HomeMy WebLinkAbout22-7-27 Signed app & pymtHARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application: 211112, 011 2'
**Property Address: -_�I 2 U V ig LI &b No
**Buyer's Names: 1a� a Qh\A t AI kyylai L\L�
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Buyer's Signatures: Ili Y s1E
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Billing Address:
Telephone No.:
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**Seller's Names:
Seller's Signatures:
Joint Owner Signature:
**Escrow Company:
**Address
**Escrow Number:
**Closing Date (Estimate):
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Phone#—Tt�040
* *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: _71311 Reinspection Date:
Pee Paid: )-1�0_ Check No:
Application Complete:
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.
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Check No. 106975
Order No. CWNB-HP-1115
Amount $250.00
Payee: City of Newport Beach
Order Number: CWNB-HP-1115
Closer Name: Heidi Parker
Property: 920 Via Lido Nord, Newport Beach, CA 92663
City of Newport Beach
100 Civic Center Drive
Newport Beach, CA 92660
Check No. 106975
Order No. CWNB-HP-1115
Amount $250.00
Payee: City of Newport Beach
Order Number: CWNB-HP-1115
Closer Name: Heidi Parker
Property: 920 Via Lido Nord, Newport Beach, CA 92663
Paid to City of Newport Beach
Date 07/21/2022
Memo: Dock Transfer Fee
Amount Breakdown
Dock Transfer Fee. $250.00
Paid to City of Newport Beach
Date07/21/2022
Memo: Dock Transfer Fee
Amount Breakdown
Dock Transfer Fee $250.00
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Date:
Inspection Requested By:
Inspector:
Pier Address:
INSPECTION FORM
Public Works
1?00 VLNJ
ier Transfer
Reinspection
GFI Present Y Need None Needed Yes Need
Anti -Siphon / Backflow Present
Other Comments
Comments / Observations
Other Request