HomeMy WebLinkAboutPA2021-309_20211223_ApplicationCommunity Development Department Planning Permit Application
1.Check Permits Requested:0 Approval-in-Concept - AIC # 0 Lot Merger 0 Coastal Development Permit O Limited Term Permit -O Waiver for De Minimis Development O Seasonal O < 90 day 0>90 days 0 Coastal Residential Development O Modification Permit O Condominium Conversion O Off-Site Parking Agreement
O Comprehensive Sign Program O Planned Community Development Plan
O Development Agreement O Planned Development Permit 0 Development Plan O Site Development Review - 0 Major O Minor 0 Lot Line Adjustment O Parcel Map
2.Project Address(es)/Assessor's Parcel No(s)1240 Newport center dr. Suite 100 APN: ORG 442-161-05
PA2-oi,t-6oq �lo \ii z__;lt\
CITY OF NEWP()HT BEJ\(H 100 Civic Center Drive Newport Beach, California 92660 949 644-3200 newportbeachca.gov/communitydevelopment
0 Staff Approval 0 Tract Map 0 Traffic Study
� Use Permit -□Minor �Conditional 0 Amendment to existing Use Permit 0 Variance □Amendment -□Code □PC □GP □LCP0 Other:
3.Project Description and Justification (Attach additional sheets if necessary):I SEE ATTACHED
4_ Applicant/Company Name j WILD STRAWBERRY CAFE
Mailing Address 1 240 NEWPORT CENTER DR
City I NEWPORT BEACH
Phone 1949 922-0762 I Fax I NONE
Suite/Unit I 1 OO ';:::======,
State I CA I Zip �I 9_2_66_0 __ �I Email I KAZICNATASHA@YAHOO.COM
5 C t tic N I KEVIN FRANKLIN ·"' ·• .. : ·. . on ac ompany��a�m�e�==================================:;------;:::===========i'
Mailing Address 1 30408 OLYMPIC ST I Suite/Unit ';:::=======�
City ICASTAIC State ICA I Zip 191 384
Phone j 213 83-6043 Fax �I N_O_N_E ___ �I Email I LIQUORSPECIALIST@MSN.COM I
6.Property Owner Name 1--iAO N-ewe2rzt Ce� �,ve I /lSSDClates ,li� I
Mailing Address I 11eo NAfeofbr eent.eti-D?tv-e. I Suite/Unit I -ivo I
City I �w� Beo.eh I State I Cit I Zip I ttiwwo I
Phone ffi44ii40 -Cf l'X> I Fax rq4'T)1</0•afrq Email 1-thotvedt@DUttnhtltvlusa ,COtl
7.Property Owner's Affidavit*: (I) (We) I tAo N , � Ce,vitett-'PP1' {� �ociates l.P. Idepose 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 perjui;y that the foregoing statements and answers herein contained and the information herewith submitted are in all re ects true and orrect to the best of (my) (our) knowledge and belief.
___...,,.,_CL.....:C......:......;;;.....->d---'-"""'-----�Title: I ld-ent I Date: I 1'2-(21 ,�, IMM/DD/YEAR
Signature(s): Title: �--------� Date: �----�I --------------
*May be signed by the lessee or by an authorized agent if written authorization from the owner of record is filed concurrently with theapplication. Please note, the owner(s)' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized.
I :\Users\CDD\Shared\Admin\Planning_ Division\Applications\Application _ Guidelines\Planning Permit Application_2021.docx Rev: 01/24/17
PA2021-309
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:
________________________________________________________________________________________
PA2021-309