HomeMy WebLinkAboutPA2022-0164_20220809_ApplicationCommunity Development Department
Planning Permit Application
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit -
0 Waiver for De Minimis Development O Seasonal D < 90 day 0>90 days
D Coastal Residential Development D Modification Permit
D Staff Approval D Tract Map D Traffic Study
D Use Permit D Condominium Conversion D Off-Site Parking Agreement D Comprehensive Sign Program D Planned Community Development Plan D Development Agreement D Planned Development Permit
D Amendment to existing Use Permit D Variance
D Development Plan D Site Development Review -O Major O Minor D Lot Line Adjustment Iii Parcel Map
Amendment D Other:
2. Project Address(es)/Assessor's Parcel No(s)
1716 ORCHID AVE, CORONA DEL MAR, CA. 92625 // Parcel No: 459-073-03
3. Project Description and Justification (Attach additional sheets if necessary):
Tentative parcel map for condominium purposes.
4. Applicant/Company Name 1716 ORCHID DEVELOPMENT LLC I
Mailing Address 1521 MARGUERITE AVENUE
J Suite/Unit ';:==========I
I City lcoRONA DEL MAR I State lcA I Zip 192625
Phone 1510-543-4936 I Fax j I Email isuMEET.SRIVASTAVA@GMAIL.COM I
s. Contact/Company Name ISUMEET SRIVASTAVA
Mailing Address 1521 MARGUERITE AVENUE
City jCORONA DEL MAR I State !CA I Zip 192625
I Suite/Unit ';:==========ij
I
I Phone 1510-543-4936 I Fax ,___ ____ --JI Email lsuMEET.SRIVASTAVA@GMAIL.COM
I
6_ PropertyOwnerName lSUMEET SRIVASTAVA-716 ORCHID DEVELOPMENT LLC J
Mailing Address 1521 MARGUERITE AVENUE I Suite/Unit ';::===========!
City jCORONA DEL MAR I State jcA I Zip 192625 I
Phone 1510-543-4936 I Fax I I Email lsuMEET.SRIVASTAVA@GMAIL.COM I
7. Property Owner's Affidavit*: (I) (We) lsuMEET SRIVASTAVA I
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) (We) further
certify, under pe lty of perjury, a he foregoing statements and answers herein contained and the information
herewith sub ed re in all res cts and correct to the best of (my) (our) knowledge and belief.
Signature(s): ....,...:::,;:::::::~~--=---J..,::::~~~--Title: !OWNER I Date: 105/02/2022 qh el-MM/DD/YEAR
Signature(s): ------;A'Hc--sk~~ft,j~"""~"".V~~;;nt I oare L------'
*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, the owner(s)' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized.
PA2022-0164
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual who
signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity
of that document.
State of California
County of Ort1hJ e } ss.
On /'.l u~ 115t f s:f-4 , 20.1:l.._ before me, \)0,; k'.i Ocboo ES,PiM ~ ,
Notary Pul5ic, personally appeared Svmeet Sr/ vf,,.,s }Kf/6 , who
proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) ®)'are
subscribed to the within instrument and acknowledged to me that 4:islshe/they executed the same in
t§/her/their authorized capacity(ies), and that by ~her/their signatures(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
Signature
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual who
signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity
of that document.
State of California
County of _________ _, ss.
On __________ _, 20__ before me,
(seal)
OAIKI OCHOA ESl'INOSA t
COMM ... 2360798 NOTARY PIJeUC.CAI.IFORNIA ORANGE COUNTY W My Term~-June 11, 20251
Notary Public, personally appeared ____________________ ,
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
his/her/their authorized capacity(ies), and that by his/her/their signatures(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature (seal)
PA2022-0164
I:\Users\CDD\Shared\Admin\Planning_Division\Current_Templates\Office Use Only Form Updated 01/27/2020
2700-5000 Acct.
Deposit Acct. No. ________________________
For Deposit Account:
Fee Pd: _______________________________________
Receipt No: ____________________________
FOR OFFICE USE ONLY
Date Filed: _______________________
APN No: __________________________
Council District No.: _________________
General Plan Designation: ____________
Zoning District: _____________________
Coastal Zone: Yes No Check #: __________
Visa MC Amex # ____________
CDM Residents Association and Chamber
Community Association(s): _______________________ Development No: __________________________
_____________________________________________ Project No: ________________________________
_____________________________________________ Activity No: _______________________________
Related Permits: ___________________________
Remarks:
________________________________________________________________________________________