ __ ,J 5. c1tvLL1'~~/Jf,,,_~_ML __ ,,. . s1au,Ltfi. ~--,J z1pLqz,(Qf LJ Phone[~~ :117:<l-!, it?_] Fax L H / t... __ J Email ICA(l:t..1W J:l~l\fa\J~'WL,f!Af* ,COP' 6~ OwnerNameL· .. H~vv~_nH>C!vAIN .... ., .. ,An,n ·---······ ..... .,·~h·----· '_q __ ... , ...... ~ .. -......... --~ ....... , ........ J Mailing Address l.::1tlJ'iA~~,f~.k:-l,~-J,f:~~JZ .. ___ ,,~~1 Suite/Unit[. . J CatyL}:0f1!7o~m "• n PM•< »MNPhwh .... ,I StateL ... U.Jt.. ............. , ZipLW.2-_l.~f.t ........ ..! Phone Ul/A,, ... _,_,,_, ___ , __ ,. ______ ,,J fax .. ,,, __ ,,.,,, __ /A_._ ..... , ... ,., ..... I Email f ~t~ .. eJ ... 'b.~-nz..A~ 17.$. •. ~o M ........ , . ., I ,, ______ ..._,,_,-»••~.,.__, ---.--.·---··----•--•=--c,w.•w•on,I 7. Property Owner's Affidavit*: (f} f:/Ve) L ..... af~~ ,l!:i! .. ,1!!': .. Yi,.,, . .,~ .. ,.,,_,,. .. ,, .. ,_ . ..,,~'"·""""''"'""·"'"'""'""··""'""""'-''''""'"'"'·~····""'.'"· depose and say that (I am) (we are) the owner(s) of the property (ies) involved in U1ls application. (0 0JVe) further certify, under penalty of perjury,. that the foregoing statements and answers herein contained and the information herewith submitted are in all respects true and correct to the best of (my) {our) knowledge and belief. Signature(.~~~~~~~~2-..~--T~~ . . ~ Oat~ J~~ Signature(s): ------------Title:[, ......................................... , ... , ............. , ... , ............ , ..... ,, ... ,, ...... , .... 1 Date: {., .......... , ... ,, ... , ...... -............. ,.,, .. , ...... ,1 *May be signed by the lessee or by an authorized agent if written authorization from the owner of record is filed concurrently with the application. Please note-, Iha owner(s)' signature for Parcel/Tract Map and tot Une Adjustment Application must be notarized, PA2019-222 F:\Users\PLN\Shared\Staff_Dir\Garciamay\Ruby\desktop\DESKTOP_\CUT_PASTE_DRAG_COPY\Office Use Only.docx Updated 08/15/17 FOR OFFICE USE ONLY\ Date Filed: _______________________ 2700-5000 Acct. APN No: __________________________ Deposit Acct. No. ________________________ Council District No.: _________________ For Deposit Account: General Plan Designation: ____________ Fee Pd: _______________________________________ Zoning District: _____________________ Receipt No: ____________________________ Coastal Zone: Yes No Check #: __________ Visa MC Amex # ____________ CDM Residents Association and Chamber Community Association(s): _______________________ Development No: __________________________ _____________________________________________ Project No: ________________________________ _____________________________________________ Activity No: _______________________________ Related Permits: ___________________________ APPLICATION Approved Denied Tabled: _________________________ ACTION DATE Planning Commission Meeting Zoning Administrator Hearing Community Development Director Remarks: __________________________________________________________________________________________ __________________________________________________________________________________________ APPLICATION WITHDRAWN: Withdrawal Received (Date): ________________________ APPLICATION CLOSED WITHOUT ACTION: Closeout Date: ________________________ Remarks: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 10.28.2019 048 282 37 1 RS-D R-1 PA2019-222 Balboa Peninsula Point Assn D2019-0547 CD2019-056 PA2019-222