LUP2013-1000711
89 NE CLEVE►-p`N� ST
LUP2�13-� 0007
o j � ng & Development Department
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The KimberlY _� a1„endment A lication
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" Including Future Land Use Map Amendments
ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED IN PERSON (NO FAX OR
DELIVERIESj TO THE PLANNING & DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE DATE.
A TOTAL OF 11 COMP�ETE SETS OF APPLICATtON MATERIALS (1 ORIGINAL AND 10 COPIES) AS REQUIRED WITHIN ARE TO
BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. SUBSEQUENT SUBMITTAL FOR THE
COMMUNITY DEVELOPMENT BOARD WILL REQUIRE 15 COMPLETE SETS OF APPLICATlON MATERIALS (1 ORIGINAL AND
14 COPIES). PLANS AND APPLICATIONS ARE REQUIRED TO BE COLLATED, STAPLED AND FOLDED INTO SETS.
IT IS INCUMBENT UPON THE APPLICANT TO SUBMIT COMPLETE AND CORRECT INFORMATION. ANY MISLEADING,
DECEPTIVE, INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION.
THE APPLICANT, BY FILING THIS APPLICATION, AGREES TO COMPLY WITH ALL APPLtCABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE:
$885
$0
Future Land Use Map Amendment only, includes Zoning Atlas
Amendment
Comprehensive Plan Text Amendment
APPLICATION TO AMEND: y� FUTURE LAND USE MAP
(selectoneJ COMPREHENSIVE PLAN (TEXT)
PROPERTY OWNER (PER DEED): ._.�,N � �� ���L� �„�.p �,,,� g i I 1�, C
MAILIIVG ADDRESS:
1 � i� 9' A-� ��c� n��.e�"�
PHONE NUMBER: 7 Z� _ 44� — O 4 7! �l '3
EMAIL• {C ���L j� %-i iG 1 r1 g� i v }}��g O lec'�
AGENT OR REPRESENTATIVE: p��, � � _ �� � c� �� �
MAILING ADDRESS: � � .� � �,� L, �� Y � �
PHONE NUMBER:
EMAIL:
ADDRESS OF SUBJECT
PROPERTY (if applicable):
PARCEL NUMBER(5):
LEGAL DESCRIPTION:
DESCRIPTION OF TEXT .
AMENDMENT (if applicabie):
Specifically identify the
requested amendment to the
Comprehensive Plan
.
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Planning 8� Development Department, 100 S. Myrtle Avenue, Clearvvater, FL 33756, Tei: 727-562-4567; Fax: 727-562-4865
Page 1 of 5 Revised 03/12
° earwater
� � Planning & Development Department
Comprehensive Plan Amendment Application
U
Submittal Package Checklist
IN ADDITION TO THE COMPLETED COMPREHENSIVE PlAN AMENDMENT APPLICATION, ALL
COMPREHENSIVE PLAN AMENDMENT APPLICQTIONS SHALL INCLUDE A SUBMITTAL PACKAGE THAT
INCLUDES THE FOLLOWING:
C� tf the application is for an amendment to the Comprehensive Plan Future tand Use Map (tUP), in
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ad¢ftion to the application, the applicant must also provide the fol/owing:
L� Proof of ownership (e.g., copy of deed, title insurance policy, or other instrument demonstrating
/° wnership) [Note: Submit two copies on/y at time of original application]
� Legal description of the property. If the property is not a platted lot of record, a current boundary
survey prepared, signed and sealed by a land surveyor currently registered in the State of Florida is
/�equired.
� Information demonstrating that the proposed amendment complies with the criteria set forth in
Section 4-603.F. The attached Comprehensive Plan Amendment Standards for Review sheet shall be
�sed to provide these responses.
�' An assessment of the impact of the proposed change on the adequacy of public facilities, the
environment, community character, and the fiscal condition of the city.
If the app/ication is for an amendmeni to the Comprehensive Plan text (CPAJ, and does not affect an
individual parcel of land, in addition to the application, the applicant must also provide the following:
0 Data and analysis to support such an amendment under Florida Statutes.
u ii�ivi'iiiaiivi� ti�iliOi�Siiaiiii� tiiai i1i� j�iiij�OS2u aii'iCiiuiiic"�iit i.t3iii�'iiiC� wiiii i,ie �iiit"'fia S�i Il3►iii iii
Section 4-603.F. The attached Comprehensive Plan Amendment Standards for Review sheet shall be
used to provide these responses.
A Traffic Impact Study is not required as part of the application for an amendment to the Comprehensive
Plan Future Land Use Map (LUP). A Traffic Impact Study may be provided at the applicant's discretion to
supplement the assessment of the impact of the proposed change on the adequacy of public facilities
(existing roadways). A Traffic Impact Study may be required at the time a site plan is submitted for
development review if the total generated net new trips generated by the proposed development meet
one or more conditions outlined on the appropriate application.
57 PUBLIC HEARING ATTENDANCE: The a licant or a lican '
pp pp t s agent is advised to attend all public
hearings scheduled for the proposed amendment including public hearings before the Community
Development Board and City Council.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 3 of 5 Revised 03/12
° 1 ter Planning & Development Department
� C e a r w a C o m r e h e n s i v e P l a n A m e n d m e n t
P
� Standards for Review
PROVIDE COMPLETE RESPONSES TO EACH OF THE SIX (6) STANDARDS FOR REVIEW EXPLAINING HOW, IN
DETAII, THE CRITERION IS BEING COMPLIED WtTH PER THIS COMPREHENSIVE PLAN AMENDMENT.
1. The amendment will further implementation of the comprehensive plan consistent with the goals,
policies and objectives contained in the plan.
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2. The amendment is not inconsistent with other provisions of the comprehensive plan.
3. The available uses, if applicable, to which the property may be put are appropriate to the property in
question and compatible with existing and planned uses in the area.
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4. Sufficient public facilities are available to serve the property.
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5. The amendment will not adversely affect the natural environment.
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6. The amendment will not adversely impact the use of property in the immediate area.
L x i S T c� S E �D a c� s �t/ o T y� ,� ,� G�"
Planning 8 Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 4 of 5 Revised 03/12
o � Planning & Development Department
� C earwater �om
prehensive Plan Amendment
� Affidavit to Authorize Agent/Representative
1. Provide names of all property owners on deed — PRINT full names:
2. That (I am/we are) the owner(s) and record title holder(s) of the following described property:
3. That this property constitutes the property for which a request for (describe request):
4. That the undersigned (has/have) appointed and (does/do) appoint:
as (his/their) agent(s) to execute any petitions or other documents necessary to affect such
petition;
5. That this affidavit has been executed to induce the City of Clearwater, Florida to consider and act on the
above described property;
6. That site visits to the property are necessary by City representatives in order to process this application
and the owner authorizes City representatives to visit and photograph the property described in this
application;
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Property Owner
Property Owner
STATE OF FLORIDA, COUNTY OF PINELLAS
Property Owner
Property Owner
BEFORE ME THE UNDERSIGNED, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON
THIS DAY OF , PERSONALLY APPEARED
WHO HAVING BEEN FIRST DULY SWORN
DEPOSED AND SAYS THAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED.
Notary Seal/Stamp
Notary Public Signature
My Commission Expires:
Planning 8� Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562�567; Fax: 727-562-4865
Page 5 of 5 Revised 03/12
s
� 1 r Planning & Development Department
� � earwate Com rehen '
p s2ve Plan Amendment Applicat�on
" Including Future Land Use Map Amendments
PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAILURE TO COMPLETE THIS
FORM WILL RESULT IN YOUR APPLICATION BEIMG FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING
APPLICATION CYCLE.
FUTURE LAND USE PLAN DESIGNATION
PRESENT:
R EQU ESTED:
ZONlNG DISTRICT
PRESENT:
R EQU ESTE D:
SITE AREA:
sq. ft.
MAXIMUM ALLOWABLE DENSITY/INTENSITY(S) :
Cu rre nt/Existing
Future Land Use(s):
Proposed Future
Land Use(s):
(units, rooms or beds per acre or non-
resideniial square footage)
acres
USE(S):
Existing (currently on site
or previous use if vacant):
Proposed (new use, if any;
plus existing if to remain):
FUTURE LAND USE PLAN DESIGNATIONS FOR ALL ADIACENT PROPERTY:
North:
South:
East:
West:
STATE OF FLORIDA, COUNTY OF PINELLAS
I, the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my
knowledge and authorize City representatives to visit and photograph the property described in this application.
Sworn to and subscribed before me this day of
Signature of property owner or representative
produced
Notary public,
My commission expires:
. to me and/or by
who is personalty known has
as identification.
Planning 8 Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 2 of 5 Revised 03/12