HomeMy WebLinkAbout18-8-7 Signed pr trnsfr,Z34
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Applicaton: 0/a Permit Number:
**Property Address: 05
g
**Buyer's Names: od O
DocuSigned by:
Buyer's Signatures:
B7678731FSCUA6..
Billing Address:
Telephone No.:
**Seller's Names: CvaA.. 4
Seller's Signatures: Wy—avk
25180894A15409.
Joint Owner Signature:
**Escrow Company: �Ll.r}'i �2 PfU()c k_) Phone# q -
**Address4—D I. OE4-r�X- ' *I- to M
**Escrow Number: 6t `T`L **Fax #:9-
Closing Date (Estimate): / N Emal r6nq @A r ' -}P...-oc-t
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
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Inspection Date: Rei pectio fate:
Fee Paid: �2 ,� �/k,No: 61-35C
Application Complete:
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 Resources Department
Date:
Inspection Requested By:
Inspector:
Pier Address
Pier Transfer
Reinspection
GFI Present
Yes Need None N[Q9,09d Yes Need
Anti -Siphon 1 Backfiow Present
Other Comments
Pump Out
Pier Location
Yes No
Operational
Recommended Action
Encroachment
Address of Complaining Party
Boat Description
CF Number
Location on Dock
Co€ ments f Observations
Other Request