HomeMy WebLinkAboutPA2023-0038_20230213_Planning Permit Owners Affidavit Signed Community Development Department
Discretionary Application
Owner’s Affidavit
CITY OF NEWPORT BEACH
100 Civic Center Drive
Newport Beach, California 92660
949 644-3200
newportbeachca.gov/communitydevelopment
\\cnb.lcl\data\Users\CDD\Shared\Admin\Planning_Division\Applications\Application_Guidelines\Planning Permit Owner's Affadavit 2022.docx Rev: 07/05/22
1. Check Permits Requested:
Approval-in-Concept - AIC # Lot Merger Staff Approval
Coastal Development Permit Limited Term Permit - Tract Map
Waiver for De Minimis Development Seasonal < 90 day >90 days Traffic Study
Coastal Residential Development Modification Permit Use Permit -Minor Conditional
Condominium Conversion Off-Site Parking Agreement Amendment to existing Use Permit
Comprehensive Sign Program Planned Community Development Plan Variance
Development Agreement Planned Development Permit Amendment -Code PC GP LCP
Development Plan Site Development Review –
Major Minor Zoning Clearance - ADU Use
Lot Line Adjustment Parcel Map Other:
2. Project Address(es)/Assessor’s Parcel No(s)
3. Project Description and Justification (Attach additional sheets if necessary):
4. Property Owner’s Affidavit*: (I) (We)
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.
Signature(s): ________________________________ Title: Date:
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.