HomeMy WebLinkAboutPA2022-0263_20221108_Discretionary Application Owner's AffidavitCommunity Development Department
Discretionary Application
Owner's Affidavit
1. Check Permits Requested:
D Approval-in-Concept -AIC #
D Coastal Development Permit
0 Waiver for De Minimis Development
D Coastal Residential Development
D Condominium Conversion
D Comprehensive Sign Program
D Development Agreement
D Development Plan
D Lot Merger
D Limited Term Permit -
0 Seasonal O < 90 day 0 >90 days
D Modification Permit
D Off-Site Parking Agreement
D Planned Community Development Plan
D Planned Development Permit
D Site Development Review -
0 Major O Minor
D Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
j 427-241-05
fl
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca .gov/commu nitydevelopment
D Staff Approval
D Tract Map
D Traffic Study
~ Use Permit -~Minor □Conditional
~ Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP OLCP
D Zoning Clearance -□ADU D Use
D Other:
3. Project Description and Justification (Attach additional sheets if necessary):
THE AMENDMENT TO THE EXISTING USE PERMIT IS TO EXTEND THE HOURS OF
OPERATION FROM 10:00 AM TO 2:00 AM, MONDAY -SUNDAY AND TO PERMANENTLY
ALLOW FOR AN OUTDOOR PATIO DINING AREA s,.;b._j«.-1-+c -t-i-te.+t:rtn>; lo,-..J.d ;M, o"J co v"n c n-1-<. of
--r/to.-t" c.er+~i,,,. £.e,;se cla--f-eJ! Fe hrv,uy :2.s--+1--.2..02.2../-ror r«Feren.:.e f'v rf'<'.S:e..s o,-.,ty_ b_y,r,r,,I be-f-w"<i!"'
G.. l e. V ( on. E vt"-f 1e > Ll-C ''L e..S-Jl>r ") ttn.t! Kcz I ,e. ,,,e.r ,£ .5 Iµc, 4 c,_ ;; 0 r/l,--,I /1.,n (''LeS5e<!')
I E Lf:VA,1'iJtv £.l"'lu 1-r i°ES LLc. 4. Property Owner's Affidavit*: (I) (We) ~ ,z
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
submitted are in all respects true and correct to the best of (my) (our) knowledge and belief.
F-./e... vtJ..+ttiN Eiu/+i'e..s1 LLC... J
Signature(s):..8;,.-/4/a,l!lf;~1·,-t-/n,Atvf{G-f;.fC:. Title: /YI A tJA 6-E/?-
J
I Oate: I iifa2-/.2o.2z l
MM/DD/YEAR
Signature(s): _______________ Title:,___ _________ __, Date:~-----~
*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.
\\cnb lcl\data\Users\COO\Shared\Adm1n\Plann1no 01v1sion\Aoolicat1ons\Aoolicallon Gu1dellnes\P/ann1na Permit Owner's Affadav1t 2022 docx Rev 07/05/22
PA2022-0263
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:
________________________________________________________________________________________