HomeMy WebLinkAboutPA2022-0306_20221215_DISCRETIONARY APPLICATION OWNER'S AFFIDAVITCommunity Development Department
Disc retionary Application
Owner's Affidavit
1. Check Permits Requested:
0 Approval-In-Concept• AIC #
Ill Coastal Development Permit
D Waiver for De Mlnimls Development
0 Coastal Residential Development
0 Condominium Conversion
0 Comprehensive Sign Program
0 Development Agreement
D Development Plan
0 Lot Merger
0 Limited Term Pennit -
0 Seasonal D < 90 day 0>90 days
0 Modification Permit
0 Off-Site Parking Agreement
0 Planned Community Development Plan
0 Planned Development Permit
D Site Development Review -D Major D Minor
D Lot Line Adjustment O Parcel Map
2. Project Address(es)/Assessor's Parcel No(s) I 2286 Channel Road / APN 048 283 02
100 Civic Center Drive
Newport Beach, Callfomia 92660
949 644-3200
newportbeachca gov/communitydevelopment
D Staff Approval
□Tract Map
D Traffic Study
D Use Permit -□Minor □Conditional
0 Amendment to existing Use Permit
D Variance
0 Amendment -□Code □PC □GP O LCP
D Zoning Clearance • □ADU D Use
0 Other.
3. Project Description and Justification (Attach additional sheets if necessary):
Revised SFR w/attached garage and roof deck in an R-1 zone previously
approved per PA 202-323, CD 2020-152, ZA 2021-028. Revision to
approved plans include a new 3rd leve1 enclosed area and new 3rd level
•May be signed by the lessee or by an authorized agent if written authorization from the owner or record is filed concurrently with the
application. Please note. the owner(s)' signature for Pare.el/Tract Map and Lot Line Adiustment Application must be notarized.
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PA2022-0306
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:
________________________________________________________________________________________