HomeMy WebLinkAbout18-11-6 Signed app`WP°� HARBOR PERMIT
ra TRANSFER APPLICATION
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t iI ` ,
i -� �00 Civic Center Drive
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• ��' Newport Beach, CA 92660
.:.... rr; Rc�..,: ; • 949-644-3044
**Date of Applicaton: o Permit Number:
"Property Address: 11oR �5-- -haq A� -1
**Buyer's Names:
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Buyer's: Slgnatures:X
Billing Address; o
Telephone: No_���
**Seller's Names: ;LJA m
Seller's Signatures:
Joint Owner Signature:
**Escrow Company: Jmsa- C—Sct mo S�,�JiC S, l,�r, Phone#
**Address�Iz. Igo,
**Escrow Number: 7-L�-- rn� **Fax #:
Closing Date (Estimate): ;y Email: C��R�S—[opt���z. <� ,�L.� o J6,Z�-A,
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: I I Lp Reinspection Date:
Fee Paid: Check No: _ 514(e2t
Application Complete: '
HarborResour ignature/Date
Special Conditions: This pern71t Is revocable by the City Council
In accordance with Title 17 of the Newport Beach Municipal Code.
DocuSign Envelope ID: 103E576B-8036-4AFA-8476-837CD6C88131
HARBOR PERMIT
TRANSFER APPLICATION
n 100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Applicaton: /, �, Permit Number:
**Property Address: ?),:.,i
r
**Buyer's Names:
Buyer's Signatures:
Billing Address:
Telephone No.:
**Seller's Names:; ?)Arrz
Seller's Signatur
z, 1 .
40
OFEO000349%4f0
Joint Owner Signature:
**Escrow Company: icSn� �,���� SIZviCLS, ��C. Phone#
**Address ct3Tw�,;Z � C�„r�z -1),t. �IHo 0 6 . Ca �itt�o
**Escrow Number: -C%C **Fax #: C��IGt� 3t5-3�g
Closing Date (Estimate): )�y Email: Ktrf, C i 0j;F 6A-���7U�
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS,
Inspection Date: lflulffReinspection Date:
Fee Paid: Check No:
Application Complete.,
Harbor Resources Signature/Date
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
INSPECTION FORAM
Harbor Resources Department
Date:
inspection: Requested By:
inspector:
Pier Address:
Pier Tra sfer
GPi Present
Anti -Siphon I Backlaw Present
Other Corn rents
Pump Out
Pier Location
Operational
Recommended Action
Encroachment
rlWdress cf Cor-pia"Ininq Pare
Boat Description
to ,tea I �
L
L
Yes / Need None Needed
1
i�
Yes No
Reinspection
Yes Need
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