The URL can be used to link to this page

Home My WebLink AboutPA2023-0117_20230608_Discretionary Application Owner's AffidavitCommunity Development Department Discretionary Application Owner's Affidavit 100 Civic Center Drive Newport Beach, California 92660 949 644-3200 newportbeachca.gov/communitydevelopment 1. Check Permits Requested: D Approval-in-Concept -AIC # D Coastal Development Permit D Lot Merger D Limited Term Permit - D Staff Approval D Tract Map 0 Waiver for De Minimis Development D Coastal Resident:al Development D Seasonal D < 90 day 0 >90 days D Modification Permit n Traffic Study D Use Permit -OM:nor □Conditional □ □ □ Condominium Conversion Comprehensive Sign Program Development Agreement 0 Off-Site Pa~king Agreement D Planned Community Development Plan D Amendment to existing Use Permit D Variance 0 Amendment -□Code □PC □GP OLCP D Development Plan D Planned Development Permit D Site Development Review - D Major D Minor D Zoning Clearance -□ADU D Use D Lot Line Adjustment ~ Parcel Map D Other: 2._ Proj~ddress(es)/As~sor's Parcel _No(s) _ _ ----·---·-· ·-_________ _ ·----1 l~l::'N 459-172-1_4 _________________________________________ _ __ .. _______ -----_____ .. ______ ---------.1 3. Project Description and Justification (Attach additional sheets if necessary): ,--. ---~------------ ! Exsting propert has 2 residential units. Proposed development will demolish the existing structures land construct 2 new residential duplex units I l -------·------- , . . *· j Robert Allen Hohberg -l 4 . Property Owners Aff1dav1t . (1) (We) _______________________ .. ______________________________ _j 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 are in all respects true and correct to the best of (my) (our) knowledge and belief. Signature 1~W£/!G,./U,_ ~ MM/DD/YEAR · 1··----------·····-1 1··- Signature(s): ----------~----Title: _________ . ____ Date: __ ---~ *May be signed by the lessee or by an authorized agent if written authorization from the owner of the record is filed concurrently with the applicatio:1. Please note, the owner(s)' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized. "Under the Levine Act, Section 84308 of the Government Code, a party to a proceeding before the City involving a license, permit, or other entitlement for use is required to disclose on the record of the proceeding any contribution in an amount of more than two hundred fifty dollars ($250) made within the preceding 12 months by the party or the party's agent to any elected or appointed officer of the City. If you have made a qualifying contribution, please ensure to make this disclosure on the record. Please review Senate Bill 1439 -Statues 2022 for further information" \\cnb.lc!\data\Users\COD\Shared\Admin\Ptanning_Oivision\Applications\Application_ Gu!delines\Planning Permit Owner's Aff adavit 2022 .docx Rev: 01/24/23 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 Lt6 ~\EY) } ss. . _ L , , On ~e 7M , 20'Z-'3> before me, ~\?Y,e~ 'eu," 1 ~'t;,."'-1 fvJ?\1 <;- Notary Public, personally appeared ~A-f:>T\\e~ \-t-,..~a , who proved to me on the basis of satisfactory evidence to be the pers n(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 ~ 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 , Notary Public, personally appeared . .. ..... GABRIELA RUI i COMM. G441920 tllTARYPUIIUC •CAUi' (seal) 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)