HomeMy WebLinkAboutPA2021-271_20211109_Application,::;"-"'·-· PO'"'• tt," . 'I,-~\
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Community Development Department
Planning Permit Application '·~i'Ir~~:/
1. 1 Check Permits Requested:
D Approval-In-Concept· AIC # D Lot Merger
D C~astal Development Permit D Limited Term Permit -
D i\Vaiver for De Minimis Development D Seasonal D < 90 day 0>90 days
D Co'astal Residential Development D Modification Permit
D Co1ndominium Conversion D Off-Site Parking Agreement
D C~mprehensive Sign Program D Planned Community Development Plan
D Development Agreement D Planned Development Permit
D De~elopment Plan D Site Development Review -D Major D Minor
D Lo\ Line Adjustment Iii Parcel Map
2. i Project Address(es)/Assessor's Parcel No(s)
/~24 Fernleaf Ave/ APN 459-113-09 ...
i
CllY OF NtWPORl llF/\CH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
ne\vportbeachca.gov/wmmunitydevelopment
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. lProject Description and Justification (Attach additional sheets if necessary):
[' EE ATTACHED
4. Applicant/Company Name lclVILSCAPES ENGINEERING, INC. j
Mailing Address 128052 CAMINO CAPISTRANO Suite/Unit j213 I -====~
iCityjLAGUNA NIGUEL I StatelcA . . . I Zipl92677 I
! Phone 1949-306-3793 Fax L I Email jWILL@CIVILSCAPES.COM I
'
5. ; Contact/Company Name jCIVILSCAPES ENGINEERING, INC. I
: Mailing Address I Suite/Unit ';:I=====:::::!'
; City '--;:=======---;=:===~State ~I -;:::====·=-' ...'.Z:'Jip~'====:j
: Phone Fax~~~~~~··~' Email~--~~~---------' I
6.: Property Owner Name IBIRE II, LLC I
; Mailing Address 17642 W. IRVING PARK RD Suite/Unit'======!'
Cit)NORRIDGE I State Ill. I Zip j60706 J
Rhone j773-961-8453 J Fax'~----~' Email jjohn@decarrier.com J
7. Property Owner's Affidavit*: (I) (Weil CA ht,.,,., &i.-1,..o ·· b.E W..P....ttih-J
depose and I 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 submitted are in all respects true and correct to the best of (my) (our) knowledge and belief.
$ignature(s): O~ Jdk.,.,-,-1L ~ I .,, ;;.,._~,"'-j I // 07, lw.,,, Title: L__v:__".c.....:...v -~-__J Date:~~/'~/_'~
Mll.1/DD/YEAR
~ignature(s): ______________ Title: ~--------~Date:~' -----J
*Mi3y 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.
l:\Us~rs\CDD\Shared\Admin\PJannlng_DMslon\Applicatlons\Appficatlon_ Guide\'nes\Plannlng Permit Appficatlon_2021.docx Rev. 01124117
PA2021-271
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, IL1,/rJ.O 1;;,
County of Coo/<. ) ss. c.'t \ \ _
On {l.}oic1\'\fb.;'--.;1.. , 2Qd--1 before me, · /<-VT\+D,4:>D(h,l ,
Notary Public, personally appeared --0~,J Sen-A"-'u·· '.:&0G?-,e,e.1e'l'v , 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 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 :C<Mrw •!I that the foregoing
paragraph is true and correct. ,
WIT my hand and official seal. t1-i~ OFFICIAL SEAL
RUTHDDOAN
NOT ARY PUBLIC • STATE OF ILLINOIS
MY COMMISSION EXPIRES:10118/22
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 _________ _J ss.
On ___________ , 20 __ before me,
Notary Public, personally appeared ,----,-,----,---,---,-------,--,-----,------,-c-c--,--'
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)
PA2021-271
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:
________________________________________________________________________________________
PA2021-271