HomeMy WebLinkAbout18-5-16 Signed app_insplooaE
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HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Applicaton: 5/11/2018 Permit Number:
**Property Address: 2282 Channel Road
Newport Beach, CA
**Buyer's Names: William E. Breech
Buyer's Signatures:
Billing Address: Z f 2- F 1 o c C,4,U >3 c,,o
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Telephone No.: F,,-( q- T 4> 4— y S�
**Seller's Names: Christine L. Simmons, Trustee
Seller's Signatures: ���r_ kllt&W
Joint Owner Signature:
Deborah Johnson
**Escrow Company: Mariners Escrow Phone# (949) 721-6486
**Address 270 Newport Center Drive, Suite 200, Newport Beach, CA
**Escrow Number: 54487-DJ **Fax #: (949) 721-8157 92660
Closing Date (Estimate): 5/29/2018 Email: djohnson@marinersescrow.com
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: Reinspection 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 FORM
Harbor ResourcesDepartment
Date:
Inspection Requested By:
Inspector:
Pier Address:
Pier Transfq
Reinspection
GFI Present Yes Need None Needed Yes Need
Anti -Siphon / Backflow Present
Other Comments /
Pump Out I
Pier Location
Yes No
Operational
Recommended Action
Encroachment
Address of Complaining Party
Boat Description
CF Number
Location on Dock
Comments / Observations
Other Request