HomeMy WebLinkAbout21-3-1 App& signaturesDocuSlgn Envelope ID; B36C463C-66C1-4A78-A4B3-OCE21607C7DD
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application:
**Property Address: 2m Jlp. La-o y �,
**Buyer's Names: jo n e L - fwd�o cv—
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Buyer's Signature53CC8041889224VA
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Billing Address: 210 via Lido Nord, Newport Beach, CA 92663
Telephone No,: 949-939-1442
**Seller's Names:
Seller's Signatures:
Joint Owner Signature:
**Escrow Company:
**Address
**Escrow Number:
**Closing Date (Estimate):
CVV
*STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCeSS,_
Inspection Date: 1 dl ! Reinspection Date: _ .-
Fee Paid: $fib Ch ck No: jI!BJ
Application Complete:11
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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,
GROVE ESCROW
GROVE ESCROW
0 SUPERIOR PRESS (888) 590.)990 JB3944293 1111111IIIII 111111111111111 IIIII IIIII IIII IIII
001183
001183
INSPECTION FORM
Date:
Inspection Requested By:
Inspector:
Pier Address:
Pier Transfer
GFI Present
Anti -Siphon / Backflow Present
Other Comments
Comments / Observations
Other Request
Public Works
A
SP-I0 l!s
Yes Need None Needed
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Reinspection
Yes Need