HomeMy WebLinkAbout24-1-5 Signed apps & pymtDocuSlgn Envelope ID: 69125DE0-4D89-42CB-989E-A700f9429726
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application: I! I S a3
**Property Address: i 5J Q
**Buyer's Names: I`1 `t N CM-QS uc
DocuSt dby: Docuftned by:
Buyer's Signatur ls� & Ste° Mew H"A
45115D0S88S14C8... IACACOCE0510C418...
Billing Address:
Telephone No.:
514 Market Street, Kirkland WA 98033
425-443-8607
**Seller's Names:
Seller's Signatures:
Joint Owner Signature:
"Escrow Company:
**Address
**Escrow Number:
**Closing Date (Estimate):
V� fJ (AN Phone#
**Email: 7
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
_____vaInspection Date:`%1 3011a: 'Reinspection Date: eP4 to a3
Fee Paid: &9-59 Check No: la-7c9
Application Complete: /1 k
Public Works Signature/Date
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
DocuSign Envelope ID: 653C51AD-32A1-4A1F-9729-39A817CA355F
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application: 051,93
a3
**Property Address: 1
0
UQ
**Buyer's Names:
Buyer's Signatures:
Billing Address:
Telephone No.:
**Seller's N
Seller's Sign
Joint Owner Sig
**Escrow Company: nvU
**Address -,?5
**Escrow Number: (06-1)1)'
**Closing Date (Estimate):
-I- 1AOY1110- bufflw4n
N Phone#
NOW
M
eKA (tm
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: _ — Reinspection Date:
Fee Paid: _ Check No:
Application Complete:
Public Works SignaturelDate
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code,
Date:
Inspection Requested By:
Inspector:
Pier Address:
Public Works
L
lE
t19
Pier Transfer
Reinspection
GFI Present Yes Need None Needed Yes Need
6s®'
Anti -Siphon / Backflow Present
Other Comments
Comments / Observations
ia) (e!,-:)3
Other Request
GROVE ESCROW
'9 001279