ANX2013-08025ClearwaterPlanning & Development Department
Petition for Annexation
ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED IN PERSON (NO FAX OR
DELIVERIES) TO THE PLANNING & DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE DATE.
A TOTAL OF 14 COMPLETE SETS OF APPLICATION AND SUPPLEMENTAL MATERIALS (1 ORIGINAL AND 13 COPIES) AS
REQUIRED WITHIN ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. APPLICATIONS
AND SUPPLEMENTAL MATERIALS ARE REQUIRED TO BE COLLATED AND STAPLED 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 APPLICABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE: $0
IMPACT FEE /ASSESSMENT FEE: TBD Information on Impact Fees or Assessment Fees is available from
the City of Clearwater Engineering Department (562- 4747).
PROPERTY OWNER (PER DEED): 4 f � fft&
MAILING ADDRESS: Z g !A l'�-ty" D (Y PA 4- 0, r ,,.2 P, 4— l 34 9,5-T
PHONE NUMBER: 2 `1 —`�4%- 0 01
EMAIL: �i �£ �. (• j- -s
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
ADDRESS OF SUBJECT
PROPERTY: l L}' 1 n t t7 ,�`I" . C Qr' u�C�� -E r2, \ J 7�-s
PARCEL NUMBER(S): U O I- U D
LEGAL DESCRIPTION: C l c_O.r iS u_n Lk A , L o-i t 8
CURRENT CITY SERVICES: SANITARY SEWER SOLID WASTE WATER
REQUESTED CITY SERVICES:_ SANITARY SEWER _� SOLID WASTE
(select all that apply)
1247 UNION ST
ANX2013 -08025
Bellman, Juanita Browning
Zoning: Atlas #:
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727 - 562 -4567; Fax: 727 -562 -4865
Page 1 of 7 - Revised 03/13
C1earNater
Planning & Development Department
Petition for Annexation
Data Sheet
PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAILURE TO COMPLETE THIS
FORM WILL RESULT IN YOUR APPLICATION BEING FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING
APPLICATION CYCLE.
FUTURE LAND USE PLAN DESIGNATION
PRESENT (COUNTY):
REQUESTED (CITY):
ZONING DISTRICT
PRESENT (COUNTY):
REQUESTED (CITY):
SITE AREA: to � ` ( acres
SIZE OF DEVELOPMENT:
Existing:
Proposed: t
(e.g., number of units, hotel rooms or
non- residential square footage)
M
i
U h and ^kr C &M I rdED�ia
rn
TR)
USE OF PROPERTY:
Existing (currently on site).
Proposed (new use, it any;
plus existing if to remain):
If residential use, is unit(s)
rental
STATE OF FLORIDA, COUNTY OF PINELLAS
Si a Q i.� am ((A f
I (we), 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
-TUI(A a 0 1 3 .by
,TaAjo who i p rsonall nown /has
ure of property owner or representative
Signature of property owner or representative
produced as identification.
Notary public,
My commission expire
:os►"Y °� @� Notary Public State of Florida
Ann Fischer
My ommission DD925501
' ?oF nod Expires 11/29/2013
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727- 562 -4567; Fax: 727 - 562 -4865
Page 2 of 7 Revised 03/13
Clearn-ater
PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE NUMBER:
Planning & Development Department
Petition for Annexation
Disclosure Statement
ry
EMAIL:
OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBJECT PROPERTY:
NAME:
INTEREST IS:
SPECIFIC INTEREST HELD:
DOES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPERTY? YES NO
CONTRACT IS:
PARTIES INVOLVED — NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
ARE THERE ANY OPTIONSTO PURCHASE THE SUBJECT PROPERTY ?? 4— YES
PARTIES INVOLVED — NAME: k 2 ro Ld 1) c _!7 1 f �j PHONE NUMBER
NAiviE: PHONE NUMBER
ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? x. YES
NO 11
orrc 9E`�
;1 ? Z'7.2 —to a CEG0
NO
PARTIES INVOLVED — NAME: 0 WEAI 1-0Qn 5F-p-t1 Cinq , PHONE NUMBER:
NAME: t L_j# PHONE NUMBER:
STATE OF FLORIDA, COUNTY OF PINELLAS
I (we), 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 d�y of
by
re of property owner or
ntative
Signature of property owner or representative
)W /i/ / who is personally known /has
produced (/ /_J�� C� as identification.
Notary public,
My commission expire gW "u Notary Public State of Florida
Ann Fiscrier
:z My Commission D092 5u1
Expires O ,
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727 - 562 -4567; Fax: 727 -562 -4865
Page 5 of 7 Revised 03113
Clearwater
PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
CITY OF CLEARWATER CASE
NUMBER:
Planning & Development Department
Petition for Annexation
Supplemental Statement
WE
I /we,
[insert names of all property owners], having filed a Petition for Annexation regarding the above property /case number,
grant consent, agree and acknowledge that the City of Clearwater may immediately or at a later time process the application
to completion, including adoption and recordation of related Ordinances, without the necessity to further notice me /us. This
Supplemental Statement shall supersede any provision in any Agreement to Annex executed by me /us or my /our
predecessors in interest.
I /we further agree and acknowledge that I /we shall not rescind the Petition for Annexation or execute any documents
attempting such rescission, and that any attempted rescission shall be of no force and effect.
STATE OF FLORIDA, COUNTY OF PINELLAS
(we), 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 applica
Sworn to and subscribed before me this day of
KiAnature of property owner (individuaVor authorized
representative of corporation, partnership or other
entity)
Signature of co- property owner
(y(� o by
� �i1 /71 I� 1ii�� who is personally known /has
produced �J(1(,�°� `�(`��,�(/ �/ as identification.
Notary public, ' ' " //" 0
My commission expir
.par Pct Notary Public State of Florida
A? Ann Fischer
OF
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727 -562 -4567; Fax: 727 -562 -4865
Page 7 of 7 Revised 03/13
P KREEX F.� FLORIDA
c OF T
O� B 1660 -2001 17:02:53 JTF
Prepared by and Return to:
Lynn Hoffstetter, Bankers Title 009072
509 South Greenwood Avenue, #A I #:01298240 9K:11545 SM:0922 EP6:0922
Clearwater, FL 33756 RECORDING 001 PAGES 1 $6.00
Parcel Number:03/29/15/15840/001/0180 DOG STAMP - Dn9 3 (560.00
TOTAL:
01- 296240 RUG-24-200-1 5 :O3pm CNI�K A}{I : $566.00
P INELLRS CC 9K 11545 PG 322 - D: $.00 '
BY -�— DEPUTY IX.M
WARRANTY DEED
THIS INDENTURE made this &/--A day of 2001 BETWEEN
MATTHEW W. SCHOMP AND AUTUMN J. JACKSON, bot unmarried persons,
as joint tenants with full rights of survivorship of.the County of,','
Pinellas, State of Florida, Grantor, and JUANITA J. BROWNING, a
�E single woman and GERALD H. BELLMAN, a single man, as joint tenants,
CC7 with full rights of survivorship, of the County of Pinellas, State
FiGC -o__� of Florida, Grantee, whose address is: 1247 Union Street,
i21I �O W Clearwater, Fl 33765
t� WITNESSETH, That said Grantor, for and in consideration of tYe.
sum of Ten and No 100 Dollars and other
� / good and valuable
considerations to said grantor in hand paid by said grantee, the
receipt whereof is hereby acknowledged, has granted, bargained and
sold to the said grantee, and grantee's heirs and assigns forever,
the following described land, situate, lying an4`,b�aring in
/,-Pinellas County, Florida, to wit:
Lot 18, Block A, CLEARDUN, according to the map\,o; plat thereof,
as recorded in Plat Book 13, Page 47, Public\ Recprds of Pinellas
County, Florida.
SUBJECT TO taxes for the year.2001 ate subsequerlt) years.
SUBJECT TO easements, restrictions and reservations of record.
And said grantor does hereby full% wari�nt the title to said land,
and will defend the same against the,labWf l claims of all persons
whomsoever.
IN WITNES WHEREOF, Grantor 4as.'hereunto set Grantors hand and
seal the y and year f }rat above written.
Signed, aled & deli 5re'e ,
in th se c of:
Witn ss 1 - Signature MATTHEW SCHOMP
Nam t S Address: 160 q H L-J J 5CT Aa!
(OP ease RrintI
S\ gna`ure J TCN
Na - ddress:
1 ase .rint) E
�aTP�TE OF FLORIDA / COUNTY OF PINELLAS
, HERBY CERTIFY that on this day before me, an officer duly
quali,f-i- ed,'to take acknowledgements, appeared MATTHEW W. SCHOMP
AND Al?TL*W J.-JACKSON who are personally known by me; or who have
produced Oentification attesting to Affiant's identity, to wit:
g . ; who executed the foregoing instrument and
acknowleaged before me the execution of the same_
WITNESS my hand and official eal in the County and State
last aforesaid this ay of 2001. -
,.ct,.
Pub c - Signs re
41N.1ge :
My commission expires Please Print)
a ' ' x_ NN HoFFSTEnMR'
r,0WNB�iGNtCC M46
Z q aI a RN 0U4 ptber 17, 2402
,';{,4f h• BonE�a RN :JMiN p�,�4cUMainle�s
I #: 2011035832 BK: 17165 -",: 2124, 02/09/2011 at 11:35 A" RECORDING 1 KEN
BURKE, CLERK OF COURT PIN. AS COUNTY, FL BY DEPUTY CLERI --LKDM08
Department of Health • Vital Statistics
STATE OF FLORIDA
MARRIAGE RECORD
TYPE IN UPPER CASE
USE BLACK INK
This "Ca". not Valid unless seal of Clerk,
C", "" or County Court, appears thereon
2011 ML 1872988
(APP[ Ir.ATinN NI IMRFRI
(STATE FILE NUMBER)
APPLICATION TO MARRY
1 GROOM 5 NAME first_ Middle. Last
L UA I In OF BIRTH (Mcnth. City . ear
GERALD H BELLMAN
07/06/1953
a -
c
tale or oreian Dunlrvi
CLEARWATER
PINELLAS
FL
WASHINGTON D C
a bHIUt5 NAME fF,r-S7- . I b e. ast I Brent
6 DATE OF BIRTH (Month. DaV Year)
JUANITA J BROWNING BROWNING
12/14/1953
7a RESLUcNLL - 1-11 Y. I UWN. OR LOCATION
7b COUNTY
c. STATE
B Birthplace (State or Forelan CounlrY)
CLEARWATER
PINELLAS
FL
WEST VIRGINIA
�•l.•i /i
WE THE APPLICANTS NAMED IN THIS CERTIFICATE, EACH FOR HIMSELF OR HERSELF. STATE THAT THE INFORMATION PROVIDED
ON THIS RECORD IS CORRECT TO THE BEST OF OUR KNOW -EDGE AND BELIEF, THAT NO LEGAL OBJECTION TO THE MARRIAGE
NOR THE ISSUANCE OF A LICENSE TO AUTHORIZE THE SAME IS KNOWN TO US AND HEREBY APPLY FOR LICENSE TO MARRY.
OF GROOM (Sign I ll name using ink)
10. SUBSCRIBED AND SWORN TO BEFORE ME ON (DATE)
'SIGNATUF3E
02/02/2011
• ..
off. a '
r�I
TITLE OF OFFICIAL
DEPUTY CLERK
12 SIGNATURE OF OFFICIAL (U in>< I
> oo�
/y��,
�`n:1� • ��
13. SIGNATURE OF BRIDE (Sig ull name using black mk)
� r
S CRIBED A OR TO BEFORE ME ON DATE
( )
02/02/2011
15. TLE OF OFFICIAL
16. SIGNATUR Of OFFICIAL (use Dead nk)
DEPUTY CLERK
>
����!y�►�i��/����s�rti
�•�{KII.�I,
r i( 1 • ••• *
LICENSE M MARRY
AUTHORIZATION AND LICENSE IS HEREBY GIVEN TO ANY PERSON DULY AUTHORIZED BY THE lA W B OF THE STATE OF FLORIDA TO PERFORM
A MARRIAGE CEREMONY WITHIN THE STATE OF FLORIDA AND TO SOLEMNIZE THE MARRIAGE OF THE ABOVE NAMED PERSONS. THIS LICENSE MUST
BE USED ON OR AFTER THE EFFECTIVE DATE AND ON OR BEFORE THE EXPIRATION DATE IN THE STATE OF FLORIDA IN ORDER TO BE RECORDED AND VALID.
J! //
t,0
1�SCW��
17. COUNTY ISSUING LICENSE
PINELLAS
1B. DATE LICENSE ISSUED
02!0212011
18a. DATE LICENSE EFFECTIVE
02!0512011
119 EXPIRATION DATE
04!06/2011
20a. SIGNATURE OF COURT CLERK OR JUDGE
20D. TITLE
20c. BY D.C.
CLERK OF THE CIRCUIT COURT
SW
CFRTIFICATE OF MARRIAGE
HEREBY CERTIFY THAT THE ABOVE NAMED GROOM AND BRIDE WERE JOINED BY ME IN MARRIAGE IN ACCORDANCE WITH THE LAWS OF THE STATE OF FLORIDA
I DA /Month. Dar. Year'
22,�� TOWN, OR LOCATION OF MARRIAGE
a ERSON PER
23c. ADDRESS Or
f Person ➢arb^^+q arwnony)
fa naary stamp)
24. S ATURE NESS :a
WIT EMON (U asc* -)
yi7yi70! j
25 SI E OF I NES T E 0 s marJl w)
Notary PUbIiC State of Florida
>
��:i�`�e1�[•'Y�n��63ffill N=21931A11l- 3:10*6161:Ul4a�l
STATE OF FLORIDA- PINELLAS COUNTY
sae I hereby cattily that the foregoing is a true
e err copy as recorded in the official records of
i 'k✓
i A Pinel, County.
rhiday of 20L„
t; b`� -• � KEN BURKE
Clerk of Circuit Court
t Deputy Clerk
1�
�3245��_
OFFICE of VITAL STATISTICS
III II„ I I
CERTIFIED COPY
o
FLORIDA CERTIFICATE OF DEATH
LOCALFILENO.
(, t, DECEDENTS NAME (Feel, Middle, Lest. Suh!)
Gerald Howard Bellman
3. �DJAT OF BIRTH st Birthday March TH,MPnn, Day, Y.,r�
JulyM, Day. Veer) 4a. AGE-La 5. DATE OF DEA
. y 6 , (Yaanl CC �I Months Days Hours Minutes 16 , 2 01 1
6. SOCIAL SECURITY NUMBER 7. GIRT- PLACE ?city and St.,. or Foreign Country) B. COUNTY Of, DEATH
214 -60 -2370
Washington, 'D "�.
Pinellas
9, PLACE OF DEATH. HOSPITAL - Inpatient •_ Emergency RoonJO.IPatlenl _ Dead on Arrival
(Check only anal
NON - HOSPITAL � Hospice FeUllry _„ NJramg Hamea -ong Term Care Facility - Oecedenl'e Hams _ Outer (Specify)
10. FACILITY NAME (ll not fnslaulicn, give Street address) 1 to CITY, TOWN, OR LOCATION OF DEATH t ID: INSIDE CITY LIMITS'
Brookside Hospice House'' Palm Harbor -Yea 'X No
12. MARITAL STATUS (Spedill) i3, SURVIVING SPOUSE'S NAME (1f wilt, give malden name)
- p_Marrletl _Marded,bulSeperatad _WWOwed _Divorced -Never Married Juanita:. J. Brownie
1N. RESIDENCE -STATE t46. COUNTY 14c. CITY. TOWN,OR LOCATION
Florida Pinellas Clearwater
14a. APT. N0. 141. ZIP CODE 14y, INSIDE CITY LIMITS? `
14d. STREET ADDRESS
1247 Union Street 33755 " Yas xNn
15a. DECEDENT'S USUAL OCCUPATION (Irltlreh NOa of work done during most of workMp Iflt.)
t6b. KIND OF BUSINESSANDUSTRY
-'80OC • Mechanic Auto
Cnol
0
I� Whae (SPAY 10 a African rdlfloiceto what decedent considered hlmeellmeroetl to be. More than aria race rtlaY be apeNfred.) '
1B. DE EOENTS RAE 1M 10 COS
I I }[ Arercan _ American Indian or Alaskan Nallw (Specify ISM) -
IU - Vietnamese - Other Asian(SPaUfy)
II 'Asian Indian Chewae - Filipino - J9Pmese - Korean
- - Dlher (Spacer)
Native Haweilen - OUemanlan of CMmorm - Samoan __ DtMr Padna 14. ($pecnYJ
e e 17. DECEDENT OF HISPANIC OR HAITIAN ORIDIN7 yea {II Yes, spediyJ XNo - Mexican _. Puerto Roman - Cuban -,_ CentraVSbuM'Amadean
1 e, Dal I decedent was of NUPsmc or Haitian n. - HNgsn , • �' "
(Specify Origin.) - - OlnarwaP.nk:lspedNl ,,.
1B. WAS DECEDENT EVER IN
e ol school completed at June of death.) U.S. ARMED FORCES?
ECEDENT•S EDUCATION (Specify me decedsnik Mst dspaa a level
_ Bth or lee8 - High school but W diploma High wmoel 'diploms or OED
Coeage but no degree College degree(SPairN)I - Associate ^Bachelor's _Maslees
_;DOdorole Yes ANo
' MOTHER'S NAME (F1181, Mlodle, Maiden Sachems)
20. FATHER $NAME (Fie6 M/dtlle, Lest, SuMw) 226 RELATIONSHIP in4
Larry Bellman 21 Maxine To E eo nber -
NT 83a. INFORMANT'S MAILING •STATE
228. INFORMANT'S NAME Florida
Juanita J. Brownie Bellman.., Wife... U
23d. ZIP CODE
• 23b CITY OR TOWN 23c. STREET ADDRESS 33755
Clearwater 1247 Union Street
i '26b. LOCATION -CITY OR TOWN 1
24: PLACE OF DISPOSITION (Name of cemetery, crematory, or Omer place) 25s. LOCATION - STATE I,
Palm State Cremator
Florida Clearwatet
26a. METHOD OF DISPOSITION -Burial _Fnl -bment -
Cremation - Donation _.PamW►I it eta Omar (Spacer)
28D. IF CREMATION, DONATION OR BURIAL AT SEA, 27.. UCENSE NUMBER (of Llcenise) 27b. UR F RA VICE LICENSEE OR PERSON gCTING q5 SpCH it r
WAS MEDICAL APPROVAL GRANTED7ER XYea -led F046664
,7 ACILfTY'S MAILING •STATE
28. ME OF FUNERAL FACILITY Abbey Affordable Cremati - -
NA !
Funeral vS 29d. ZIP CO.DE
29b. CITY OR TOWN, 29c. STREET ADDRESS 33774
?
Largo 1241 Ulmerton Road
II IIII I. I
30. CERTIFIER: Certify hV elan To lM be of my knowleUge, death ocaatsd at the uma, dale and place and d • 10 de eause(e) end manner slatatl
Me I am an • On the s of ...minalion, and /or Inveadgsdon, in my opinion. death occurred at the time, del. 4.0 dace, due to Ina cause(s) and nroruter slated.'.
(Check--) ,
31.: (Signature an of ter) 31b. OA SIG ED (mhvddWM 32. TIME OF DEATH (24 hr.) 33. MEDICAL. EXAMINER'S CASE NUMBER
,o. 3 Z� 2orl 1540
- 35. NAME OF ATTENDING PHYSICIAN (If o1Mr IMn CMi6sr)
34a. LICENSE MBER of Cadifff) 34b. C FITIFI 'S AME tp
•I 1(.. .100A rifG.e "l.s t 36d. 21P E.
36e. CERTIFIERS. STATES 36b. CITY OR TOWN 3Ba STREET ADORES$
Palm 164 West Lake Road 34684;
Florida elm Harbor, 30b.DATEFILE BY REGISTRAR (114o., Day, Y11
37. SUBREGISTRAR • Signature and Daft
3Ba. LOCAL REGISTRAR •3rgnamn
` 40 REPORTED TO MEDICAL EXAMINER DUE TO
3a. PROBA84E BANNER OF DEATH i The Idlowing era unWr the IuN7idion of lee madlcai examiner: - .s4 No
Natwal i - AUideM Suicide Homicide Pending Investigation Undelarrm ed CAUSE OF DEATH7 -Yes
CAUSE OF DEATH - PART I. Enter IM chain Of events - disease., injuries, or _.plicaliom, • the% directly rauseo the deem. Enter only one cause one Una. i AF Dow to Death
(See Instructions on Dock) DO NOT enter larmlnal Went ZL"" at, respiratory areal. or ventricullar fibrillation without showing the efrology. I dl
IMMEDIATE CAUSE /n1 Lr
(Final disease or Condition a /fie e, //TELL
resulting m death)
I
( Seouenliany Hsi conditions,
i1 any, leading to IM Cause D. I -
listed online a. Ether the i
li UNDERLYING CAUSE
',. (disease or injury that e.
II initiated the events „
p
resulting In death) LAST - r
d• 42a. WAS AN AUTOPSY 42P WERE AUTOPSV FINDINGS - AVAILABLE
�I PART 11. Other ni dll' n ca IrOUt'm to death but not resultng fn the underlying Gauss given in PART 1. PERFORMED? TO COMPLETE THE CAUSE OF DEATH?,
43a. IF S - Yes �Oo - Yes No
i SURGERY MENTIONED IN PART I OR 11, ENTER REASON FOR SURGERY 43b. DATE OF SURGERY (Mo., Day, Yr.) 44. DID TOBACCO USE CONTRIBUTE TO DEATH+ , , ;
_Yes No - Probably Unknown
I
e 45.IF FEMALE; WAS SHE PREGNANT WITHIN THE PAST YEAR:
Yea ;•' No _ Unkrwwri If :Yes, ePeclly Ilmeleme' _ at Jim of deHp -within I to 42 days Wtleath - WDhq?.49 dsYa to 1 you of tleath
e 46. DATE OF INJURY (Month. Day, Vesr) 47, TIME OF INJURY. (24 hr: }' 4f(.1NJURYAT WORK? 49a LOCATION OF 'INJURY STATE
. 49c. STREET -Yes NO .
48b. CITY OR TOWN T
ADORES$ - 49d AP•T. NO: 49a. ZIP CODE .
n S1. PUCE OF INJURY (a 0. Oecedenfd Soma.
So. DESCRIBE HOW INJURY OCCURRED consln d-Vt., eanutenl, wooded area)
ICI
IF TRANSPORTATION INJURY, 529. Status Of Decedent Driver/Operator - Passenger - Pedestrian •_ Other (Spacib)
52b. Type of Vehicle CarIMIMivan S.U.V. - Motorcycle - Pickup Truck/Cargo Van -Bus Heavy Transport - Other (Speoly)
I II
r I
istrar, Pinellas County Issued: March 28, 2011
I
Chief Deputy Reg ,
OF'cHe Srgr -
VPV SOT FIARID DEPARTM96FTT OP
'n' THIS DOCUMENT IS PRINTED OR PHOTOCOPIED ON SECURITY' PAPER WITH A WATERMARK OF THE GREAT- - HEALT
n \ ? <0 WARNING: SEAL OF THE STATE OF FLORIDA. DO NOT ACCEPT WITHOUT VERIFYING THE PRESENCE OF THE WATERMARK..
THE DOCUMENT FACE CONTAINS A MULTI - COLORED BACKGROUND AND GOLD EMBOSSED SEAL THE BACK .
CONTAINS SPECIAL LINES WITH TEXT AND SEALS IN THERMOCHROMIC INK. _
• DH FORM 1947 (08/04)
f =
COO WEtPJbt n �,,. : • @13M7 MT III II VIII VIII IIII I II illll I III II it IIII IIII r
�j= 37711691
Property Appraiser General Information
Interactive Ma of f this parcel Sales Query Back to Query Results New Search Tax Collector Home Paae
03- 29 -15- 15840- 001 -0180
Online Property Record Card
Page 1 of 7
Contact Us WM
Portability Calculator Data Current as of June 18 2014 Email Print Radius Search Improvement Value
per F.S. 553.844
Ownership/Mailing Ownership/Mailing Address
Site Address
BROWNING, JUANITA J
Homestead Use Percentage: 100.00%
1247 UNION ST
1247 UNION ST
CLEARWATER FL 33755 -1150
Classified Agricultural:
No
1) r perty Use: 0110 (Single Family Home)
[click here to hide] 2014 Legal Description
CLEARDUN BLK A, LOT 18
Living Units: 1
201.4 Exemptions Mortgage Letter File for Homestead
Exemption
2014 Parcel Use
Census Tract
Homestead Use Percentage: 100.00%
Homestead: Yes
Government: No
Non - Homestead Use Percentage:
0.00%
Classified Agricultural:
No
Institutional: No
Historic: No
2013 Parcel Information 201.3 Trim Notice
Most Recent Recording
Sales Comparison
Census Tract
Evacuation Zone
NOT the same as a FEMA Flood Zone
Plat Book/Page
11545/0922
$72,600 Sales uer
121030263001
r E
013/047
2013 Final Value Information
Year Just/Market Value Assessed Value/ SOH Cap County Taxable Value School Taxable Value Municipal Taxable Value
2013 $58,306 $57,142 $24,500 $31,642 $24,500
[click here to hide] Value History as Certified (yellow indicates correction on file)
http: / /www.pcpao.org /general.php ?strap = 152903158400010180 6/18/2014
Property Appraiser General Information
Year
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
Homestead
Exemption
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
lust/Market
Value
$58,306
$56,187
$66,252
$73,400
$101,000
$101,200
$151,900
$133,700
$107,700
$88,700
$82,200
$70,600
$59,900
$55,100
$55,800
$54,700
$48,300
$47,900
Assessed Value/
SOH Cats
$57,142
$56,187
$66,252
$73,400
$82,509
$82,427
$80,026
$78,074
$75,800
$73,600
$72,300
$70,600
$56,700
$55,100
$55,800
$49,000
$48,200
$46,700
2013 Tax Information
Click Here for 2013 Tax Bill Tax District: CW
2013 Final Millage Rate 22.1348
2013 Est Taxes w/o Cap or Exemptions $1,290.59
A significant change in taxable value may occur when sold due to
changes in the market or the removal of exemptions. Click here for
more information.
Seawall: No
Land Use
County 'Taxable
Value
$24,500
$24,500
$24,500
$24,500
$32,009
$31,927
$54,526
$52,574
$50,300
$48,100
$46,800
$45,100
$31,700
$30,100
$30,800
$24,000
$24,100
$23,300
School Taxable
Value
$31,642
$30,687
$40,752
$47,900
$57,009
$56,927
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Page 2 of 7
Municipal Taxable
Value
$24,500
$24,500
$24,500
$24,500
$32,009
$31,927
$54,526
$52,574
$50,300
$48,100
$46,800
$45,100
$31,700
$30,100
$30,800
$24,000
$24,100
$23,300
Ranked Sales
(what are Ranked Sales')
See all transactions
Sale Date
Book/Page
Price
((/LT V/I
24 Aug 2001
11545 / 0922 ■
$80,000
Q I
19 Oct 1998
10273 / 1880 ■
$54,900
U I
03926 / 0945 0
$16,900
Q
2013 Land Information
Frontage: None
Land Size Unit Value Units Total Adjustments
View:
Adiusted Value Method
http: / /www.pcpao.org/general.php ?strap= 152903158400010180 6/18/2014
Property Appraiser General Information
Single Family (01) 60x102 270.00 60.0000 0.8827
[click here to hide] 2014 Building 1 Structural Elements Back to Ton
Site Address: 1247 UNION ST
Quality: Average
Square Footage: 1720.00
Foundation: Continuous Footing
Floor System: Wood
Exterior Wall: Cb Stucco /Cb Reclad
Roof Frame: Gable Or Hip
Roof Cover: Shingle Composition
Stories: 1
Living units: 1
Floor Finish: Carpet/Hardtile/Hardwood
Interior Finish: Drywall/Plaster
Fixtures: 5
Year Built: 1951
Effective Age: 55
Heating: Central Duct
Cooling: Cooling (Central)
Description
Utility
Ooen Porch Unfinished
Open Porch
Garage Unfinished
$14,300
Open plot in New Window
Building 1 Sub Area Information
Living Area Ft2 Gross Area Ft
0 140
0 140
0 24
0 280
Factor
0.35
0.15
0.21
0.25
Page 3 of 7
FF
Effective Ft'
49
21
5
70
http: / /www.pcpao.org /general.php ?strap = 152903158400010180 6/18/2014
Property Appraiser General Information
Page 4 of 7
Base Semi - finished 200 200 0.80 160
Base 936 936 1.00 936
Total Living SF: 1,136 Total Gross SF: 1,720 Total Effective SF: 1,241
[click here to hide] 2014 Extra Features
Description Value /Unit Units Total NewValue Depreciated Value Year
No Extra Features on Record
[click here to hide] Permit Data
Permit information is received from the County and Cities. This data may be incomplete and may exclude permits that do not result in field reviews (for example for water heater
replacement permits). Any questions regarding permits should be directed to the permitting office in which the structure is located.
Permit Number Description I E Issue Date Estimated Value
No Permit Data Found
n .:.
http : / /www.pcpao.org /general.php ?strap= 152903158400010180 6/18/2014
Property Appraiser General Information
Page 5 of 7
Interactive Map of this parcel Map Legend. Sales Query Back to Query Results New Search Tax Collector Home Page Contact Us
http: / /www.pcpao.org /general.php ?strap= 152903158400010180 6/18/2014
Property Appraiser General Information
http: / /www.pcpao.org /general.php ?strap = 15290315 8400010180
Page 6 of 7
6/18/2014
Pinellas County Public GIS Viewer
Property Report: El Close Window
1247 UNION ST
03/29/15/15840/001 /0180
0
Prooertv ADDralser
General
Municipality: CLEARWATER
Subdivison: CLEARDUN
Tax District:
CW
Census Block:
1009
Census Tract:
026300
Zipcode:
33755
Acreage: .141
Public Safety
Fire District: 05 - Clearwater
Evacuation Level: E
Political
Voter Precinct: 528
At -Large District: District 2
Norm Roche
Tax Collector
Single Member District: District 5
Karen Williams Seel
Environmental
within 330ft. of Eagles Nest: No
within 660ft. of Eagles Nest: No
Recycling b City)
Curbside: null
Dropoff: null
Pickup: null
Page 1 of 1
http: / /gis.pinellascounty.org /public_gis/ web /parcel_report2.cfm ?TYPE= ADDRESS &STN... 6/18/2014
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Clearwater
V
Prepared by:
Engineering Department
Geographic Technology Division
700 S. Myrtle Ave, Clearwater, FL 33756
Ph: (727)562-4750, Fax: (727)526.4755
www.MyClearwate r.com
Disclaimer
Public information data is lumished by the Coy of Clearwater Engineering
Department, and must be accepted and used by the recipient with the
understanding that the data received was collected for the purpose of
developing a graphic infrastructure inventory- As such, The CHy of
Clearwater makes no warranties, expressed or implied, concerning the
accuracy, completeness, reliability, or suitability of this data for any
other particular use. Furthermore, the City of Clearwater assumes no
liability whatsoever associated wtth the use or misuse of such data.
Nonce:
This map may not incorporate the latest field Information. For the most up -to -date
depiction of this Infrastructure, consult the City of Clearwater's GIS Mapping
Applications at: Idtp:llcbarwalerlGlSlNdex.asp
N
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LMDR -Low Medium Density Residential
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MHDR - Medium High Density Residential
HDR -High Density Residential
MHP - Mobile Home Park
CRNCOD Coachmen Ridge Neighborhood Conservation
Overlay District
IENCOD - Island Estates Neighborhood Conservation
Overlay District
COMMERCIAL DISTRICTS SPECIAL USE DISTRICTS
p - Office IRT - Industrial, Research and Technology
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Zoning Atlas
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V
Prepared by:
Engineering Department
Geographic Technology Division
700 S. Myrtle Ave, Clearwater, FL 33756
Ph: (727)562-4750, Fax: (727)526.4755
www.MyClearwate r.com
Disclaimer
Public information data is lumished by the Coy of Clearwater Engineering
Department, and must be accepted and used by the recipient with the
understanding that the data received was collected for the purpose of
developing a graphic infrastructure inventory- As such, The CHy of
Clearwater makes no warranties, expressed or implied, concerning the
accuracy, completeness, reliability, or suitability of this data for any
other particular use. Furthermore, the City of Clearwater assumes no
liability whatsoever associated wtth the use or misuse of such data.
Nonce:
This map may not incorporate the latest field Information. For the most up -to -date
depiction of this Infrastructure, consult the City of Clearwater's GIS Mapping
Applications at: Idtp:llcbarwalerlGlSlNdex.asp
N
W E
200 100 0 200
S Feet
Legend
4 City Owned Property
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SDR Transfer of Development Rights
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Zoning Legend
RESIDENTIAL DISTRICTS
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HDR -High Density Residential
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CRNCOD Coachmen Ridge Neighborhood Conservation
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COMMERCIAL DISTRICTS SPECIAL USE DISTRICTS
p - Office IRT - Industrial, Research and Technology
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° Clearwater
U
Prepared by:
Engineering Department
Geographic Technology Division
100 S. Myrtle Ave, Clearwater, FL 33756
Ph: (727)562 -4750, Fax: (727)526 -4755
www.MyC[earwater.com
Disclaimer
Public information data is furnished by the City of Clearwater Engineering
Department, and must be accepted and used by the recipient with the
understanding that the data received was collected for the purpose of
developing a graphic infrastructure inventory. As such, the City of
Clearwater makes no warranties, expressed or implied, concerning the
accuracy, completeness, reliability, or suitability of this data for any
other particular use. Furthermore, the City of Gearwater assumes no
liability whatsoever associated with the use or misuse of such data.
Notice:
This map may not incorporate the latest field information. For the most up -b-dsb
depiction of this infrastructure, consult the City of ClearlaalsrY GIS Mapping
Appliutlonsrt htlpllclarwahdGlSlindell.asp
N
W E
200 100 0 200
S Feet
Legend
4 City Owned Property
• Agreement to Annex
109- Transfer of Development Rights
I�12345 J SUB NUMBER (* -Refer to Plat)
� 0 BLOCK NUMBER
N
D Oi SUB PARCEL NUMBER
3zaz PARCEL NUMBER (M &B)
LAND HOOK (COMMON OWNERSHIP
PLATTED SUBDIVISION BOUNDARY
0 COUNTY HIGHWAY
so STATE HIGHWAY
,s U.S. HIGHWAY
- - -- Trails
Unincorporated Enclave
Unincorporated
-----Outside of Clearwater Service Area
Zoning Legend
RESIDENTIAL DISTRICTS
LDR -Low Density Residential
LMDR -Low Medium Density Residential
MDR - Medium Density Residential
MHDR - Medium High Density Residential
HDR -High Density Residential
MHP - Mobile Home Park
CRNCOD - Coachman Ridge Neighborhood Conservation
Overlay District
IENCOD - Island Estates Neighborhood Conservation
Overlay District
COMMERCIAL DISTRICTS SPECIAL USE DISTRICTS
0 -Office IRT - Industrial, Research and Technology
T - Tourism I - Institutuional
C - Commercial OS/R -Open Space /Recreational
D - Downtown P -Preservation Area
Zoning Atlas
Updated: 61512014
NE 11
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' I I
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♦ifi yam.
ntlf 2 •� -
t ♦ _
�7 4 16
° Clearwater
U
Prepared by:
Engineering Department
Geographic Technology Division
100 S. Myrtle Ave, Clearwater, FL 33756
Ph: (727)562 -4750, Fax: (727)526 -4755
www.MyC[earwater.com
Disclaimer
Public information data is furnished by the City of Clearwater Engineering
Department, and must be accepted and used by the recipient with the
understanding that the data received was collected for the purpose of
developing a graphic infrastructure inventory. As such, the City of
Clearwater makes no warranties, expressed or implied, concerning the
accuracy, completeness, reliability, or suitability of this data for any
other particular use. Furthermore, the City of Gearwater assumes no
liability whatsoever associated with the use or misuse of such data.
Notice:
This map may not incorporate the latest field information. For the most up -b-dsb
depiction of this infrastructure, consult the City of ClearlaalsrY GIS Mapping
Appliutlonsrt htlpllclarwahdGlSlindell.asp
N
W E
200 100 0 200
S Feet
Legend
4 City Owned Property
• Agreement to Annex
109- Transfer of Development Rights
I�12345 J SUB NUMBER (* -Refer to Plat)
� 0 BLOCK NUMBER
N
D Oi SUB PARCEL NUMBER
3zaz PARCEL NUMBER (M &B)
LAND HOOK (COMMON OWNERSHIP
PLATTED SUBDIVISION BOUNDARY
0 COUNTY HIGHWAY
so STATE HIGHWAY
,s U.S. HIGHWAY
- - -- Trails
Unincorporated Enclave
Unincorporated
-----Outside of Clearwater Service Area
Zoning Legend
RESIDENTIAL DISTRICTS
LDR -Low Density Residential
LMDR -Low Medium Density Residential
MDR - Medium Density Residential
MHDR - Medium High Density Residential
HDR -High Density Residential
MHP - Mobile Home Park
CRNCOD - Coachman Ridge Neighborhood Conservation
Overlay District
IENCOD - Island Estates Neighborhood Conservation
Overlay District
COMMERCIAL DISTRICTS SPECIAL USE DISTRICTS
0 -Office IRT - Industrial, Research and Technology
T - Tourism I - Institutuional
C - Commercial OS/R -Open Space /Recreational
D - Downtown P -Preservation Area
Zoning Atlas
Updated: 61512014
NE 11
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° Clearwater
U
Prepared by:
Engineering Department
Geographic Technology Division
100 S. Myrtle Ave, Clearwater, FL 33756
Ph: (727)562 -4750, Fax: (727)526 -4755
www.MyC[earwater.com
Disclaimer
Public information data is furnished by the City of Clearwater Engineering
Department, and must be accepted and used by the recipient with the
understanding that the data received was collected for the purpose of
developing a graphic infrastructure inventory. As such, the City of
Clearwater makes no warranties, expressed or implied, concerning the
accuracy, completeness, reliability, or suitability of this data for any
other particular use. Furthermore, the City of Gearwater assumes no
liability whatsoever associated with the use or misuse of such data.
Notice:
This map may not incorporate the latest field information. For the most up -b-dsb
depiction of this infrastructure, consult the City of ClearlaalsrY GIS Mapping
Appliutlonsrt htlpllclarwahdGlSlindell.asp
N
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200 100 0 200
S Feet
Legend
4 City Owned Property
• Agreement to Annex
109- Transfer of Development Rights
I�12345 J SUB NUMBER (* -Refer to Plat)
� 0 BLOCK NUMBER
N
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3zaz PARCEL NUMBER (M &B)
LAND HOOK (COMMON OWNERSHIP
PLATTED SUBDIVISION BOUNDARY
0 COUNTY HIGHWAY
so STATE HIGHWAY
,s U.S. HIGHWAY
- - -- Trails
Unincorporated Enclave
Unincorporated
-----Outside of Clearwater Service Area
Zoning Legend
RESIDENTIAL DISTRICTS
LDR -Low Density Residential
LMDR -Low Medium Density Residential
MDR - Medium Density Residential
MHDR - Medium High Density Residential
HDR -High Density Residential
MHP - Mobile Home Park
CRNCOD - Coachman Ridge Neighborhood Conservation
Overlay District
IENCOD - Island Estates Neighborhood Conservation
Overlay District
COMMERCIAL DISTRICTS SPECIAL USE DISTRICTS
0 -Office IRT - Industrial, Research and Technology
T - Tourism I - Institutuional
C - Commercial OS/R -Open Space /Recreational
D - Downtown P -Preservation Area
Zoning Atlas
Updated: 61512014
NE 11
4 ♦ I
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ORDINANCE NO. 8485-13
AN ORDINANCE OF THE CITY OF CLEARWATER,
FLORIDA, ANNEXING CERTAIN REAL PROPERTY
LOCATED ON THE SOUTH SIDE OF UNION STREET,
APPROXIMATELY 600 FEET WEST OF BETTY LANE
(COUNTY ROAD 355), CONSISTING OF LOT 18, BLOCK A,
CLEARDUN SUBDIVISION, WHOSE POST OFFICE
ADDRESS IS 1247 UNION STREET, CLEARWATER,
FLORIDA 33755, INTO THE CORPORATE LIMITS OF THE
CITY, AND REDEFINING THE BOUNDARY LINES OF THE
CITY TO INCLUDE SAID ADDITION; PROVIDING AN
EFFECTIVE DATE.
WHEREAS, the owner of the real property described herein and depicted on the
map attached hereto as Exhibit A has petitioned the City of Clearwater to annex the
property into the City pursuant to Section 171.044, Florida Statutes, and the City has
complied with all applicable requirements of Florida law in connection with this ordinance;
now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY
OF CLEARWATER, FLORIDA:
Section 1. The following- described property is hereby annexed into the City of
Clearwater and the boundary lines of the City are redefined accordingly:
Lot 18, Block A, CLEARDUN subdivision, according to the map or plat
thereof, as recorded in the Plat Book 13, Page 47, Public Records of
Pinellas County, Florida.
(ANX2013- 08025)
The map attached as Exhibit A is hereby incorporated by reference.
Section 2. The provisions of this ordinance are found and determined to be
consistent with the City of Clearwater Comprehensive Plan. The City Council hereby
accepts the dedication of all easements, parks, rights -of -way and other dedications to the
public, which have heretofore been made by plat, deed or user within the annexed
property. The City Engineer, the City Clerk and the Planning and Development Director
are directed to include and show the property described herein upon the official maps and
records of the City.
Section 3. This ordinance shall take effect immediately upon adoption. The City
Clerk shall file certified copies of this ordinance, including the map attached hereto, with
the Clerk of the Circuit Court and with the County Administrator of Pinellas County,
Florida, within 7 days after adoption, and shall file a certified copy with the Florida
Department of State within 30 days after adoption.
Ordinance No. 8485 -13
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PASSED ON FIRST READING
November 20, 2013
PASSED ON SECOND AND FINAL TIAnAmhar S �n� 3
READING AND ADOPTED `-
— GtP.() ►Lt n Cr C -t
Approved as to form:
Leslie K. Dougall- ide
Assistant City Attorhq
George N. Cretekos
Mayor
Attest:
Rosemarie Call
City Clerk
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icy
Ordinance No. 8485 -13
Proposed Annexation
Owner: Juanita Browning Bellman Case: ANX2013-08025
Site: 1247 Union Street Property 0.141
Size (Acres):
Land Use Zoning
PIN: 1 03-29-15-15840-001-0180
From Residential Urban (RU) R-4
To: Residential Urban (RU) LMDR Atlas Page: 251 B
Exhibit A
C:\Users\Ellen.Ayo\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Oullook\Y12Z6LNP\ANX2013-08025
Proposed Annexation.docx
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Proposed Annexation
Owner: Juanita Browning Bellman Case: ANX2013-08025
Site: 1247 Union Street Property 0.141
Size (Acres):
Land Use Zoning
PIN: 1 03-29-15-15840-001-0180
From Residential Urban (RU) R-4
To: Residential Urban (RU) LMDR Atlas Page: 251 B
Exhibit A
C:\Users\Ellen.Ayo\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Oullook\Y12Z6LNP\ANX2013-08025
Proposed Annexation.docx
ORDINANCE NO. 8486-13
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA,
AMENDING THE FUTURE LAND USE PLAN ELEMENT OF THE
COMPREHENSIVE PLAN OF THE CITY, TO DESIGNATE THE
LAND USE FOR CERTAIN REAL PROPERTY LOCATED ON THE
SOUTH SIDE OF UNION STREET APPROXIMATELY 600 FEET
WEST OF BETTY LANE (COUNTY ROAD 355), CONSISTING OF
LOT 18, BLOCK A, CLEARDUN SUBDIVISION, WHOSE POST
OFFICE ADDRESS IS 1247 UNION STREET CLEARWATER,
FLORIDA 33755, UPON ANNEXATION INTO THE CITY OF
CLEARWATER, AS RESIDENTIAL URBAN (RU); PROVIDING AN
EFFECTIVE DATE.
WHEREAS, the amendment to the future land use plan element of the comprehensive plan
of the City as set forth in this ordinance is found to be reasonable, proper and appropriate, and is
consistent with the City's comprehensive plan; now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF
CLEARWATER, FLORIDA:
Section 1. The future land use plan element of the comprehensive plan of the City of
Clearwater is amended by designating the land use category for the hereinafter described property,
upon annexation into the City of Clearwater, as follows:
Prpert Land Use Catego
Lot 18, Block A, CLEARDUN subdivision ac- Residential Urban
cording to the map or plat thereof, as recorded (RU)
in the Plat Book 13, Page 47, Public Records
of Pinellas County, Florida.
(ANX2013- 08025)
The map attached as Exhibit A is hereby incorporated by reference.
Section 2. The City Council does hereby certify that this ordinance is consistent with
the City's comprehensive plan.
Section 3. This ordinance shall take effect immediately upon adoption, contingent upon
and subject to the adoption of Ordinance No. 8485 -13.
PASSED ON FIRST READING
PASSED ON SECOND AND FINAL
READING AND ADOPTED
Approved as to form:
Leslie K. Doug I- des
Assistant City Att ey
November 20, 2013
Rpie-D "11
qur ,nCrq_V�0S
George N. Cretekos
Mayor
Attest: ' ►1s' o,
Rosemarie Call
City Clerk
Ordinance No. 8486 -13
Future Land Use
Owner: Juanita Browning Bellman Case: ANX2013-08025
Site: 1247 Union Street Property 0.141
Size (Acres):
Land Use Zoning
PIN: 1 03-29-15-15840-001-0180
From Residential Urban (RU) R-4
Residential Urban (RU) LMDR
To: Atlas Page: 251 B
Exhibit A
C:\Users\Ellen.Ayo\AppData\Local\Microsoft\Windows\Tcmporary Internet Files\Content. Out] ook\Y12Z6LNP\ANX2013-08025
Future Land Use Map-docx
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Future Land Use
Owner: Juanita Browning Bellman Case: ANX2013-08025
Site: 1247 Union Street Property 0.141
Size (Acres):
Land Use Zoning
PIN: 1 03-29-15-15840-001-0180
From Residential Urban (RU) R-4
Residential Urban (RU) LMDR
To: Atlas Page: 251 B
Exhibit A
C:\Users\Ellen.Ayo\AppData\Local\Microsoft\Windows\Tcmporary Internet Files\Content. Out] ook\Y12Z6LNP\ANX2013-08025
Future Land Use Map-docx
ORDINANCE NO. 8487 -13
AN ORDINANCE OF THE CITY OF CLEARWATER,
FLORIDA, AMENDING THE ZONING ATLAS OF THE CITY
BY ZONING CERTAIN REAL PROPERTY LOCATED ON
THE SOUTH SIDE OF UNION STREET APPROXIMATELY
600 FEET WEST OF BETTY LANE (COUNTY ROAD 355),
CONSISTING OF LOT 18, BLOCK A, CLEARDUN
SUBDIVISION, WHOSE POST OFFICE ADDRESS IS 1247
UNION STREET CLEARWATER, FLORIDA 33755, UPON
ANNEXATION INTO THE CITY OF CLEARWATER, AS
LOW MEDIUM DENSITY RESIDENTIAL (LMDR);
PROVIDING AN EFFECTIVE DATE.
WHEREAS, the assignment of a zoning district classification as set forth in this
ordinance is found to be reasonable, proper and appropriate, and is consistent with the
City's comprehensive plan; now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY
OF CLEARWATER, FLORIDA:
Section 1. The following described property located in Pinellas County, Florida, is
hereby zoned as indicated upon annexation into the City of Clearwater, and the zoning
atlas of the City is amended, as follows:
Pro a Zoning District
Lot 18, Block A, CLEARDUN subdivision ac- Low Mediium
cording to the map or plat thereof, as recorded Density
in the Plat Book 13, Page 47, Public Records Residential (LMDR)
of Pinellas County, Florida.
(ANX2013- 08025)
The map attached as Exhibit A is hereby incorporated by reference.
Section 2. The City Engineer is directed to revise the zoning atlas of the City in
accordance with the foregoing amendment.
Section 3. This ordinance shall take effect immediately upon adoption, contingent
upon and subject to the adoption of Ordinance No. 8485 -13.
PASSED ON FIRST READING
PASSED ON SECOND AND FINAL
READING AND ADOPTED
November 20, 2013
December 5, 2013
— C(W-,1e (CTCc 0;
George N. Cretekos
Mayor
Ordinance No_ 8487 -13
Approved as to form:
Leslie K. Dougal i es
Assistant City A ey
Attest:
Rosemarie Call
City Clerk
,i. 10F it/F
Ordinance No. 8487 -13
BERMUDA ST
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Zoning Map
Owner: Juanita Browning Bellman
Case:
ANX2013 -08025
Site: 1247 Union Street
Property
0.141
Size (Acres):
Land Use Zoning
PIN:
03- 29- 15- 15840 -001 -0180
From : Residential Urban (RU) R -4
To: Residential Urban (RU) LMDR
Atlas Page:
251 B
Exhibit A
C: \Users\EIIen.Ayo\AppData \Local \Microsoft \Windows \Temporary Internet Files \Content.Oudook \Y12Z6LNP\ANX2013 -08025
Zoning Map.docx
S:Tlanning DepartmentT D B \Annexations (ANX) \Active Cases \Union St. 1247 ANX2013 -08025 - Bellman \Maps \ANX2013 -08025
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ANX2013 -08025
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Bellman\Maps\ANX2013 -08025 Future Land Use Map.docx
Location Map
Owner: Juanita Browning Bellman Case: ANX2013 -08025
Site: 1247 Union Street Property Size (Acres):
0.141
Land Use Zoning
PIN: 03-29-15-15840-001-0180
From : Residential Urban (RU) R -4
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SAPlanning Department \C D B\Annexations (ANX)\Annexations Inactive or finished applications \Union St. 1247 ANX2013 -08025 -
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Owner: Juanita Browning Bellman
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Site: 1247 Union Street
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Land Use Zoning
PIN:
03-29-15-15840-001-0180
From :
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I 251 B
S:\Planning Department \C D BWnnexations (ANX) \Annexations Inactive or finished applications \Union St. 1247 ANX2013 -08025 -
Bellman \Maps\ANX2013 -08025 Proposed Annexation.docx
Zoning Map
Owner: Juanita Browning Bellman Case: ANX2013-08025
Property Site: 1247 Union Street Prop 0.141
Land Use Zoning
PIN: 03-29-15-15840-001-0180
From Residential Urban (RU) R-4
To: Residential Urban (RU) LMDR
Atlas Page:
251 B
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Zoning Map
Owner: Juanita Browning Bellman Case: ANX2013-08025
Property Site: 1247 Union Street Prop 0.141
Land Use Zoning
PIN: 03-29-15-15840-001-0180
From Residential Urban (RU) R-4
To: Residential Urban (RU) LMDR
Atlas Page:
251 B
SAPIannin.- Department\C D B\Annexations (ANX)\Annexations Inactive or finished applications\Union St. 1247 ANX2013-08025 -
Be11rnan\MapMNX2013-08025 Zoning Map.docx
Descriptions provided by Engineering for Annexation:
ANX2013 -08025
Short description for Ordinance Title:
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, ANNEXING
CERTAIN REAL PROPERTY LOCATED ON THE SOUTH SIDE OF UNION
STREET, APPROXIMATELY 600 FEET WEST OF BETTY LANE (COUNTY
ROAD 355), CONSISTING OF LOT 18, BLOCK A, CLEARDUN
SUBDIVISION, WHOSE POST OFFICE ADDRESS IS 1247 UNION STREET,
CLEARWATER, FLORIDA 33755, INTO THE CORPORATE LIMITS OF THE
CITY, AND REDEFINING THE BOUNDARY LINES OF THE CITY TO INCLUDE
SAID ADDITION; PROVIDING AN EFFECTIVE DATE.
Full Legal Description for Section 1 of the Ordinance:
Section 1. The following- described property is hereby annexed into the City of Clearwater and
the boundary lines of the City are redefined accordingly:
Lot 18, Block A, CLEARDUN subdivision, according to the map or plat thereof, as
recorded in the Plat Book 13, Page 47, Public Records of Pinellas County, Florida.
(ANX2013- 08025)
The map attached as Exhibit A is hereby incorporated by reference.
Drafted by: (Michael B. Kirn)
Checked by
(Pawel Dembinski)
Approved by. (Tom Mahony)
Date: 8/27/2013
Date: _�>
Date: Id?,q// 3
Descriptions provided by Engineering for ANX2013 -08025 1 of 1 8/27/2013 3:50 PM
Annexation Map Request
Planner Name: Andrew Hayslip
Case Number: ANX2013 -08025
Date Requested: 08/13/13
Date Requested for: 08/27/13
Maps Needed
® Color Aerial
® Proposed Annexation
® Existing Surrounding Uses Basemap
® Location Map
® Zoning /Flexible Development Map
® 2" x 2" Location Map for Newspaper
® 2" x 2" P D F
® Future Land Use
Required Documents
® Legal Description - to be hand delivered WA r' 1 PLEex) Ptgz�qts
® Plat - to be hand delivered .5
® Map with Proposed Site Highlighted,
IN ADDITION TO THE REQUESTED MAPS, PLEASE PROVIDE VERIFICATION THAT THE LEGAL
DESCRIPTION WE HAVE PROVIDED IS CORRECT "D ACCU ATE
Thomas Mahony, PSM, Geographic Technology Manager 04 G
Map Name
Owner: Juanita Browning Bellman
Case: ANX2013 -08025
Site: 1247 Union Street
Property 0.141
Size (Acres):
Land Use Zoning
i
PIN: 03- 29- 15- 15840- 001 -0180
From : Residential Urban (RU) R -4
Residential Urban (RU) LMDR
To:
Atlas Page: i 251 B
SAPlanning Department\C D B\Annexations (ANX) \Active Cases\Union St. 1247 ANX2013 -08025 - Bellman \Maps\ANX2013 -08025
Map Request Form.docx
January 9, 2014
Juanita Browning Bellman
1247 Union Street
Clearwater, FL 33755
CITY OF CLEARWATER
PLANNING AND DEVELOPMENT DEPARTMENT
POST OFFICE Box 4748, CLEARWATER, FLORIDA 33758 -4748
MUNICIPAL SERVICES BUILDING, 100 SOUTH MYRTLE AVENUE, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562 -4567 FAx (127) 562 -4865
RE: Petition for Annexation for 1247 Union Street (0.141± acres) — ANX2013 -08025
Dear Ms. Bellman:
Please be advised that the annexation petition for the above referenced property was approved by the
Clearwater City Council on December 5, 2013. The property is now designated by the City's Residential
Urban (RU) future land use category and Low Medium Density Residential (LMDR) zoning district and
subject to the requirements of the Clearwater Community Development Code. The City ordinances for
the annexation, Future Land Use Map amendment and Zoning Atlas amendment are enclosed for your
files.
To begin City services, please contact the Clearwater Customer Service Department at (727) 562 -4600.
If you have further questions or need additional information, please contact me at (727) 562 -4626 or
Andrew.Hayslip @myclearwater.com.
Sincerely,
CITY OF CLEARWATER
Andrew Hayslip,
Planner II
Enclosures: Ordinances 8485 -13, 8486 -13 and 8487 -13
GEORGE N. CRETEKOS, MAYOR
DOREEN HOCK- DIPOLITO, COUNCILMEMBER JAY POLGLAZE, COUNCILMEMBER
BILL JONSON, COUNCILMEMBER PAUL F. GIBSON, COUNCILMEMBER
,,EQUAL EMPLOYMENT AND AFFIRMATIVE ACTION EMPLOYER"
�9hATEp -���
Clearwater City Commission Work session Item #:
Agenda Cover Memorandum
SUBJECT/RECOMMENDATION:
Final Agenda Item #
Meeting Date: 10 -16 -13
Approve the annexation, initial Future Land Use Map designation of Residential Urban (RU) and initial Zoning
Atlas designation of Low Medium Density Residential (LMDR) District for 1247 Union Street (Lot 18, Block
A, Cleardun Subdivision); and Pass Ordinances #8485 -13, #8486 -13 and #8487 -13 on first reading.
(ANX2013- 08025)
9 and that the appropriate officials be authorized to execute same.
SUMMARY:
This voluntary annexation petition involves a 0.141 -acre property consisting of one parcel of land occupied by a
single - family dwelling. It is located on the south side of Union Street, approximately 600 feet west of Betty Lane
(County Road 355). The applicant is requesting annexation in order to receive solid waste service from the City, and
will connect to City sewer when it is available in the future, as part of the City's Idlewild/The Mall Septic -to -Sewer
Project. The property is contiguous to existing City boundaries to the south. It is proposed that the property be
assigned a Future Land Use Map designation of Residential Urban (RU) and a Zoning Atlas designation of Low
Medium Density Residential (LMDR).
The Planning and Development Department determined that the proposed annexation is consistent with the provisions
of Clearwater Community Development Code Section 4 -604.E as follows:
• The property currently receives water service from the City. Collection of solid waste will be provided to the
property by the City. The applicant will connect to the City's sanitary sewer service when it is available, and is
aware of the fee that must be paid in order to connect and the financial incentives available. The property is
located within Police District II and service will be administered through the district headquarters located at
645 Pierce Street. Fire and emergency medical services will be provided to this property by Station #51
located at 1720 Overbrook Avenue. The City has adequate capacity to serve this property with sanitary sewer,
solid waste, police, fire and EMS service. The proposed annexation will not have an adverse effect on public
facilities and their levels of service; and
• The proposed annexation is consistent with and promotes the following objective of the Clearwater
Comprehensive Plan:
Objective A.6.4 Due to the built -out character of the City of Clearwater, compact urban development
within the urban service area shall be promoted through application of the Clearwater Community
Development Code.
Objective A.7.2 Diversify and expand the City's tax base through the annexation of a variety of land
uses located within the Clearwater Planning Area.
Policy A.7.2.3 Continue to process voluntary annexations for single - family residential properties upon
request.
The proposed Residential 1, _ .an (RU) Future Land Use Map ca )ry is consistent with the current
Countywide Plan designation of this property. This designation primarily permits residential uses at a density
of 7.5 units per acre. The proposed zoning district to be assigned to the property is the Low Medium Density
Residential (LMDR) District. The use of the subject property is consistent with the uses allowed in the district
and the property exceeds the district's minimum dimensional requirements. The proposed annexation is
therefore consistent with the Countywide Plan and the City's Comprehensive Plan and Community
Development Code; and
• The property proposed for annexation is contiguous to existing City boundaries to the south; therefore, the
annexation is consistent with Florida Statutes Chapter 171.044.
View looking south at the subject property 1247 Union Street.
West of the subject property
View looking easterly along Union Street
Across the street, to the north of the subject property
East of the subject property
View looking westerly along Union Street
ANX2013 -08025
Bellman, Juanita Browning
1247 Union Street
August 13, 2013
Juanita Browning Bellman
1247 Union St.
Clearwater, FL 33755
CITY OF CLEARWATER
PLANNING AND DEVELOPMENT DEPARTMENT
Posr OFFICE Box 4748, CLEARWATER, FLORIDA 33758 -4748
MUNICIPAL SERVICES BUILDING, 100 SOUTH MYRTLE AVENUE, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562 -4567 FAX (727) 562 -4865
RE: Petition for Annexation for 1247 Union Street (0.141± acres) - ANX2013 -08025
Dear Ms. Bellman:
The City of Clearwater Planning & Development Department has conducted a preliminary review of your
application for annexation for the property described above and has determined the application is complete. The
application case number is ANX2013 -08025
The following City board review schedule has been tentatively established for your application. You will be
notified if you are required to attend the meetings and should there be any change in meeting time or location.
09/05/2013 Development Review Committee Meeting
Time TBD* Municipal Services Building, 2nd floor
Planning & Development Department, Conference Room 216
100 S. Myrtle Ave., Clearwater, FL
*Please call Sherry Watkins at 727.562.4582 no earlier than one week
prior to the meeting for the approximate time of the case review.
10/16/2013
City Council Public Hearing (first reading)
6:00 PM
City Hall Council Chambers, 3`d Floor
112 S. Osceola Ave., Clearwater, FL
11/07/2013
City Council Public Hearing (second reading)
6:00 PM
City Hall Council Chambers, 3`d Floor
112 S. Osceola Ave., Clearwater, FL
If you have any questions, please do not hesitate to contact me at Andrew.Hayslip @myclearwater.com or
727.562.4626.
Sincerely,
Andrew Hayslip,
Planner 11
GEORGE N. CRETEKOS, MAYOR
DOREEN HOCK- DIPOLITO, COUNCILMEMBER JAY POLGLAZE, COUNCILMEMBER
BILL JONSON, COUNCILMEMBER PAUL F. GIBSON, COUNCILMEMBER
"EQUAL EMPLOYMENT AND AFFIRMATIVE ACTION EMPLOYER"
CITY OF CLEARWATER PUBLIC HEARING NOTICE
ANNEXATION, LAND USE PLAN AND ZONING ATLAS AMENDMENTS
The City of Clearwater, Florida, proposes to adopt the following ordinances:
ORDINANCE NO. 8485 -13
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, ANNEXING CERTAIN REAL PROPER _1Y LOCAT ED ON
FHE SOUTH SIDE OF UNION STREET, APPROXIMATELY 600 FEET WEST OF BETTY LANE (COUNTY ROAD 355),
CONSISTING OF LOT 18, BLOCK A, CLEARDUN SUBDIVISION, WHOSE POST OFFICE ADDRESS IS 1247 UNION
STREET, CLEARWATER, FLORIDA 33755, INTO THE CORPORATE LIMITS OF THE CITY, AND REDEFINING THE
BOUNDARY LINES OF THE CITY TO INCLUDE SAID ADDITION; PROVIDING AN EFFECTIVE DATE.
ORDINANCE NO. 8486 -13
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, AMENDING THE FUTURE LAND USE PLAN ELEMENT OF
THE COMPREHENSIVE PLAN OF THE CITY, TO DESIGNATE THE LAND USE FOR CERTAIN REAL PROPERTY
LOCATED ON THE SOUTH SIDE OF UNION STREET APPROXIMATELY 600 FEET WEST OF BETTY LANE (COUNTY
ROAD 355), CONSISTING OF LOT 18, BLOCK A, CLEARDUN SUBDIVISION, WHOSE POST OFFICE ADDRESS IS
1247 UNION STREET CLEARWATER, FLORIDA 33755, UPON ANNEXATION INTO THE CITY OF CLEARWATER, AS
RESIDENTIAL URBAN (RU); PROVIDING AN EFFECTIVE DATE.
ORDINANCE NO. 8487 -13
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, AMENDING THE ZONING ATLAS OF THE CITY BY
ZONING CERTAIN REAL PROPERTY LOCATED ON THE SOUTH SIDE OF UNION STREET APPROXIMATELY 600
FEET WEST OF BETTY LANE (COUNTY ROAD 355), CONSISTING OF LOT 18, BLOCK A, CLEARDUN SUBDIVISION,
WHOSE POST OFFICE ADDRESS IS 1247 UNION STREET CLEARWATER, FLORIDA 33755, UPON ANNEXATION
INTO THE CITY OF CLEARWATER, AS LOW MEDIUM DENSITY RESIDENTIAL (LMDR); PROVIDING AN EFFECTIVE
DATE.
The proposed ordinances will affect the land area shown on the map in this advertisement:
(INSERT MAP HERE)
Schedule of Public Hearings:
Wednesday, November 20, 2013 before the City Council (1St Reading), at 6:00 p.m.
Thursday, December 5, 2013 before the City Council (2nd Reading), at 6:00 p.m.
All public hearings on the ordinances will be held in Council Chambers, 3rd floor of City Hall, 112 South Osceola Ave,
Clearwater, Florida. The ordinance and complete legal description of the property proposed for annexation, by metes and
bounds, may be inspected or obtained at Official Records & Legislative Services, located at City Hall. (Juanita Browing
Bellman) ANX2013 -08025 Assigned Planner: Andy Hayslip (727) 562 -4626
Interested parties may appear and be heard at the hearing or file written notice of approval or objection with the Planning
and Development Director or City Clerk prior to the hearing. Any person who decides to appeal any decision made by the
Board or Council, with respect to any matter considered at such hearings, will need to request a record of the proceedings
and, for such purpose, may need to ensure that a verbatim record of the proceedings is made, which record includes the
testimony and evidence upon which the appeal is to be based per Florida Statute 286.0105.
Michael Delk Rosemarie Call, MPA, CMC
Planning and Development Director City Clerk
City of Clearwater
P.O. Box 4748, Clearwater, FL 33758 -4748
A COPY OF THIS AD IN LARGE PRINT IS AVAILABLE IN OFFICIAL RECORDS & LEGISLATIVE SERVICES. ANY
PERSON WITH A DISABILITY REQUIRING REASONABLE ACCOMMODATION IN ORDER TO PARTICIPATE IN
THIS MEETING SHOULD CALL (727) 562 -4093 WITH THEIR REQUEST.
To learn more about presenting to Clearwater boards and City Council, go to
http:// clearwater.granicus.com /ASX.php ?publish id =13 and click on "Resident Engagement Video." You can also check
the informational video out from any Clearwater public library.
Ad: 11/6113 & 11/20/13
ANXZU i uO
REIDY ROY M PATRICIO FELIPE P C/O BURBINE R TODD
443 RICHMOND ST 447 NORFOLK ST 4500 140TH AVE N STE 202
DUNEDIN FL 34698 DUNEDIN FL 34698 CLEARWATER FL 33762
DONOGHUE JANETTE L PATRICIO CARLOS BLANKENSHIP JAMES S
38 HIGHLAND AVE PATRICIO HORTENSIA BROWN CANDYCE E
DUNEDIN FL 34698 8 HIGHLAND AVE 542 NORFOLK ST
DUNEDIN FL 34698 DUNEDIN FL 34698
SCOTT DEBORAH B
STEINWAY WILLIAM A
KORMAN DAVID C
26 HIGHLAND AVE
STEINWAY BROOK C
536 NORFOLK ST
DUNEDIN FL 34698
4 HIGHLAND AVE
DUNEDIN FL 34698
DUNEDIN FL 34698
DUNEDIN FL 34698
DUNEDIN FL 34698
BRAINARD MELISSA
BAILEY MICHAEL
ELDRIDGE RYAN
22 HIGHLAND AVE
21 HIGHLAND AVE
530 NORFOLK ST
DUNEDIN FL 34698
DUNEDIN FL 34698
DUNEDIN FL 34698
PETERSON BRODY HARRIS LINDA J EST NUCCIO NICHOLAS A
448 NORFOLK ST 25 HIGHLAND AVE 522 NORFOLK ST
DUNEDIN FL 34698 DUNEDIN FL 34698 DUNEDIN FL 34698
TYNDALL MARY ANN
MANTIONE JACQUELINE
COLE GABRIEL L
CLARK MARJORIE
37 HIGHLAND AVE
512 NORFOLK ST
442 NORFOLK ST
DUNEDIN FL 34698
DUNEDIN FL 34698
DUNEDIN FL 34698
DUNEDIN FL 34698
WATTS MARI
C/O OF TONI BRAY
C/O ALICE MARY WEAVER
436 NORFOLK ST
1603 BONAIR ST
3 HIGHLAND AVE
DUNEDIN FL 34698
CLEARWATER FL 33755
DUNEDIN FL 34698
430 N NORFOLD ST LAND TRUST
CONWAY JOHN
KREIDLER JAMES M
TRUSTEE CO THE
519 RICHMOND ST
KREIDLER LINDA M
PO BOX 430
DUNEDIN FL 34698
9 HIGHLAND AVE
OZONA FL 34680
DUNEDIN FL 34698
GOODWIN FAMILY TRUST
GILL STEPHEN A
COX KITTY O
GOODWIN SIDNEY D THE
525 RICHMOND ST
STEWART FRANKLIN L
427 NORFOLK ST
DUNEDIN FL 34698
13727 JUDY AVE
DUNEDIN FL 34698
HUDSON FL 34667
HAINES CYNTHIA V
CONRAD DONALD W SR
STRANGE STEPHEN
441 NORFOLK ST
CONRAD KAREN A
1030 SEDEEVA ST
DUNEDIN FL 34698
531 RICHMOND ST
CLEARWATER FL 33755
DUNEDIN FL 34698
MC CAIN HARRIS C WARNER ALAN B FUERST DARLENE
525 NORFOLK ST 1235 UNION ST 1260 PALM ST
DUNEDIN FL 34698 CLEARWATER FL 33755 CLEARWATER FL 33755
DIFFENDERFER DEBBIE
MIHALINEC LINDA
FOX ALISON J
DIFFENDERFER ROBERT
1237 UNION ST
1256 PALM ST
1415 MAIN ST LOT 29
CLEARWATER FL 33755
CLEARWATER FL 33755
DUNEDIN FL 34698
HERNANDEZ DELIA R
SMITH DARRELL G
CASSIDY BILL J
49 CORNELL ST
PO BOX 456
CASSIDY DORTHY
MANCHESTER CT 06040
MONTEAGLE TN 37356
102 FARRAR DR
CLEARWATER FL 33755
AURORA IN 47001
MANDRIGUES GARY
EGNACHESKI CHRISTOPHER
CECIL KIMBERLY A J
MANDRIGUES DARILYN
1245 UNION ST
1246 PALM ST
4675 NEPTUNE DR SE
CLEARWATER FL 33755
CLEARWATER FL 33755
ST PETERSBURG FL 33705
DUNEDIN FL 34697
CLEARWATER FL 33755
' " " "' " "'
BROWNING JUANITA J
VENEGAS ENRIQUE
547 NORFOLK ST
1247 UNION ST
1244 PALM ST
DUNEDIN FL 34698
CLEARWATER FL 33755
CLEARWATER FL 33755
PENA EUSTACIO A
FISCHER ANN M
HASTY SAMUEL C
PENA FELIPA M
1253 UNION ST
1238 PALM ST
559 NORFOLK ST
CLEARWATER FL 33755
CLEARWATER FL 33755
DUNEDIN FL 34698
ZELLER JOSEPH L
REYO JULINDA
NINRAT JANTAKAN
1030 OSAGE ST
AMNAY RAMESHWAR
1234 PALM ST
CLEARWATER FL 33755
1255 UNION ST
CLEARWATER FL 33755
CLEARWATER FL 33755
DEL VALLE JULIA
REED DONALD L
MC ATEER KENNETH D
1219 UNION ST
REED LOIS A
MC ATEER MARY C
CLEARWATER FL 33755
PO BOX 526
1230 PALM ST
DUNEDIN FL 34697
CLEARWATER FL 33755
ROSE DONNA K
PRUITT - VAZQUEZ AMY J
CHAMUSCO KAREN
1223 UNION ST
VAZQUEZ SILVERIO B
1224 PALM ST
CLEARWATER FL 33755
1263 UNION ST
CLEARWATER FL 33755
CLEARWATER FL 33755
PAULTRE FRANTZ G
TINGLING ANDREW M
MOLINA MAUREEN
1308 VERMONT AVE
TINGLING DIANNE
MOLINA AMILCAR
TARPON SPRINGS FL 34689
1505 SEASPRAY LN
1222 PALM ST
DUNEDIN FL 34698
CLEARWATER FL 33755
BUBAR JOAN E ALI AZEEM MALCOLM BRADLEY
1220 PALM ST ALI SABITA 169 ALVIN ST
CLEARWATER FL 33755 205 STEEPLECHASE LN KITCHENER ON N2J 3,17
PALM HARBOR FL 34684 CANADA
HAMM CATHY M TORRES CECILIA JONES PATRICK J
HAMM JOSEPH A 1259 PALM ST 1220 BERMUDA ST
2420 PINTAIL WAY CLEARWATER FL 33755 CLEARWATER FL 33755
ROBERTA GA 31078
MC CLENNING ELFRIEDA L EST GALLIPEAU MARIE T H R FLORIDA LLC
1215 PALM ST 1263 PALM ST 1726 E 7TH AVE STE 6
CLEARWATER FL 33755 CLEARWATER FL 33755 TAMPA FL 33605
WEBER DENISE A STUTLER SOPHIE BRZOSTEK HENRY A
1221 PALM ST 1264 BERMUDA ST 1245 BERMUDA ST
CLEARWATER FL 33755 CLEARWATER FL 33755 CLEARWATER FL 33755
GARSON TIMOTHY T TOELLE BETSY J HOOPER JANA N
GARSON ROSEMARY G 1262 BERMUDA ST 1247 BERMUDA ST
1780 TEAKWOOD LN CLEARWATER FL 33755 CLEARWATER FL 33755
DUNEDIN FL 34698
DAWSON CLIFFORD B III HARVEY ERIC PETERS JAMES W
1233 PALM ST HARVEY LIZA 1251 BERMUDA ST
CLEARWATER FL 33755 12136 SAINT CRISPIN CLEARWATER FL 33755
EL PASO TX 79936
SHERMAN MARJORIE HALL VADA LORRAINE GROVER ERNEST R JR
1235 PALM ST BARCLAY MARVIN D REM GROVER LINDA J
CLEARWATER FL 33755 1250 BERMUDA ST 1255 BERMUDA ST
CLEARWATER FL 33755 CLEARWATER FL 33755
JUBB LYNNE R THE AMNAY CHATERAM
* * * * * * * * ** JUBB PETER S THE AMNAY SHANTI EST
1103 SUNSET POINT RD 1242 BERMUDA ST 1312 RICHLAND DR
CLEARWATER FL 33755 CLEARWATER FL 33755 DUNEDIN FL 34698
WHITEHEAD KEVIN FRANZESE MICHAEL A BENDER MARILYN
WHITEHEAD TRACY 1234 BERMUDA ST HALPERIN RICHARD
1245 PALM ST CLEARWATER FL 33755 10401 MCDOWELL MOUNTAIN RANCH APT 230
CLEARWATER FL 33755 SCOTTSDALE AZ 85255
RUCH CHRISTOPHER E DURAKOVIC HASIBA RAY SHANDA
3315 WIND CHIME DR W 1232 BERMUDA ST RAY KEITH
CLEARWATER FL 33761 CLEARWATER FL 33755 1273 UNION ST
CLEARWATER FL 33755
C & K SAFETY HARBOR LLC
200 9TH AVE N STE 200
SAFETY HARBOR FL 34695
SANDERSON THOMAS R
1283 UNION ST
CLEARWATER FL 33755
MEDEIROS GILBERT
1282 PALM ST
CLEARWATER FL 33755
COX DAWN MICHELLE
1278 PALM ST
CLEARWATER FL 33755
ROBINSON KATHLEEN
ROBINSON THURMAN
1274 PALM ST
CLEARWATER FL 33755
CARROLL ROBERT J
CARROLL BETH A
950 PINE HILL RD
PALM HARBOR FL 34683
LEONE JARED M
1266 PALM ST
CLEARWATER FL 33755
DESMOND BONNIE J
1267 PALM ST
CLEARWATER FL 33755
FISHER JEREMY T
DE CICCO NICOLE S
1271 PALM ST
CLEARWATER FL 33755
CASE BARBARA
CASE KENNETH R
1275 PALM ST
CLEARWATER FL 33755
SCOTT MICHAEL R LIVING TRUST
SCOTT MICHAEL R THE
14256 LORA DR
LOS GATOS CA 95032
HOLCOMBE SARAH 1
1276 BERMUDA ST
CLEARWATER FL 33755
COATES BARRIE
9839 119TH WAY
SEMINOLE FL 33772
° �learwater
U
Planning & Development Department
Petition for Annexation
ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED IN PERSON (NO FAX OR
DELIVERIES) TO THE PLANNING & DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE DATE.
A TOTAL OF 14 COMPLETE SE7S OF APPLICATION AND SUPPLEMENTAL MATERIALS (1 ORIGINAL AND 13 COPIES) AS
REQUIRED WITHIN ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. APPLICATIONS
AND SUPPLEMENTAL MATERIALS ARE REQUIRED TO BE COLLATED AND STAPLED 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 APPLICABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE:
IMPACT FEE/ASSESSMENT FEE
PROPERTY OWNER (PER DEED):
$0
TBD lnformation on Impact Fees or Assessment Fees is available from
the City of Clearwater Engineering Department (562-4747).
MAILINGADDRESS: 1 �, �'*'I l.�t�,� e t� �5-�- ('_"�f.� t,�Q..-�-�f� 'i-- � �,.� •�<,S'�
PHONE NUMBER: � 2'� ���$- OD � g C,.�n.onn,�� 'l.a'�l�- �'��-� v�3 �- L�'�i,�
EMAIL: �i �� '�" � �' � -r 3 (� Y�-�.. t � � G biYl
��
ArENT OR RFPF�FSFNT�IT�VFo
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
ADDRESS OF SUBJECT �/
PROPERTY: L � �-I- '� I�- t'� � t� 11 �1 `I" , � � � (i,l �' t.�-}C�-T_f R, Y" � � � � ! �J S
PARCEL NUMBER(S): 0.3 -�, l'- �,�' `�S c� �- U' [� O I' CU ( C� D
LEGAL DESCRIPTION: (` L_�p�f C l,�n lj L�c �• L, a'I I$
CURRENTCITYSERVlCES: SANITARYSEWER
REQUESTED CITYSERVICES: �_ SANITARY SEWER
(select a!1 that apply)
SOLID WASTE
�_ SOLID WASTE
'� WATER
�lanniny & Development Department, 100 S. Myrtle Avenue, Clearvrater, FL 33756, TeL 727-562-45&7; Fax: 727-562-4865
Paye 1 of 7 f Re�✓ised 03/13
° Clearwater
U
Planning & Development Department
Petition for Annexation
Data Sheet
PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAILURE TO COMPLETE THIS
FORM WILL RESULT !N YOUR APPLICATION BEING FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING
APPLICATION CYCLE.
FUTURE LAND USE PLAN DESIGNATION
PRESENT (COUNTY): �
REQUESTED (CITY}: �C
ZONING DISTRICT
PRESENT (COUNTY):
REQUESTED (CITY):
�� n�-� I r.� ��. ,� b a. �n. i r2 �-�-
d r��-- � a 1 �� ��a �. � C'�u,
SITE AREA: �, � �� acres
SIZE OF DEVELOPMENT :
Existing: l
Proposed: �
(e.g., number of units, hotel rooms or
non- residential square footagel
USE OF PROPERTY:
Existing (currently on site):
Proposed (new use, if any;
plus existing if to remain):
If residential use; is unitfs)
rentai ?
��(��1A,1
���
.St t►� W� 4 � Q(b„ �_ F�,�
s� �
STATE OF FLORIDA, COUNTY Of PINELLAS
I(we), 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 ,o� day of
��i�� �oi3 , .bY
;��,�(j� �`�1 �j ��Jf%��//'�, who i p rsonall nown/has
� �,«�„� � q�� ����;� produced ,�,(� J�� l,�% ��"_/,�%� 2 as identification.
Sig�y(ature of property owner or representative
otary pub
My commission expi
Signature of property owner or representative
�1/'J r�/� ���,�c-�—
�A/a.A�J41►AASIAAAAJ►A.
ol�Y Pv� Notary Public State of Florida
� Ann Fischer
y, � � My ommission DD925501
'?o�n,o� Expires 11l29/2013
Planning & Development Department; 100 S. Nlyrtle Avenue, Clearwater, FL 33756, Tal: 727-562-4567; Fax: 727-562-4365
Page 2 of 7 Revised 03I13
°: l rwater
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PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
PHONE NUMBER:
EMAiL: 1'1, �� f--��J" 3�l h oi- a �' - C� n rri
AGENT OR REPRESENTATiVE: ,il
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
Planning & Development Department
Petition for Annexation
Disclosure Statement
OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBIECT PROPERTY:
NAME:
INTEREST IS:
SPECIFIC INTEREST HELD:
DOES A CONTRACT EXIST FOR SALE OF THE SUBIECT PROPERTY? YES __� NO
CONTRACT IS:
PARTIES INVOLVED — NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY? � YES NO
PARTIES INVOLVED — NAME: �i,�y� t �/ PHONE NUMBER: �pl� C�1 Um �-
. � ���rt �..�f��rls/ -��U��1 �,� �1� ��S �
IVHIVIC: v Yf"IVIVC IVVIVIDCIt: /J _) �I_6'_'%��' _� O� ���.�.L�j\
� b� J �� J
ARE THERE ANY MORTGAGES OR LIENS ON THE SUBIECT PROPERTY? x YES NO
PARTIES INVOLVED—NAME: � W�,�V �..0�� S��l/i ��ny , PHONE NUMBER: �-8�0 "��ol� `�1�-la J c,�
NAME: 1' / R PHONE NUMBER:
STATE OF FLORIDA, COUNTY OF PINELLAS
1(we), the undersigned, acknowiedge 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:��� �J �� �f, �pj�y of
. by
�
ature of property owner or
Signature of property owner or representative
produced
._.--
Notary pub�ic,
My commission expire�
a
.
a
is personally known/has
as identification.
Notary Public State of Florida
nn isc er
� My Commission DD' �::�u�
c....�.e� � � ion��n.: .
.... . . _ '.,: V'1lV'+lAR�
Planning & Developrnent Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 5 of 7 Revised 03113
° �lear�at�r
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PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
CITY OF CLEARWATER CASE
NUMBER:
Planning & Development Department
Petition for Annexation
Supplemental Statement
S
I/we,
[insert names of all property owners], having filed a Petition for Annexation regarding the above property/case number,
grant consent, agree and acknowledge that the City of Clearwater may immediately or at a later time process the application
to completion, including adoption and recordation of related Ordinances, without the necessity to further notice me/us. This
Suppiemental Statement shall supersede any provision in any Agreement to Annex executed by me/us or my/our
predecessors in interest.
I/we further agree and acknowledge that i/we shall not rescind the Petition for Annexation or execute any documents
attempting such rescission, and that any attempted rescission shall be of no force and effect.
STATE OF FLORIDA, COUNTY OF PINELLAS
I(we), 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 appiica i n�
Sworn to and subscribed before me this �� day of
�j�nature of property owner (individuyor authorized
representative of corporation, partnership or other
entity)
Signature of co-property owner
produced �
L
Notary public,
My commission expi�- -.�-
�r
t° .
�. by
is personally known/has
�i � as identification.
�
Notary Public State of Florida
Ann Fischer
Planning & Development Department, 100 S. Nfyrtle Avenue, Clearwater, FI_ 33756, TeL• 727-562-4567; Fax: 727-562-4865
Page 7 of 7 ftevised 0311 �
�
1247 UNION ST
ANX2013-08025
1
Bellman, Juanita Browning Planning & Development Department
zonin9: At'as#: Petition for Annexation
V v � � �.
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 COMPLETE SETS OF APPLICATION AND SUPPLEMENTAL MATERIALS (1 ORIGINAL AND 10 COPIES) AS
REQUIRED WITHIN ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. APPLICATIONS
AND SUPPLEMENTAL MATERIALS ARE REQUIRED TO BE COLLATED AND STAPLED 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 APPLICABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE:
IMPACT FEE/ASSESSMENT FEE:
$U
TBD lnformation on Impact Fees orAssessment Fees is available from
the City of Cleanvater Engineering Department (562-4747).
PROPERTY OWNER (PER DEED): Sunstream Lane Development, LLC
nn,aiutv� a�oRESS: 2850 Sunstream Lane, Clearwater, FL 33759
PHONE NUMBER: 727-725-1245
EnnAi�: tmmcnay@hotmail.com
AGENT OR REPRESENTATIVE: Terence M. McNay
nnaiuN� a,��RESS: 2850 Sunstream Lane, Clearwater, FL 33759
PHONE NUMBER: 727-725-1245
Ennai�: tmmcnay@hotmail.com
ADDRESS OF SUBJECT
PROPERTY: Sunstream Subdivision
PARCEL NUMBER(S): 32-2$-� 6-QQQQQ-� 3Q-Q� QQ
N 1/2 OF SW 1/4 OF NE 1/4 OF SEC 32-28-i6 LESS N 360 FT OF W 700FT THEREOF & LESS THAT
LEGAL DESCRIPTION: �54.s7FT FOR Pog TH Sss�a'�' 8" 6 6�FT TH S64D q'01 "W 1'� FT TH 7�iD4 '43"l^! 10� 0 FT
TH N82D46'40"W 33.42FT TH N43D54'59'1/V 29.50FT TH NOOD16'32"E 40.70FT TO POB CONT 14.73
AC(C)
CURRENT CITY SERVICES:
REQUESTEDCITYSERVICES: X
(select all that applyJ
SANITARY SEWER
SANITARY SEWER
SOLID WASTE
X SOLID WASTE
WATER
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 72T-562-4865
Page 1 of 7 Revised 01/12
LL
v �
° � ���.��marwater
;,_��
U
Planning & Development Department
Petition for Annexation
Data Sheet
PLEASE ENSURE THAT THE FOLLOWtNG INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAILURE TO COMPLETE THIS
FORM WILL RESULT IN YOUR APPLICATION BEING FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING
APPLICATION CYCLE.
FUTURE LAND USE PLAN DESIGNATION
PRESEivT (couNrir): (P) Preservation / (RL) Residential Low
REC2uESTE� (ciTV): Preservation / Residential Low
ZONING DISTRICT
PRESErvT (courvnr): (AE) Agricultural Estate Residential
REQuESTE� (anr): (LDR) Low Density Residential �
SITE AREA:
SIZE OF DEVELOPMENT :
14.946 acres
Existing: 14.698 AC
Proposed: 11.462 AC
(e.g., units, hotel rooms or non- (30 LOtS)
residential square footageJ
USE OF PROPERTY:
Existing (currently on site):
Proposed (new use, if any;
plus existing if to remain):
Vacant / Preservation
Residential / Preservation
STATE OF FLORIDA, COUNTY OF PINELLAS
I(we), 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 'ZS day of
S��n� , 20�3 . by
�c�2llc( i����S , who is personally kn�uvn/has
produced
Signature of property owner or representative
My commission expires:
Signature of property owner or representative
as identification.
`Notary PuDlic - Stue ol FbtfQ�
1lly Comm. Expwa Feb 2�. 241!
Commission #� EE 145T�0
Bonded Throu� tqdon�l Motuy �.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 2 of 7 Revised 01/12
6'i
LL . . '.�..��:��:�,..
° �� �-�rwater
U �
Planning & Development Department
Petition for Annexation
Submittal Package Instructions & Checklist
IN ADDITION TO THE COMPLETED ANNEXATION PETITION FORM, ALL PETITION FOR ANNEXATION PACKAGES SHALL
INCLUDE A SUBMITTAL PACKAGE THAT INCLUDES THE FOLLOWING:
J� Signed and sworn (notarized) disclosure of interest statement (form attached).
� If the property is not a platted lot of record, a current survey identifying the dimensions, area and location of the
property having been prepared, signed and sealed by a land surveyor currently registered in the State of Florida within
the most recent 12 months. [Note: Submii two copies only]
❑ If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of the
annexation, requisite site plans, plat, and engineering plans.
❑ Terms of a proposed Agreement to Annex, if any.
0 If the proposed annexation requires a change in the land use classification and zoning category assigned to the
property, a justification for such change must be submitted in writing. If the requested zoning is not consistent with the
Future Land Use Map of the City of Clearwater Comprehensive Plan, the applicant will be required to file a companion
application to amend the map.
� Proof of ownership (e.g., copy of deed, title insurance policy, or other instrument demonstrating ownership). [Note:
Submit two copies only]
❑ If connection to city services is desired prior to the effective date of the annexation, applicant must provide notarized
Petition for Annexation Supplemental Statement (form attached). [Note: Submit original only]
� If applicant is designating an agent/representative to work with City, applicant must provide notarized Affidavit to
Authorize Agent/Representative (form attached). [Note: Submit original only)
INFORMATION REQUIRED TO COMPLETE THE PETITION FOR ANNEXATION APPLICATION AND DATA SHEET CAN BE
FOUND ON THE FOLLOWING DOCUMENTS AND/OR ONLINE AT THE FOLLOWING WEBSITES. IF THE APPLICANT IS
UNCERTAIN WHERE TO LOCATE THIS INFORMATION OR NEEDS ADDITIONAL ASSISTANCE, PLEASE CONTACT THE
PLANNING AND DEVELOPMENT DEPARTMENT, LONG RANGE PLANNING DIVISION AT 727-562-4567.
❑ PARCEL NUMBER (Parcel I.D. Number) can be found on the Warranty Deed. It can also be found by searching the
Pinellas County Property Appraiser's Office website at www.pcpao.or� (search database by address).
❑ LEGAL DESCRIPTION can be found on the Warranty Deed. It can also be found by viewing the property record online at
the Pinellas County Property Appraiser's Office website at www.pcpao.or�.
❑ FUTURE LAND USE PLAN DESIGNATION (COUNTY) can be found by viewing a Property Report using Pinellas County's
Public GIS Viewer available online at http://�is.pinellascountv.or�/public �is/. Search by property address or Parcel I.D.
Number and report will appear.
❑ FUTURE LAND USE PLAN DESIGNATION (CITY) is typically the same as the land use designation in Pinellas County, unless
applicant is proposing a change (see submittal package requirements for more information).
❑ ZONING DISTRICT (COUNTY) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer
available online at http://Qis.pinellascountv.or�/public �is/.
❑ ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's
Zoning Atlas, available online at
http://www.myclearwater com/�ov/depts/pwa/engin/publications/en�atlas/atkas asp.
❑ SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online
at http://�is.pinellascountv.or�/public �is/.
Planning 8� Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 3 of 7 Revised 01112
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LL
p t. ��
���:e� ��arwater
� -
���,�;.
ATTENDANCE AT PUBLIC HEARINGS
Planning & Development Department
Petition for Annexation
Information for Applicants
The applicant or applicant's representative is encouraged to attend City Council public hearings unless the annexation
pertains to a property developed or to be developed with one single family dwelling.
STANDARDS FOR ANNEXATION
In determining whether to annex a property, the City shall consider the extent to which:
❑ The proposed annexation will impact public services (e.g., water, sewer, police, parks, etc.).
❑ The proposed annexation is consistent with the City of Clearwater Comprehensive Plan.
0 The proposed annexation requires a change in the future land use and zoning classifications assigned to the
property as well as the jurisdiction for said change.
❑ Existing or proposed development is consistent with City regulations.
❑ Terms of a proposed Annexation Agreement, if any, promotes the City of Clearwater Comprehensive Plan.
PROPERTY OWNER AGREEMENT
Please be advised that, in consideration of the annexation, the property owners do hereby agree that:
❑ All structures and improvements which are erected upon said property subsequent to the date of this petition for
annexation shall comply with all applicable City of Clearwater regulations and ordinances as set forth in the City
Code of Ordinances;
❑ If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of
the annexation, requisite site plans, plat, and engineering plans to ensure compliance with the city's Community
Development Code (see Submittal Package Instructions Checklist). It is recommended that the applicant meet with
Planning and Development Department staff to review plans and/or discuss the applicable city regulations.
❑ All annexations of residential dwellings of eight dwelling units or more shall convey such recreation facilities fees
and recreation land dedication and/or fees in the amount and manner prescribed by Chapter 54, Article II of
Clearwater Code of Ordinances; and
❑ When any substandard abutting street or utilities are subsequently upgraded by the City to meet City Standards,
said improvement(s) will be done on an assessment basis, consistent with City procedures therefore.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 4 of 7 Revised 01112
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° � ��rwater
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Planning & Development Department
Petition for Annexation
Disclosure Statement
PROPERTY OWNER (PER DEED): Sunstream Lane Develo�ment L� r
MAIUNG ADDRESS: 2g50 Sunstream Lane, GlParwatPr, EL 33�59
PHONE NUMBER: 727_725-�2t�5
EMAi�: tmmcnavCa)hotmail.com
AGENT OR REPRESENTATIVE: Terence M. McNay
nnAiurv� Ao�RESS: 2850 Sunstream Lane, Clearwater, FL 33759
PHONE NUMBER: 727-725-1245
EMAIL: tmmcnavCc�hotmail.com
OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBIECT PROPERTY:
NAME:
INTEREST IS:
SPECIFIC INTEREST HELD:
DOES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPERTY?
CONTRACT IS:
PARTIES INVOLVED - NAME:
NAME:
ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY?
PARTIES INVOLVED - NAME:
NAME:
ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY?
PARTIES INVOLVED - NAME:
NAME:
_ YES _� NO
PHONE NUMBER:
PHONE NUMBER:
_ YES X NO
PHONE NUMBER:
PHONE NUMBER:
YES
PHONE NUMBER:
PHONE NUMBER:
�1L
STATE OF FLORIDA, COUNTY OF PINELLAS
I(we), 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 2� day of
��-.r� 0�3 , by
�
�,,�;* �-a-r�� 'M`��S . who is personall n/has
produced
property owner or representative
Notary publi
My commission expires:
Signature of property owner or representative
as identification.
Mot�ry PuDlic - St�te of NorM�
='',�7 Commiaiion �f Ef 1�5730
Planning � Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Te 72��67odii6rdTbjDi�i9AN�i�iWyyAyfp,
Page 5 of 7
�
� Planning & Development Department
} ����� Petition for Annexation
�
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Ai�idavit to �luthorize Agent/Repre�entative
1. Provide names of all property owners on deed — PRINT full names:
Sunstream Lane Development, LLC _ _
c/o Terence NL. McNay _-- ---____ _ - - -- -- -- - -- - - --
2. That (I am/we arej the owner(s) and record title holder(s) of the foflowing described property:
' � : . 11�11 / � �1 1 - �1 1- - �� _ _
3. That this praperty constitut�s the property for which a requesi for (describe requestj:
-- Request for City af Ciearwater Annexatior� ,
4. That the undersigned (has/havej ap�nted and (does/db) appoint:
�awrence E. Mill�
as (his/theirj ag�nt(s) to execute any petitions or other documents necessary to affect such petition;
'�. Th�t ifiFs aifidav"rt has been ercecuted ta induce the Crty of E�earwater, Florida to consider and act on the above
.
descr�be�d+���'h►• , .. ., ,
. ::,_ : ,
6. 7`hat site visits to the property are necessary by Gty representatives in order to process this application and the
owner authorizes Crty representatives to vi�it and phota�raph the property described in this applieation;
7. �TF.y� (1/�re), th� _u...n�lersigned autharityt hereby certify that the foregoing is true and correct.
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ProPerty Orvr�er Property Ow�er
ST'At'� QF Ft:ORIDA„ COUNTY OF PINELtAS
BE�QR�. NI� THE UNDERSI("sl�FEp, AN �fFt€�R t7t1tY Ct�MM155�N�Ei BY THE [�111V� OF TTiE �it'ATE UF FE�RfDq, O!V
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Planning & Development Department
Petition for Annexation
Supplemental Statement
PROPERTY OWNER (PER DEED): Sunstream Lane Development, LLC (c/o Terence M. McNay)
MAILING ADDRESS: 2g50 Sunstream Lane. Clearwater. FL 33759
CITY OF CLEARWATER CASE
NUMBER:
i/we, _ Terence M. McNav
[insert names of all property owners], having filed a Petition for Annexation regarding the above property/case number,
grant consent, agree and acknowledge that the City of Clearwater may immediately or at a later time process the application
to completion, including adoption and recordation of related Ordinances, without the necessity to further notice me/us. This
Supplemental Statement shall supersede any provision in any Agreement to Annex executed by me/us or my/our
predecessors in interest.
I/we further agree and acknowledge that I/we shall not rescind the Petition for Annexation or execute any documents
attempting such rescission, and that any attempted rescission shall be of no force and effect.
STATE OF FLORIDA, COUNTY OF PINELLAS
I(we), 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 Z�J day of
�`f- l� �-��' ./i `:�
/.�'-.
S' re o property owner (individual or authorized
representative of corporation, partnership or other
entity)
Signature of co-property owner
��n2 . 2 ��3 . bY
�.-�« �i�` G'M��� , who is personally known/has
produced
Notafy pyblic;�
/,
My commission expires:
as identification.
DE80RAH J 60ff
Ccmmis:lon # EE U5730
londed TMouph Nriioml Motuy bsu.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 7 of 7 Revised 01112