HomeMy WebLinkAbout20200529_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit -
D 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
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca. gov /comm u n itydevelopment
p f-1-9.--01,.0 -lJ BO 00 P-"' I '-tJW
D Staff Approval
D Tract Map
D Traffic Study
D Use Permit -□Minor □Conditional
D Amendment to existing Use Permit
D Variance
D Development Plan D Site Development Review -D Major D Minor
0 Amendment -□Code □PC □GP OLCP
D Other:
Iii Lot Line Adjustment D Parcel Map
2 .. ProjectAddress(es)/Assessor's Parcel No(s)
14800 SURREY DRIVE, PARCEL NO. 475-074-01
3 .... Pr<:>j~c:t l:}E!~cripti<:>n ~nc.t ~'-'~tific:~ti<:>n (Att~ch. ~c.tdi~i<:>l'lal sh.E!et~ if nE!c:e~~ary):
ILOT LINE ADJUSTMENT OF RESIDENCES .
4. Applicant/Compa.-.y Nal!le IRDM su~y~~IN.~
Mailing Address 123016 LAKE FOREST DRIVE Suite/Unit !...1_4_o __ 9~=======::::.=,
City jLAGuNA HILLS State jcA j Zip.,_J9_2e_5_3~~--'--'j
Phone 1949-~22~1~69 Fax ~J ----------~' Email ,~D~~u~vE~l~~(g?~~~l~.co~ I
5. Contact/Company Name IRDM SURVEYING I
Sul·te·'Un 1·t ·1---------1 Mailing t\c.tdJE!S~ .,.____---~-~-~---~--~--;:::====-=--=--=--=::--....... 1 .
City __ ,..______ --~ ......... -.......... -...::::::::-...:::::-...::=--=:::-.::::::::.::::::::.::::;~~ --........ -......... ~ ........ -......... ---'~ ........ state ,____._I ~ ---~----_-_"'"""=._----:::...-"'.::...l _z ........ ip __ l ____ I
Phone I Fax _I ________ j Email .!.....J -'--'-'--'~-~~----~_.I
6_ Owner Name jJoH~ T VVARD ANDKATHERINE A CAREYA~C? TRUSTEES ?F THE CARE~ U~IN~ TRUST 5-31-19.
M .1. Add ·.14·8· oo .. s. UR. REY D·R··· IV···E·· S "t ·'U ·t ·1 81 Ing .. .. rE!sS .::::=============================----====:==:==:::=:...___.:::~U~I e, m '--. _~_-..::::-..::::-..::::..:::.::::::.:::::.:::::::::::==:
City jcoRONA DEL MAR State ,_!c~A~ ..... ~· =======::::.::::.::::.-::::.1 .............. z ...... J::....P ....... J.,_9_.-2_6~2_·~5_. ____ -___ ------~ -....:-....... '---'-
Fax ,.......1 ............... -~-1 Email ;!.-...-1 ~---------
7. Property Owner's Affidavit*: (I) ~J K v-1-th l,iJ& fJ • <!flt!lf , J., ~ ~ ~ lAJ ~
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) (We) further
certify, under penalty of perjury, that the foregoing statements and answers herein contained and the information
herewith sub dare in all respects true and correct to the best of (my) (our) knowledge and belief.
I . I
*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.
PA2020-080
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:
________________________________________________________________________________________
PA2020-080
ALL-PURPOSE
CERTIFICATE OF 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
Countyof Qr0tnge,
}
}
On Aft\.\ ¥:f) ')<y]-0 before me, Carissa Moni ue Norman, Notar Public
ere rnse name an I e o e o teer
personallyappeared ]"ohY\ J. wtury} ) Ka+he,ctne A-. Ca/e'f '
who 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 signature(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.
CAI
Notary Public Signature (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM
This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed, should be completed and attached to the document. Acknolwedgentsfrom
tinued) Af (I l(CAt1 j;,
Number of Pages __ Document Date ':l /?d /'>W'
CAPACITY CLAIMED BY THE SIGNER
□ Individual ( s)
□ Corporate Officer
(Title)
□ Partner( s)
□ Attorney-in-Fact
□ Trustee(s)
□ Other _________ _
other states may be completed for documents being sent to that state so long as the
wording does not require the Califomia notary to violate California notary law.
• State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
he/she/they, is lftfe ) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re~seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
❖ Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
❖ Indicate title or type of attached document, number of pages and date.
❖ Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document with a staple.
PA2020-080
Community Development Department
Planning Permit Application
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 O Planned Development Permit
D Development Plan O Site Development Review -D Major D Minor
Ill Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
716 CAMEO HIGHLANDS DRIVE, PARCEL NO. 475-074-08
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
D Use Permit -□Minor □conditional
D Amendment to existing Use Permit
D Variance
□ Amendment -□Code □Pc □GP □LCP
D Other:
3. Project Description and Justification (Attach additional sheets if necessary): lor LINE ADJUSTMENT OF RESIDENCES
4. Applicant/Company Name._lR_D_M_s_u_R_V_E_v,_N_G ________________ .,.....-_-...:-_-_-_-_-_-..=-..::::-'_I
Mailing Address ='2=30=1=6=L=AK=E==FO=R=E=S=T=D=R=IV=E========::;-----;::::=======::'.~S=.:u::::i~te/Unit ~14=09========::::::'..I
City !LAGUNA HILLS State I CA I Zip _,__,9_26_5_3 ___ __.I
Phone 1949-422-1869 Fax I I Email jRDMSURVEYING@GMAIL.COM j
5. Contact/Company Name =j R=D=M=S=U=R=V=E=v=,N=G======================:=:;---------;:==========~'
Mailing Address .,__ _______________ .... -_-_-_-_-_-_-___ ___. __ S_u_i_te/Unit ,_I .... _________________ -i___.l
City"---~ __ -~----_-_::::-_-_-_-__ ---;:::::..~~~-==---==::-1State ~' _ ~---_-_-_-_-_~_I _Zi-=--p _j ---1'
Phone I Fax ~I -----~' Email.,__ ____________ ___,
0 N JOHN 0. LINDGREN JR. AND GALE MARIE ATWOOD TRUSTEES OF THE ATWOOD/LINDGREN TRUST.
6. wner ame ~--;::::::;::=======================================i-------;::::===========i
7 / ~ Mailing Addreis j 11'cAMEO HIGHLANDS DRIVE I Suite/Unit_,__,.---_-..:::::-..:::::-..:::::--=--=-==~
City jcoRONA DEL MAR State jcA I Zip 192025 I
Phone I 9lf ~ -'1 d.l -1 Li 1 5 Fax _,__I _N_/_A _ ____.j Email I 0.)50-..t con <o 'a@,8,rna.1 \, C.G¥r/l
7. Property Owner's Affidavit*: (I) (We) 1-JoHN Cl, l1 I\JD<o~EIU I
depose and say that (I am)~ the owner(s) of the property (ies) involved in this application. (I) <:!!§) further
certify, under penalty of perjury;-ffiat 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.
~t:=~.L.::~~~~~==::::_-=---Title: 1-r Y-u..<:,-\-e.e I Date: fzz /tpr~ { 1 iiJo2v
DD/MONEAR
~----------------Title: 1--f<lA. s + e e.. I Date: lz-2-Ap 6 I, 2o F 0
*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.
F:\Users\CDD\Shared\Admin\Planning_Division\Applicallons\Application_Guldelines\Plannlng Permit Application -CDP added.docx Rev: 01/24117
PA2020-080
California Jurat Certificate
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 OY-Cl Vt~ <e
S.S.
Subscribed and sworn to (or affirmed) before me on this 22-
20 2° , by ____ \~) ......;;;.C)_,:.h...;;_n.....;..._~o~-~-N:-~-f---.s;~-+-ne;-(:-) (\__.__ _______ and
_ __,,(: __ ;-J_()J_\_e, __ m.........__Pr_t_w_o_c)_d _____ , proved to me on the basis of
Name of Signer (2)
satisfactory evidence to be the person(s) who appeared before me.
I
E m I
For other required information (Notary Name, Commission No. etc.)
DANIELA CHAVEZ ~
COMM ... 2300791 n
NOTARY PUBLIC-CALIFORNIA -i
ORANGE COUNTY W
My Term Exp. August 9, 2023 J
Seal
OPTIONAL INFORMATION -----------
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of
this jurat to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Document
The certificate is attached to a document titled/for the purpose of
containing ___ pages, and dated _______ _
Method of Affiant Identification
Proved to me on the basis of satisfactory evidence:
0 form(s) of identification O credible witness(es)
Notarial event is detailed in notary journal on:
Page # __ Entry# __
Notary contact: _________ _
Other
D Affiant(s) Thumbprint(s) D Describe: __
, "" ""~', ~".-' ~f \MhAII/ I 1 •~•~•.
PA2020-080
· .~ Community Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit -
D 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
D Development Plan D Site Development Review -D Major D Minor
[ii Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
722 CAMEO HIGHLANDS DRIVE, PARCEL NO. 475-074-07
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
D Use Permit -□Minor □Conditional
D Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP □LCP
D Other:
3. Project Description and Justification (Attach additional sheets if necessary):
ILOT LINE ADJUSTMENT OF RESIDENCES
4. Applicant/Company Name ~IR_D_M_s_u_R_V_EY_I_NG ________________ .========-=-..:::::--_j
. Mailing Address 123016 LAKE FOREST DRIVE Suite/Unit ~'-4_0_9-=--=--=--=--=--=--=--=-~'
City !LAGUNA HILLS State! .---c-A------, Zip -'--19_26_5_3 ___ __.I
Phone 1949-422-1869 I Fax......-------, Email IRDMSURVEYING@GMAIL.COM [
5. Contact/Company Name IRDM SURVEYING I
Mailing Address Suite/Unit -=--'---__________________ __._I
City -----;::::::==:::::==:::::==:::::==:::::==:::::==:::::==::-;----;::.======:=:::-s_tate --;::...-=--=--=---=---=---=--=--=--:.:::::.'-Z-=-ip_ ~'--_-_ -_ -_------~,I
Phone~-------~ Fax_l ____ ~I Email ___________ ~
0 N 'LEONG. SKEIE AND CHERYL A. SKEIE TRUSTEES OF THE SKEIE FAMILY REVOCABLE TRUST 1-23-08
6. wner ame __ ~=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-.=:;----------:=============:
M ·1· Add !122 CAMINO HIGHLANDS DRIVE I S "t /U ·t I a1 mg ress ~----------------------' U1 e m -;=..-=--=--=--=--=--=--=--=--=--=--:::.
City lcoRONA DEL MAR State lcA / Zip _19_26_2_5 ___ _
Phone j(q4 q) lt,L.Jtt-5Ct, It,? Fax I I Email I ~~.t2.~~ <Sf.>C.G,LJ.:8AL, ~,-
7. Property Owner's Affidavit*: (I) (We) ~ N~~i:;; \ ,5 Q
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this pplication. (I) (We) further
certify, under penalty of perjury, that the foregoing statements and answers herein contained and the information
herewith submitted all respects true and correct to the best of (my) (our) knowledge and belief.
Signature( : -"'--~~~.....:.~(JI'.-.,__=-_-_--__ ~_-_ .. __ ,,~--Title: I C, lA.)A../~l reut,-z~ I Date: I 4 I z-z,I 202A> I
DD/MONEAR
Signature(s): ~() ft. '?i-ku L Title· IOJ.J'iWI/ -t:(li1l«..__ I Date: k/73/.20?0 f
*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.
F:\Users\CDD\Shared\Admin\Plannina Division\Aoolications\Aoolication Guidelines\Plannina Permit Aoolication -CDP added.docx Rev: 01/24/17
PA2020-080
California Jurat Certificate
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 C) Y Ci\ V\ ~ Q
S.S.
Subscribed and sworn to (or affirmed) before me on this ')d-day of A--pri l
Month
20 zO , by ___ L._e_o_V\ ___ 6_::;i_. _s_·_~_~_\_e.. _________ and
Name of Signer (1)
__ C _____ h_e.._v-_d __ l __ VT-_~ -~-~_e_t 'E., ____ , proved to me on the basis of
Name of Signer (2) ·
satisfactory evidence to be the person(s) who appeared before me.
For other required information (Notary Name, Commission No. etc.)
DANIELA CHAVEZ ~
COMM ... 2300791 o
NOTARY PUBLIC-CALIFORNIA -1
ORANGE COUNTY W
My Term Exp. August 9, 2023 J
Seal
OPTIONAL INFORMATION -----------
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of
this jurat to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Document
The certificate is attached to a document titled/for the purpose of
containing ___ pages, and dated _______ _
Method of Affiant Identification
Proved to me on the basis of satisfactory evidence:
0 form(s) of identification O credible witness(es)
Notarial event is detailed in notary journal on:
Page#__ Entry# __
Notary contact: _________ _
Other
D Affiant(s) Thumbprint(s) D Describe: __
""' ""~"_.,,....::it \Af\A/\h/ I 1,~,v,.
PA2020-080