HomeMy WebLinkAbout17-1-26 signed appHARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Applicaton: Permit Number:
**Property Address: 720 via Lido Nord
**Buyer's Names: Li, I 4c�- Q--TAv,
Buyer's Signatures:
Billing Address:
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Telephone No.: ri yel 4 3�- ZL4 13
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**Seller's Names:
Seller's Signatures: _ ---/
Joint Owner Signature:
**Escrow Company: Phone# G yy-393 g
"Address
**Escrow Number: Q,s/�'/� -1�D **Fax #:93,V
Closing Date (Estimate) ,? 3 - f r Email: C41 Ci,—)
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
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Inspection Date:
Fee Paid:
Application Complete:
Reinspection Date:
Check No:
Harbor Resources Signature/Date
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
INSPECTION FORM
Harbor Resources Department
Date: 1/11 7
Inspection Requested By:
Inspector:
Pier Address:
,P"ier Transfer J}
GFI Present
Anti -Siphon / Backflow Present
Other Comments
Eelgrass
7c-40 VLN
Yes Need None Needed
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Date Time ❑ Eelgrass Within 15' of Project
Eelgrass Within 15' - 30' of Project
❑ No Eelgrass in Project Area
Pump Out
Pier Location
Yes No
Operational
Recommended Action
Encroachment
Address of Complaining Party
Boat Description
CF Number
Location on Dock
Comments / Observations
Other Request
Reinspection
Yes Need
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