HomeMy WebLinkAboutPA2022-0259_20221103_Discretionary Application Owner's AffidavitCommunity Development Department
Discretionary Application
Owner's Affidavit
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit-
□ Waiver for De Minimis Development D Seasonal D < 90 day 0>90 days
D Coastal Residential Development D Modification 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
□ Development Plan D Site Development Review -D Major D Minor D Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
11314 Bison Ave. Newport Beach, 92660
C
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
~ Use Permit -lilMinor □Conditional
D Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP □LCP
D Zoning Clearance -□ADU D Use
D Other:
3. Project Description and Justification (Attach additional sheets if necessary):
I The parking was evaluated under the original blanket use permit back in the early 2000s, which
allowed for 10 fast casual type restaurants in the shopping center. This should still apply for this use
in this space. Please see the attached parking matrix.
------------------------····----------·-·-·--··----·-----·------------·--·----------_____________ ., ________________________ !
4. Property Owner's Affidavit*: (I) (We) jTimoiny iviurphy I
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (1) (We) further certify,
under penalty of perjury, that the foregoing statements and answers herein contained and the information herewith
submitted aret;;in an-~ez:zz-= ~/and correct to the best of (m1:,.(coeur)pknreowsl1'eddegentand belief.I I // / . / I
Signature(s): ---~,,,,,.-'---+--,,,:;...--------Title:~---------~ Date: , / b.'J.#0~>-
MM/DDIYEAR r -I
Signature(s): ______________ Title: ~I---------~ Date:~:-----~
*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.
llcnb.lclldata\Users\CDD\Shared\Admin\Planning_Division\Applications\Application_Guidelines\Planning Permit Owne(s Affadavit 2022_docx Rev: 07/05/22
PA2022-0259
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:
________________________________________________________________________________________