HomeMy WebLinkAbout22-7-12 Signed appv
HARBOR PERMIT
TRANSFER APPLICATION
u k 140 Civic Center Drive
C,fr Newport Beacli, CA 92660
949-644-3044
**Date of Application: Jo ot5 ? '2-0 z_
**Property Address:, u
**Buyer's Names: i"4 } r i &A'IfS) %� 11 t-V
Buyer's Signatures: /4-1 r) RR``
Billing Address: q� oikywr--, PANE- lVEW606r-Ml�-A 91660
Telephone No.: y�i _7t J- 011 1
"Seller's Names: EC
Seiler's Signatures: -,
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Joint Owner Signature:
**Escrow Company:?`l�l' Phone#,
**Escrow Number:
**Closing Date (Estimate): f A,'
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
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Inspection Date:]2_ZReinspection Date;
Fee Paid: � `f5 Check No:
Application Complete:, S
Public Works Signature/Date
oj)0 ial Conditions: This hermit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Munlclpal Code.
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INSPECTION FORM
Public Works
Date:
Inspection Requested By: Z'
Inspector:
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Pier Address: glct f80_VSj jLQ
Pier Transfer
Reinspection
GFI Present Yes i None Needed Yes Need
Anti -Siphon / Backflow Present —J
Other Comments
Comments / Observations
Other Request