HomeMy WebLinkAboutPA2021-291_20211207_ADU QuestionaireCITY OF NEWPORT BEACH
ACCESSORY DWELLING UNIT (ADU) AND
JUNIOR ACCESSORY DWELLING UNIT (JADU)
QUESTIONNAIRE
1 Property Owner Name
3 Whal is the size and.bedroom
c:ourtt pf ytiur.ADV/JA8U :: .. : , , , , ; , ;, ,, , ', • '. ;" ,,, ·<~·,· 0 I;
bedrooms -----+----
.4 W~at•i~;tt\,:cqrr~~(mij~~lilYt~nt, .••••
ofif nof:.occi;a'.ipied~;,:the·a'ntrcfpc1~cj• $
•ro.9,~t~1vtt~n11✓.f~ • '. ·\. { •• , •
; (For m1-1!tipl~ 1-i.r)its;;. pl~se attach a t,able)
'''.! J ':. ·''\;~,; :'if,L:',{i;:;.,, ,;'.,:. ·<:. :.<(\0
·:·;,.:(:,. -t<<J.tr,.::;, F,X~J:,
Print Name
--&-month
Utilities included?□ Yes □ No
ff Rental / Supplemental Income
ti Permanent housing for senior
relatives 'ff Permanent housing for non-senior
relatives
Permanent housing for caretakers
Permanent housing for household
employee
~ Guest housing for visitors
□ Other: --------
~ Main house
□ Accessory Dwelling Unit
$ Junior Ac.9.§lssory °'welling Unit
□ None t;?11\+f tL-.
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PA No. Zoning Clearance No. ZC Approval Date
Building Permit No. Building Permit Issued Date Income Category
Planner Date Remarks