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HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Applicaton: 04/05/2018 Permit Number:
"Property Address: 618 Via Lido Nerd
Newport Beach, CA 92663
**Buyer's Marries: Michael J. Carver and Brenda L. Carver, as Trustees of the
M. and a r evocable Trust dated March 22, 2000
Buyer's Signatures:
Billing Address: ,D &K 4 zo
01-41216e, zw 9 Z g"Si5
Telephone No,: `( l L 4 - --1 1-4 3 - a S'3 Bfe�J-c, Ce. LL
**Seller's Names: Gant. t. Primny,"TrAtee of the Gary E. Primm Family Trust
- ...__,Seller's Signatures: v
er 5 gnafure:
"Escrow Company: Blue Water Escrow Phone# 949-478-7900
*Address 1400 Newport Center Dr. #125, Newport Beach, CA 92660
**Escrow Number: 18-5839-JM **Pax #: 949-478-7999
Closing Date (Estimate): 05/17/18 Email: Jason@bluewaterescrow.cam
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
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Inspection Date:
Fee Maid:
Application Complete:
Reinspection Date:
1 Check�No:
Harbor Resokahs 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: �41 �/j
Inspection Requested By: .�
Inspector:
Pier Address:
Pier Transfer
GFI Present
Anti -Siphon / Backflow Present
Pump Out
Other Comments
Pier Location
(A Cf 5 V�_ /\A
Yes Need None Needed
4
Yes No
Operational
Recommended Action
Encroachment
Address of Complaining Party
Boat Description
CF Number
Location on Dock
Comments / Observations
Reinspection
Yes Need
Other Request
It