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ANX2014-12026,. LL 2116 BURNtCE DR ° � ea�ater ANX2014-12026 velopment Department � 3elcher Area - Multiple Properties for Annexation ?oning: Low Medium Density Re Atias #: 308B ALL APPLICATIONS ARE TO BE FILLED OUT C�MPLETELY 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 COMPLEfE SETS OF APPLICATION AND SUPPLEMENTAL MATERIALS {1 ORIGINAL AND 13 COPIES) AS REQUIRED WITHIN ARE TO BE SUBMITTED FOR REVIEW BY 7HE 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 APPUCATION, AGREES TO COMPLY WITH ALL APPLICABLE REQUIREMEfVTS OF 7HE COMMUNITY DfVELOPMENT CODE. APPLICATION FEE: SD lMPACT FEE/ASSESSMENT FEE: TBD lnformation on lmpact Fees orAssessment Fees is available from the City of ClearwaterEngineering Department (562-4747). PROPERTY OWNER (PER DEED): Nathan J. and Kathy L. 5outo MAILING ADDRESS: 2116 Burnice Drive, Clearwater, FL 33764 PHONE NUMBER: (727) 461-6496 EMAII: nsouto@tampabay.rr.com AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBIEC7 2116 Burnice Drive, Clearwater, FL 33764 PROPERTY: PARCEL NUMBER(S): 2a-29-15-31050-0oo-olao LEGAL DESCRIPTION: Glen Ellyn Estates �ot 14 CURRENT CITY SFR VlCFS: fiFQUESTED ClTY SERVICFS: X (select all that apply) SANITAftY SEWER SANITARY SE�NER SOLID WASTE x x SOLID WASTE WATER �l��,iiir � : . , � . � _ . �'ref, _ �3/�:i, 7 ,2_ �i > ' -.=io `>6 i�� in�= �! ��i . < . Y:,� _ , ,.. . _ w o } Planning & Development Department > � ea�t�t�� 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 tNCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING APPLICATION CYCLE. FUTURE LAND USE PLAN DESIGNATION PRESENT (COUNTY): REQUESTED (CITY}: ZONING DISTRICT PRESENT (COUNTY): REQUESTED (CITY): StTE AREA: 0.236 SIZE OF DEVELOPMENT : Existing: 1 Proposed: 1 (e.a.; number of units, hotel rooms or non- resrdential square footoge) Residential Low (RL) Residential Low (RL) R-3, Single Family Residentiai Low Medium Density Residential (LMDR) acres USE OF PROP�RTY: Existing (currently on site): Proposed (new use, if any; plus existing if to remainj: If residential use, is unit(s) raniai i Singfe ramily Single Fami � STATE OF FLORIDA, COUNTY OF PINELLAS I(wel, 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 appiicaiion. �� y:� Sworn to and subscribed before me this �°S day of ��`-F.��a7C �E / , o/�/ • �y ; � /� ��7c'c�l��J��- ��N �:Lt �' , who is personally known/has •� � � / produced � L— C� �- as identification. �� >IG��. }:*��IC� _ � Signature of property owner or representative 7 , , �"' i- , _� . - � L%�� ' � — c.;i. �—��-�� : ,; Notary pub My commission zxpires: �,.,.�,;-_�„ � _ _ - �i�� ii �� `�t`( CO?V;*,S:SSiON � E£60377 .. ,;, < - `�°�"iCp.�y _.._..._ Co. Signature o� pro�erty own�r or representative ��r9 r; �<-�-� a�r�'�`'` � ;�,,,.t�rz�k'� } -_./ �,,,��a,� �le�.'�-,'a'' f' ��. FzY,r t�.l�,t"+'�.7t/',�''Jt ?lann�i�y 3, iJeveioprn�r�t f�epartrt�ent, '!�4 S. �Ayrile ,4�reniaa, Clearwater; �L 33756, 1"si 7�T��62-dba7; Fax: 727-b62-4805 ;JgP � �t � i�evised �3l13 0 ° ��ter �� Planning & Development Department Petition for Annexatio� Submittal Package Instructions & Checklist IN ADDITION TO THE COMPLETED ANNEXATION PETITION fORM, ALL P�TITlON FOR ANNEXATION FACKAGES SHALL INCLUDE A SUBiV11TTAl PACKAGE THAT INCtUDES THE FOLLOWlNG: ❑ Signed and sworn (notarized) disciosure 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 th2 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: Submit 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. ❑ if the pr000sed 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 Futur° Land Use Map of the City of Clearwater Comprehensive Plan, the apolicant 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] D If connection to city services is desired prior to the effective date of th2 annexation, applicant rnust provide notarized Petition for Annexation Supplemental Statement (form attached). [Note: Submit original only) i� If appiicant is designating an agent/representative to wor� with City, apolicant must provide notarized Affidavit to Authorize Agent/Representative (forrn attached). [lUote: Submit original only] INfORMAT10�1 REQUIRED TO COMPLETE 7HE PETtTION FOR ANNEXATl0�1 APPLiCAT10N AND DATA SHEET CAN BE �OUND ON THE �OLLOWING DOCUMENTS AND/OR ONLINE A7 THE �OLLOtiVIiVG WEBSITES. IF THf APPiICAiVT IS UNCERTAiN WHERE TO LOCATE THIS INFORMATION OR iVEEDS ADDITIONAL ASSISTANCE, PLfASE CONTACT TNE PLANNlNG AND DEVELOPMENT DEPARTMENT, LONG RANGf PLANNING DIV15tON AT 727-562-4567. O 0 � ;] PARCEL �IUMBER tParcel t.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.orQ (searcn 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 vvww.pcpao.or�. FUTURE L4�1D USE PLAtV DESIGNATION (COUNTY) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online at htto://Qis.pinellascounty.or�/ouolic Qis!'. Search by property address or Parcel I.D. �umber and report will appear. � UTUR� LAND USE PLAN DESlGNAT10N (CITY) is rypically the same as �he land use designation in !'inellas County, unless applicant is oroposing a change (see submittal package requirements r'or more information). '? ZOI��ING DISTRICT (COUNTY) can be found by viewing a Prop2rty Report using Pinellas Countl/s Public GiS Viewer availabl� online at nttp:/��is.pinellascounrl.or�/oublir �is!. J ZOiViyG DISTRICT (CIT(} can be found by cor�tacting tne Planning and Develooment Department or viewing the City'� Zonin� ,4tlas, available online at �.:�_J �' "/';'/ :71`lCl2�f'�N3L�f.CO(71�°0�/id2pI5%pb�li; ?(i�'�;��_�J �_r3Lir�i ' � ! �� -i�' l-�d�..3�0. _� `,i �� %�,�.`^. (=1.r��$) Ca^ D� FOUIIG� �J�/`✓Ie;Nlflo 3 �(OU?i1'j i?.2!JO(� !.JSjil� ?�'i�ji?S `^CtJ'lt`y�5 �!�fJ�IC J{S �11QL+;2t" �Vdl�a(J12 Or;�ii't' - - �8��_�� (l.�r ��1!p�_�nI�C QI�� ,.�. . ,..,_ ... , ._tF' ,'IC..,, . � . . �.._. .-.. � . ;.. _, ., � .J" . ._.'�Ge J1?�-i�JDJ _ _. . . � .. I �. ._ , ° l�ar�v�t�r �� U ATTENDANCE AT PUSLIC HEARINGS Planning & Development Departmen# �'etition for A�nexatio� Informaiion for A�plicar�ts The appiicant 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 ��?R AN!�ExoTlON In determining whether to annex a property, the City shall consider the extent to which: ❑ The proposed annexation wil) impact public services {e.g_, water, sewer, police, parks, etc.). ❑ The proposed annexation is consisteni with the City of Ciearwaier Comprehensive P(on. � The proposed annexation requires a change in the future land use and zonino classifications assigned to the property as well as the jurisdiction for said change. ❑ Existing or proposed development is consistent �vith City regulations. O Terms of a or000sed Annexation Agreement, if any, promotes the City of Clearaater Comprehensive Plan. P'ROP�RTY OW�IER AGRE�MfNT Please �e advised that, in consideration of �ne 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 i _i_ _L r __ 'i�ii "-� __J'_�...,. __ r t..�tL aL.� /':�. l�'Pli v:: '.+._._ _ �./ __- _ A( � i� lilC t P' u��.�._.n�.�v�� ..��.,�� ....'�'�'�r�� ..� � �r:'::::.�U.t'. L..j ... �............. .�a_.....:.... ...... _._......._ _ ..., "' ._._.. ... _.._ _._� Code of Ordinances; ❑ Ali residential rental units, including singie-family residences must comply with the requirements in the city`s residertial rental ordirance, whic� requires the properry owner to obta'sn a 8usiness Tax Receipt upon annexation into the city; � 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 shall be submitted to ensure compliance with the cit�/s Community Development Code (see 5ubmittal Package instructions Cnecklist}. it is recommended that ine applicant meet with Planning and Development Department staff to review plans and/or discuss the applicable city regulations; �� All annexations of residential dwellings of ?ight d�,velling units or more shall convey such recreation facilities fees i_._� J_J".. •' .J/ c - ��,. + a �vL4 rh�n+o cT n�-r��lo 11 „f a1"i� (E'CfedllV(1 Id1IU UCUil,diiVi� aiw/vi tcc5 iii u c oiiivuii� diiu iiioinici � icSC�i vy ,�-� � �.-�- � Clearwat�r Code oT Ordinances; and � When any substandard abutting street or utilities are s�bsequently upgraded 'oy the City to meet City Standards, said improvement(s) will be done on an assessment basis, consistent with City �rocedures therefore. �'r,-tn� i � _. _ =v9i0om?n� '��:��r,r . _ , . +-�1,r�'� �-t..a ;fa8n�r �irr, -,_ "�3. , . _I '.�.� ' SSi. ax %`L7-�o2-4365 ;,yrr _ .-;� . .��. . , R.•;ise,, ° C �arwater U PROPERTY OWNER (PER DEED): MAILING ADDRESS: PHONE NUMBER: EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAII: Planning & Development Department Petition for Annexation Disclosure Statement Nathan 1. and Kathy L. Souto 2116 Burnice Drive, Clearwater, FL 33764 (727) 461-6496 nsouto@tampabay.rr.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 SUB.}ECT PROPERTY? CONTRACT IS: PARTIES INVOLVED — NAME: NAME: _ ARE THERE ANY OPTIONS TO PURCHASE THE SUBIECT PROPERTY? PARTIES INVOLVED— NAME: NAMF: ___. ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? PARTIES 1NVOLVED — NAME: NAME: YES X NO PHONE NUMBER: PHONE NUMBER: YES X NO PHONE NUMBER: PHONE NUMBER: YES PHONE NUMBER: PHONE NUMBER: X NO STATE OF FLORIDA, COUNTY OF PINELLAS I 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. /`'.G� day of Sworn to and subscribed before me this -� , t/ ��;�-e'/7"� �; ; � O% -bY ; `'�� j;�1�> .�- {5� ��I�,C? �-f( ` , who is personally known/has �' ;,/ �/�" , � produced � � � > �' as identification. /� /,�;,( r •� � r ; ,., � � __. , -- ; Signature of prop°rry owner or representative , �� ; � — C ��, _ .. �. y,�.r.;�.. `(,� _ _ ,�� r i i�i �'�� u � . , Notary pubiic, � `""�:, TM �r ��' , , . � ,_ � � _ -,� : ` My commission expires: . . __' � i. � }a�10'`� � � E � .. 1� � ;�q 2015 _ �,..' . --- . °""as � c I � — — ---- --- -- -- U` r- � : � _.. ±<� ri'"�V.N _ _ � �,.� �tiw � Jrl:'i �7( ie re�2niatlVe . °�. �` '=: �� Si�nat, �- �� -'r'� -'r, p . _ ,:,�:- - �-d`hF'i , _ �, ' .. s�,;3' -- �° . _ _ , :;:; ? . <<.. _ � t��. _� , ,�, �. . �,, ;,�.5ed03+"�- ° C ear�vater U Planning & Development Department . Petition for Annexation Affidavit to Authorize Agent/Representative 1. Provide names of ali property owners on deed — PRINT fuil names: Nathan J. and Kathy L_ Souto 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 2116 Burnice Drive, Clearwater, FL 33764 3. That th+s property constitutes the property for �,vhich a req�!est for (describe request): Annexation in order to receive solid waste and sanitary sewer service. 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; S. Th�t 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 ne�essary by City representatives in order to process this application and the owner authorizes City representatives to visit and photograph the properiy described �� h�s application; 7. That (I/we}, the undersigned authority, hereby certify that the foregoing is true and correct. Nathan 1. and Kathy l. Souto � -� rivj�c�.y t!'.':.�..... Property Owner � , �' ; 1/ 'T'�: � `i , _ � \.r �� ,�f / 7 !\Cc>_ �--'�•I _ —_1L�=�- � -,� %I`„�Th�,-, _�� ,.� Property Owner Property Owner Sii-+TE OF FLORt�JA, �LOUNTY OF PINELLAS BEFORE ME THE UNDERSIGNED, AN OFF�CER DULY COMNifS�iOUt� �Y � NE �^�"J� Q� T�� STqT� nF FLORIDA, ON THIS _ �, � � � DAY OF ` ;f �C` � /�� Z � � �� ' /�/ , PERSONALLY APPEARED � � � ��,� �; � ��t �-� WHO HAVING BEEN FIftST DULY SWORN �-�` %� Cf r� �� ----�—_° DEPOSED AND SAYS THAT HE/SHE FULLY UNDERSTAiVDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. � 'Vi+'b t' � � e'1 i r,s+�.,�+ - �.vvv�r �'"'�°p�""`%� V�C�[ 1{J `�fU;� �u�� j � Cot.��n��o�. � 5�0�?; �� .;:ri�s ?nJ�n �;,. �o�s i-sa, �_w t:tk; F. ?F,in;y Di>cwn� .vss. �:o. �n.v+-n.n:tr:n;�..,�•:•..,•;�,t,.Ty*.. �r�' � Notary Seai/SiamN i ! � � �I -- � � G-� = _. i �' r , , C �--- _ - �_ -' _ `Notary Public 5ignature A�ly Commission Expir�s: � "/C� �� ,;'��J S.tyt'.;� Av?nue; Clear�,vater. �L. 33i5o �2� '27 :ih? j5n7; rax:'27�552-�'l$65 P+.a�,ning & Oev>;�op�;,-r,i i�a�3r� r�er �. �evised 0311' ':'_}�? � :JT / o Planning & Development Department � �,, :�a,�a,t�r Petition for Annexation � Supplemental Statement PROPERTY OWNER (PER DEED): Nathan J. and Kathy L. Souto MAILING ADDRESS: 2116 Burnice Drive, Clearwater, FL 33764 CITY OF CLEARWA7ER CASE NUMBER: I/we Nathan 1. and Kathy L. Souto [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 �ater 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, COUN7Y 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. J J Svrorn te and subscribed before me this __._ /_ r day of �� b , �� ',;" -r C i�C � ;'� ��:'� Y ' J�c��-/�c,,, :� ��hG� ;��,� �� , who is personally known/has J L, -� produced ��- � i� '`� as identification. � �� 7 �, Signature of property owner (individual or authorized representative of corporation, partnership or other entity) i , �' "�� .' � ='c.,� � �:�t �, ` � '�- _'�:: Signature af co=property owner ; i /.--� - ��. C �� Notary public,;`� c My commission expires: i/j(;Kl 7iJ lv1v�+�• •• *:tY CC�i:vi1SS10N � FE�%?7 % �-� c�. ost� rl. VaxY t�'a.,awn� .";.•a: ��. �1�� , r �� , . � , �: ; - ;�; - , _. _. � � �� .,�„ a , � � � � � � m � i, 0 Ls. ta � � a, U � � v u � b OU N l� ��y.� K ✓ �t ,. �:« r� \: Cl P. �: �;;� ' .., . . .. F, ..� �.4 .�, INST� •'1`1�»at F'INELLRS COUN� . FLA. i'w�nw�+a�r ouo MAY !3 r 1991 3:1 AF'M OFF � REC � RK 7564 Pp 391 IMOIVID �O IMO�YIO '�his i6)arranty �erd v,,,r,. �r�,. �tn ,�„>� „i Mnv ,,. ►>. �� ► r,y Louis Burst �nd Francea W. 8orst. hus6ond and aife ii��minnrl��r iti��Mi ti�v lJr��lur. I�i Naehan J, Suuto nnd Knthy i.. So�to, his w::e �� u•l�n+r pmtu�itco a�i��rr.s i. �•? /1(r �� t.� i,i i c � �l r� i�rrvinn�lrr rniiw� I��r fPnufrr: �� 'A) l -f'r / r � = �1� Z �/ tW6ur��r �v.l. 6n.iu �h. I.nn. •'pu�xr° �ml .•� �n.r" i� lu�b �0 �Ar pu�b� fo iAA Impmne�l •nd iM A.D.. Ire.l npuvn�+�Ae. u�A a,.irm ol inJi.iJ�.t�. •n.l iA• .w�nwN� �nd wl�n� nl sc�pr�lG+nq �ltn:SSffl�. ��Iml ►ii�� prnntur. �ur �uu� In ,•ui��tilrrniio�� u� !'ia �nm of < l0.00 ��„r u�r��. rn�ua��i�� rur�ai�irrrtltnnt. rrrrlpl rn�u�n•u( ie lirrol�y e�rGnou��d��v��. �i��rr�iv tuonfs. I�arpalns. r�Ile. nllrt�a. ro- m(�rs. rr�rn�ra� rmu�rps ane� ron(irn�s luitu t�i�� flrnt�l��o, nii li�nl crrluin �nn�� Ihtatr (n Ptnellus c,��,�Y.1�r�„�,r�. �.�Z: Lui t4, GLEN ELLYN F.5TATGS aecord[ng Co [he Ple[ therrof, as recorded �� '� "� ih Pla[ 9ook 34, Ps�;e 32 uE Y�sb?!c Recorda uf PINELLAS Cnunty, Flurida. ;� a�� _, , , 5ub3ec[ tu ensementb nnd rea[ricilons uE recurd. ,',' — �� . �� ' __ _ — t � � � - .-- -_Grantur's Suc. Ser. D (Luuls} � � _, ,�`t.��rancur's Soc. Sec. !/ (Francey) � ��(��j Vi� Dc"un�.•��dry l��• 'r.f. '-.�J v\ �i.O.II�� ... .. . `�. � � : ��.� 1 i�• � 9�' Parcel D 24/29/l5 /3 1 0 50/000/0 1 4Q t `,..��.; -��' ;�.�;:,,,�; I .. .:�. "'" � : ' 'u.; :ny; c�erx �'ogcther (: ll�o lanements, hersdunmsntr an a�� `~� �,��i � � ppurtonancrs �J�o�oto 5sionpina ar !n any u�llo apparintrdnp. .' -' � �� ` __, ` � �'o �iaue and tn �lold� t{�a eame 1n jrte ilmp�o �orrve�. � > � , , ', � I Tln� I��o granlor horohy couenmil� wtlh iai� ,dranisu� ti�at I�is grol�lur li iow(ui�y a�h� o( ,ard lanci t. i in lro �Implo; t��o! Ihe grnnlon c�u pooc! riphl nnq 1¢ut��N niithmUyc 10' snil an�i conury aafc� �an�; f�at Iht i prnr�lar hrro��y (ully warranl� Iho tlti� lo sat�i,%omi an� t��t�t c{efen�i t�� sama agaln�t t�w lnu�Ju� eialm� o) , � n1� n��enn• �nlmm.nnn.�r nnrt innl �ni.i Innri�e��{�w ni, nii i..n[urnnrnnfa�, qySanr inra± mrn�in� ±��nu�urni ' �_-_'_' _ "__-__"'_ • '"'_'" ""__' _'_"_ _...._ _� - .`' -... _ ... io i)ecemRes il, 19 �,� Graotee's Soc. 5ec.,B (Nnthan) Gran[ee's Suc;��YC.�U �KII�}�y) �n �Uitness �1��cof� I�i� iuici pvanlor h�: �lpn�d onr� ,.ol.d tha. pna�nla ths day an� y�or � (I»I abous wrillrn. � ' i r � �� , � �� . _ SI eci, ara(rd nn�I,��!lueceii.tn oyr pro�rna: „ _ , � . � T�,k ,�� . : _.c..... .� [eiL'd.T ................ _ . ^ . ..... �.... ....... � . .. . ....... .................... . — „ � ` ............. '.- -- ' . .. _" .Luui Borst �- �;, ' ., � � ' �% r r �il,c-...(!/'- /-!�La �!c; . ..... .,i ...-' '`...� . `. �� .:dc..Y..ti ..:..................... .....,...[.f.L ....... . . ..1...:... . �.. .......� . \. ` � ` , �Y�IiI'l•s i�/. �Ul' fspc� �iiqw ,g� e;44�ot�s yff �STA'T� c�P�Fi�url�� h;rtRL,=E�! F. Dcftl_A�ER, _�:I.ERh `CC3UNTYOF�� Plnrllas R[:CDkIi VFF:(FIED C�Yt � . ,� � i,ItE&£�Y�CER7IFY thai an this d�y, bt(ore mr, an officcr duly �uihori�2d 'tn the Sute aforr�sid and in �he County �torcuid ta uke .� �rknowledKmenu, perwn►11y app'ired��_ .. Loi�is Borat and Frantes W. U��rs[, h��sbind acid wife -�. .. . 'R�ie inehumeM wa� p�epamd by: �o mr inawn ta Lr thr p.non s� ddcrihed in �nJ who txe�ulrS the ST�EtiVAHT 7II'[.0 OF CLfAH�4A7FA (otrtoin� irotrument �nd Tiley �c4uowled�ed Eelore mr that They �� U:1Wn D. Flickox.._�..L r.rtcuted ihe �xmr. ]2^0 C.wr1 Sto-»t � ��-�V1li\FSS my h�nd ind ollitial it�t in t�e (:ounly and L'teonvc;cr. iL 3!6'.J ...:� ..itnu')nit �alorifaiJ t�i� % C�l tiay �� YThl:.h hvttu��nl wa� p�,�r....�: lnclJaNul ..�ay . f�#. U. 19 9 � lo ndiiac, �i R�11C.SIlYl1':c�liJ k'clly. `� yO..� I " ..t�.f�-F'.� /�.�'.�i� �., _ _ _ _ �.�, _ -.•__ ; _ ..... _. iVUtBCV �t1�Jl lC. �luLt .,, �';:�;Y':��i ' .- .�.. . . /�,,. 77,�1 h,�;.��,,;:,�r j�n�y�,��J � , . � � >�; _.;�,f:�:..;�; :�, .. j 1 rr;,::,. , �� , �� _'-`, 1 -.; . `> � � � `� . , �� „ _;_ � iv w 0 � � � � C� CD o D � � m Q � c _ � � � � CD � Vi O �� cD CD Cn � v � � ' W O IW � ,� N ZV _, /'� � N � � �..i � � � � � � �� •ry a�� ,i � 0 � � �arwater 2116 BURNICE DR ANX2014-12026 �elopment Department u 3elcher Area - Multiple Properties for Annexation ?oning: Low Medium Density Re Atias #: 308B ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED IN PERSON (NO FAX OR DEIIVERIES) 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 INFORM�tTION MAY INVAUDATE YOiJR HPPLi�ATION. 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 orAssessment Fees is available from the City of Clearwater Engineering Department (562-4747). PROPERTY OWNER (PER DEED): Denis S. Malfant and Janah K. Malfant MAILING ADDRESS: 2106 Pleasant Parkway, Clearwater, FL 33764-4866 PHONE NUMBER: 727-449-1891 EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBIECT 2106 Pleasant Parkway, Clearwater, FL 33764-4866 PROPERTY: PARCEL NUMBER(S�: 24-Z9-15-06426-000-0060 LEGAL DESCRIPTION: Bell-Cheer Sub l�t Add Lot 6& W% of Lot 7 CURRENT CITYSERVICES: SANITARY SEWER SOLID WASTE REQUESTEDCITYSERVICES: x SANITARY SEWER ;i SOUD WASTE (select all that apply) � WATER I.�nnina '�'?e�,eloprneni Department. 1�?C S. V?y;�i� '.��ent,e, ?;learr✓a'ter. �i_ 33756, 7e1: 727-562-4567; �ax: 727-b62�-4865 �age � of ' Revisect 03/13 ° � at�r � � �a� U Planning & Development Department Petition for Annexation �ata Sheet PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAIIURE TO COMPLETE THIS FORM WILL RESULT IN YOUR APPLICATION BEING FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWtNG APPLICATION CYCLE. FUTURE LAND USE PLAN DESIGNATION PRESENT (COUNTY): Residential Low (RL) REQUESTED (CITY): Residential Low (RL) SITE AREA: ZONING DISTRICT PRESENT (COUNTY): REQUESTED (CIIY): 0355 SIZE OF DEVELOPMENT : Existing: 1 Proposed: 1 (e.g., number of units, hotel rooms or non- residential square footage) R-3, Single Family Residential Low Medium Density Residential (LMDR) acres USE OF PROPFRTY: Existing (currently on site): Proposed (new use, if any; plus existing if to remain): If residential use, is unit(s) ... �? ��r��p�. Single Family Dwelling Single Family Dweiling No STATE OF FLORIDA, COUNTY OF PINELIAS i(we), the undersig�ed, acknowie�ge thGt all :-epres�ntations made in this a�•plication are true anci accurate to the besi of ��y knowledge and authorize City representatives to visit and phetograph the prcperty described in this application. Sworn to and subscribed before me this 1� day of J�,fl�i�ii�'�'�i�. �_. by Signature of prope�ty owner dr representative M�t� -,-�-�-�s -(�8-c� ��1, _;: , �. ,, , /Gr, i,..l. , %l ��—;'_�--. ,�— ; of property owner or representati�� -- �3�- S3- S��—C� who is personally known/has produced �'l.�U�� ;5 as identification. Notary pub�, / My commission expires: �ic�u�t PYi1NC • Sqtf 01 fl0fld� Yy Canm. Es�irs� � i�, 281t CaeaNsnoit � �F 9321�0 6� Planning 8 Development Department, 100 S. Myr;!e Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 2 of 7 Revised �J3/13 LL ° : =arw t r � � � � � Planning & Development Department - Petition for Annexation U 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: ❑ 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: Submit two copies only] 0 If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of the annexation, r2quisit2 site pians, piat, and engin�ering pians. ❑ Terms of a proposed Agreement to Annex, if any. ❑ 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 effedive 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] INFORI�JlATlON REQUIRED TO COMPLETE THE PETITION FOR ANNEX�4TI0lV APPLlCATION AND DATA SHEET CAN BE FOUND ON THE FOLLOWING DOCUMENTS AND/OR ONLINE AT THE FOLLOWING WEBSITES. IF THE APPLICANT tS 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). � �EGAL CESC�'�?�C"� �ar, be f� und on the 1,"Jar!-anty Deed. It can also be found by viewing the propery 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.org/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://gis.pinellascounty.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.mvclearwater.com/�ovJdeptsJpwa/en�in/publications/engatlas/atlas.asp. � SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online at http:(/�is.pinellascounty.org/public .�is/. ?!anning ��eve{opment Dep�;?ment. 100 S. t�lyrtlP �,fenue, Clearwaier, F± 33758, jel: 727-502-4�07; Fax.: 727-562-4865 ?age 3 of' 2evised 03/13 LL ° rwat�r �� U 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 w��ther ie anr�ex a property, t� e City sha�l c�nsicier th2 exte�i 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 ciassifications assigned to the property as well as the jurisdiction for said change. 0 Existing or proposed development is consistent with City regulations. - ' 0 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, ihe 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 �rdinances; 0 All residential rental units, including single-family residences must comply with the requirements in the city's residential rental ordinance, which requires the property owner to obtain a Business Tax Receipt upon annexation inio ihe city; ❑ If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of the a^nexation, requis:te sste plans, plat, and engineering plans shall be submitted to �nsure compliance �vith the cit,y's Corr�muniiy Developmen� Cod� (se� Submittal Package Ir.st�:�ctions Checklist). It is recommended that the applicant meet with Planning and Development Department staff to review plans and/or discuss the applicable city regulaiions; ❑ 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 8�evelopment Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 4 of 7 Revised 03/13 LL � � � ��rwater U Planning & Development Department Petition for Annexation Disclosure Statement PROPERTY OWNER (PER DEED): Denis S. Malfant and Janah K. Malfant MAILING ADDRESS: 2106 Pleasant Parkway, Clearwater, FL 33764-4866 PHONE NUMBER: 727-449-1891 EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHOl�JE NUMBER: 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 SUBIECT PROPERTY? YES CONTRACT IS: PARTIES INVOLVED-NAME: PHONE NUMBER: NAME: PHONE NUMBER: ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY? PARTIES INVOLVED - NAME: n�A�!EE: YES PHONE NUMBER: D!-Il��lG AI�Il�/�RFR. ;.� N O ✓ NO ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? 1% YES NO PARTIES INVOLVED - NAME: �� ,� � � ; .;,; ,; �� , ,,�i PHONE NUMBER: �= (, �'� - � S ! � �> � C NAME: PHONE NUMBER: STATE OF FLORIDA, COUNTY OF PINELLAS I(we), the undersigned, acknowledge that ail 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�. y Sworn to and subscribed before me this i" t day of f �(xbC�lc3�2� 2DG`�-( . by � , who is personally known/has ;` ,;'� ��- �. �� ' ; produced �(l.y 1��r �� as identification. Signature of property ewner or epresentative n � � n �_ � , � - 1. Notary . � , r , _, ',' ,�;!:- � j ,` .. ; � i �_ �� p P Y � P� � � _� _ __-- -- � ��' r— . ; Signature of ro ert oUmer or rP resentativ� Pianning & Dv��elopment Departrnent. �1"D ��.. �rty,*te ?v � Page 5 of 7 n expires � � J. M. Iq�1'EIYS- ►�an► �ere - u� a �or� Co� �r Fi ts�iae /�� 2�� ;Fax:72i-5o2-48S5 Rsvised 03i93 o [` + Planning & Development Department � t� �t��t��r Petition for Annexation � Af� davit to Authorize Agent/Representative 1. Provide names of all property owners on deed — PRINT full names: Denis S. Malfant Janah K. Malfant 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 2106 Pleasant Parkway 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; 5. � hat site visits to the property are necessary by C�t�� representatives in order to process this application and the owner authorizes City representatives to visit and photograph the property described in this application; 7. That {1/we), the un�signed authority, hereby certify that the foregoing is true and correct. � ; �-., �% ; :� Propert Owner � Property Owner �� ' �` CE/b ; i.�'� ilT� ��/ j� ' � , �property Owner :�—.— Property Owner .J STATE OF FLORIDA, COUNTY Cr �IPlELLAS BEFORE ME THE UNDERSIGNED, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON THIS I� �JAY OF ��L- , � 6� , PERSONALLY APPEARED ��--�� -�W �L'��'" Y�� WHO HAVING BEEN FIRST DULY SWORN DEPOSED AND SAYS THAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. �i�. n �,�it .�,(.(/�--_' J. M. ANOIIEIYS � .. — • • �Y�'�bltafforld� Notary ublicSignature M�► Comn�. EqM�� ArO ta. 2018 �., / ivota� m � � � ��f� My Commission �xpires: .' ( :�� f � ��'-3 / Ptanning 8 Development Department, 100 S. IVlyrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 6 of 7 Revised 03/13 LL ° � �ar�wat�r � r U PROPERTY OWNER (PER DEED): Denis S. Malfant and Janah K. Malfant MAILING ADDRESS: 2106 Pleasant Pa GTY OF CLEARWATER CASE NUMBER: Planning & Development Department Petition for Annexation Supplemental Statement Clearwater, FL 33764-4866 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, inciuding 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 �� day of �. 6�o V.1J�15 �12» , G� �"t . by ; Jw % ' -- -_L, ' e Signature of prope �y owner individual or authorized representative of corporation, partnership or other entity) , � I%(' - ` f % �/ of co-property owner who is personally known/has produced ��'�' �'1� as identification. Notary p,trjarlic, My commission expires: �(� �j � J � � � �l �lik • � � �� A► Can�r. EqN+q 1wA 11� lA11 � i ff 1�31Ae � Plarning & Developmsnt DeparUn�nt 1,� ��. �,�, ?v�.;nu�e, ��Iearn+ater, FL '33756, 7e1: 727-562-A567; �ax.: 727-562-d865 �'age 7 of 7 Revised !�3!'13 2004286670 BK: 13708 PG: 2052, 07/t5/2009 at 06:29 PM, RECORDING 1 PAGES 00 D DOC STAMP COLLECTION $1645_� KARLEEN F. DE BLAI�R, CLERK OF COtJR", T,TnG COUNTY, E'I. BY DEPUTY CLERK: C. %R03 3 'repared By and RETURN TO: 'ammi N. Chapman 'IONEER TITLE, INC. 9296 US I-IWY 19 N, SiJTTE 104 :LEARWATER, FL 33761 icidenta! to che issuance of a title insurancc policy. 'ile Number: 04-06058 •arcelID tt: 24-29-15-06426-000-0060 WARRANTY DEED (MCiVtUUALj . 'hts WARRANT'Y BEED, dated July 09, 2004 by tONALD A. PETERSON, joined by his �vife PATJLA PETERSO�I Nhose post office address is: '2479 AI.EXANDER SHORES, ST. CLAIR, hiI 48a81 ereinafter called the GRANI'OR, to �EVIS S. �i.�.I.FANI' and J�\TAH K. NIALF�'VT, HUSBAND AND WI FE, 7ENANCY BY THE ENTI RETY rhose post office address is: 106 PLEASAI�T PARK�VAY, CLE,�RWATER, FL 33764 zreinafter called the GRANI'EE: �� (�Vhcrzvzr used hercin the terms'Grancor" and "Gsantec" include all partits to this insirument and ihe � heirs, Iegal rcpre;zntatives and as>igns of indi��duals, and !he successors 2nd assigns of torporationt.) V[TNESSETA: That thc GRANTOR, for and inconsideration of thesum of $10.00 and other valuable considerations, receipt �hereof is hereby 2eknowledged, hereby grants, bazgains, sells, aliens, remises, releases, conveys and co�rms i:nto the GRANTEE, il that certain ]and situatz iu PSTVELLAS County, Florida, viz: ,ot 6 and the West 1/2 of Lot 7, BELL CFIEER FIl2ST ADDITION, according to the map or plat thereet as ecurded in Plat Book 33, Page 54, Yubiic Rernrds of Piueilas County, Florida. UBIECTTO covenants, conditions; rettrictions; reseraations; limitatiors, eacepirnrs �nrtamP�,T,P�i� �fr��r,� ;s�.,y .„,,:a >szssments for the year 2004 and subseque�it years; and ro al! applicable zoning ordinances andlor reshictions and pro�ibitions nposed by governmental autherities, ii any, OGETHER u2th all the tenemcnts, hereditaments and appurte¢ances thereto Selonging or in anyv.�ise appertaining. O HAVF qVD 70 ROLI3, :h� s:mc ia E e s;.:.t,te ,`o:e��er. �?D THE GN ��yTOR !ze;eb� cov�r,anW •.vi:h szid G° 1�;TEE Lha; �,. �� abo.e r,osed, i1-ic vRAi�ivR is iawiul;y saizzd oi ;aid nd in fee simple; that the GRANTOR has good right and lawfiil auilionty to sell and convey said land; that ine GR4NTOR hPre6v �11y wzm_...,, :h� : ::e .� �:.i3 !a :.: a,:d wiL' ,�',e:e,-�d : .z sa,�,e agairst t��z I:,wS�l r_a;,,,< �__ P��,,..� ...�..�..�.�, :Y�.��.W . , � W ITNESS WHERE(�F, GR�TOR has signed and szaled these presents thz datc set forth above. fGNED IN "IHE PRESENCE OF "fN� FOLLOWING "f��'O WITNESSES: Vifiess 1 ��.��_____� tGi�': ' RONALD A. PETEF2SON rintName: M . CH NfA . _ .. . _ /itness # 2 _ - PAiJI..A PETER t��: rint I�tame: t/1 L. !-� e lii a r� , [atc of FLpttIDA .OUIICy OI P 1�`ELLi� S HE FOkEGOI?�G I\i'STRtJ�fE:�IT w�as ack�to�c�ledged befere r;e c: .;c:;• ^9, 2�0� y: RONALD A. PETER50N, joined by his wife PAUL:�1 PE'TERSOi�' %ho peronally appeared befure me, and who is personaily ;�o��m to me, or has �roduced a Driver's License vr 'assport as iden[i'tication, and �vho did not ?ake an oath. � . ,/� iNecary Sczi) SIGNAT[JRE. � _ r T'am � i. Chapma�, i+o ar� P li�� - r fw.0 v cw�-M!� �� I r '�i� : itv �CUAItG�i.N a� 2'�'w"s1& � . ix,,;,�'4 tPAES.1ar+a72 f.'t� i �,�.ry;� x.-�adM N�.+.m°�re.;.�#.,v+ � L"• ,v w O (D �� cn (D � � � � � � � n� c � � �� o� 7 � cn O `G � (D �7 �-. �� v �t �.J 0 � W D N Z� X� N � � 1"!7 W � � 1 � � N O Z Q� � v �_ .�t�3. ,� a��•°• � �`'r ,,� f ... .._ ��, '�' �� % ��'• _a.�r ,,- � ,,.'y � �.c�•�....... � �� as.»"` —1 � p' vJ, � ��-.._: � � � M �^ ;; �.-- ..�I � � N n � i—_ �sv� �O �-==' i.�r °'p� o �, '� ' � w co o- r- � x�c � �i o �. c, s = �;-,�"=,�.�� _. �� :- ^ b'��r i� �� w �� F V i.- :. . � � �, 1 � _..� } r.� G 7 � �-`. _��_. 2004286670 BK: 13708 PG: 2052, 07/�5/2004 at 08:29 PM, RECORDING 1 PAGES 00 D DOC STAMP COLLECTZON $1645_ KP.RLEEN F_ DE BLAI�R, CLERK OF CQURi C.LAS COt3NTY, EZ BY DEPUTY CLERK: t 1R03 3 repared By and RETURN TO: 'ammi N. Chapman [ONEER TITLE, INC. 9296 US FI�VY 19 N, SU1TE 104 ZEARWATER, FL 33761 cidental to tAe issuance of a tide inso�-ancc poliry. ile Number: O�i-06058 arcellD #: 24-29-15-0642�d00-0060 WARRANTY DEED (INCtV:DL';.Lj � . his WARRAN'I'Y DEED, da[ed July 09, 2004 by ONALD A. PETER50N, joined by his wife PAi1LA PETERSON vhose post office address is: 2a79 ALEXANDER SHORES, ST. CLAIR, MI 48081 �reinafter called the GI2AN"I'OR, to EN1S S. �1.4I.FANT and JAiVAH K. MALFAIVT, HUSBAND r�ND DlI FE , TENANCY 8Y THE ENTI RETY hose post office address is: l06 PLEASAPiT PARKWAY, CLEARWA7'Elt, FL 33764 :reinafter called the GRANTEE: ,�� (Vlherzver used herein the tecros'Granlor" and "Grantee" incl�de all partics to this insirument and the � hzirs, legal repre;ematives and as;igns of individuals, and !he suceessors :nd assigns of corporations.) JITNESSETH: 77iat theGRANTOR, for and inconsideration of thesum of $10.00 and othervaluable considzrations,rzceipt hereof is hereby aclrnowlcdgcd, hereby gtants, bazgai¢s, sells, aliens, remises, releases, conveys and co�rms unto the GRAN7'EE, I that certain land simace in P7NELLAS Counry, Florida, viz: ot 6 and the West 1/2 of Lot 7, BELL CHEER FIRST ADDITION, according to the map or plat thereof as :corded in Plat Bouk 33, Page 54, Public Rernrds of Pinellas County, Floricia. _B1EC"1' TO covenants, condi[iuns, restrictions, reservations, limitatior,s, zasements and a� zzmenU oF record, ii any; taxes and szssments [or the year 2004 and subsequcnt years; and to al! applicable zoning ordinances and%or reshictions and prohibitions ipesed by governmental authorities, if any, JGETHER u�fti all chz tenemznls, hereditaments and appurtenancrs ehereto belon�iog or in any�.�nse appertaining. � HA VE .4ND TO HOC.D, �e s:me is �e si.:.�,te :o:ever. \0 Tl-?E v1L4NTOR herzey cuvenanW with said GRANTEE that exczpt as abovz notzd, the GRAN70R is !awfully seized of said nd in fee simplt; that thz GFUNTOR has good right and lawfiil auiliority to sell and convey said land; that the GR4NTOR hereby ��_.._...- .........,. :U S.^.;u [+,.., :IIC, 1.;�I uC.i:i.� Li2'�u�lZ 3�dinSt iix i�wii�l ria�m . '_ ___ __ _ �Y�......... ..•.....�.v.....a. + iAii'I'NESS WHEREOF, GRANTOR has signed and,eated these presents the daie set forth above. GNED Iti' THE PRESENCE OF THE FOLLOWING T�VO WITPiESSES: > %imess 1 - - � [GN: I20NALD A. PETER50N int 1�Tame: M. CH MA - —. - _ : __ . �itness # 2 . - PAULA PETER ��: d... �� r��.fi ir.tName: iIl L... \-1�1iie�v-r� , 2CC UC {�'�Q�DA ounr� c'i P�'ELLa3 HE FOREGOIiVG INSTRUtifENT was ac!cnow'edged'n. efere r..e ::a ?L!y �9, ZOJ� ;: KONALD A. PETERSON, joined by his wife PAULA PETERSON h'v personally appeared befure me, and who is personallp'.�own to me, or has� roduced a Driver's License or assport as identiiication, and whu did not take an oath. �� "„c e. , SIGiV?�T�Tt't." �/ � � �� ----- Tamr � i. Chapman, _,1c�ary P� li�- � j F,.. r,� 7AM#6 "t GH„r,� 3�` 3 I �e 4P( GDIMdIS�C+`r a � �I ,� (F�1£a ,;ara,ay , I,�� ^u'4 :..dea'r.�+.o�yT.ccuwr <.. j ,..�, ;ag�'`�t! �,y9 ! . '� �e �.� ; ��, _ � .'��.: i��n� ��\�Ai .�^"—� � � 4U ,`�J �y ' � � ` .�� L = �^ � - - i: N n ;-, c �,y� —V ��' � 7 ;�,�._; �,� ,� �-� ;,�w ��;��`- o'`� �� f/l � y'� �.."�,;• � � SD 2 �-• :� -n —:_�?-� v� �'� -�o�._, � ,.`� � �� _-� rp �V',9 � T; �-. r.-�."f . `�* � 1 `�1� �� _ I o ,� �: � � �.�rwat�r � 2116 BURNICE DR ANX2014-12026 3elcher Area - Multiple Properties ?oning: Low Medium Density Re Atlas #: 308B �lopment Department 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 APPLlCANT 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: $0 TBD Information on /mpact Fees orAssessment Fees is available from the City of ClearwaterEngineering Department (562-4747). PROPERTYOWNER(PERDEED): (�p`�� V_ �'vati�v ci� /1��fia*,d �i ,..,,-�-rov� MAILING ADDRESS: 2,� �Z �,rvt r Lc T�c;� � C1�cut'c,J�,,-Ytr� �►- �3�� PHONE NUMBER: �,��-,�:3J •- j�'C�.� EMAII: i�ENT OR REPRESENTATIVE: � � MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBIECT PROPERTY: ?,I 5'3-� �[�,r,n; �� Dri v� PARCEL NUMBER(S): �y - �,q- �rj -3itj � � -OaC� -bo$Q� LEGAL DESCRIPTION: (�(,en CI f vn �5 �'�c S Lafi � CURRENT ClTYSERVICES: SANITARY SEWER SOLID WASTE REQUESTED CITYSERVICES: � SANITARY SEWER �G SOLID WASTE (select afl that apply) ►�i%11� �lanniny & Uevelopmer�t Departm�r,t. iG0 S. +Yfyrtie Rvenue, Clearw�ter. FL'33756. Tel: '727�-562-4b67; F�x: 727-562-48b5 Paye 1 of 7 R�vised 03i13 LL o Planning & Development Department � � ��ar�vat�r 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 SITE AREA: PRESENT (COUNTY): Rn,s;�'�-;41 {�a,_, t Z�� REQUESTED (CITY): j�,s:�Nfi:s.t L.v�..� CR�.� ZONING DISTRICT PRESENT (COUNTY): REQUESTED (CITY): D . 2"� (� SIZE OF DEVELOPMENT : Existing: _ Proposed: (e.g., number of units, hotel rooms or non- residentiat square footage) R 3 � 5;,�,�� '��„ti ��a�„fi;�,� �, M..J M-o.l.,: vn-. �{., s��r�Y ?Q,Gti,�•,$-:u)� Li'��9,1 acres USE OF PROPEftT`l: Existing (currently on site): Proposed (new use, if any; plus existing if to remain): If residential use, is unit(s) rental? Jlna.l'� �a••�; ►�l Sint��c �u.-��N- -�- 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 �d authorize City representatives to visit and photograph the property described in this application. �% � Sworn to and subscribed before me this � day of �/' `��`� L�� -f--. by '� f�% � `��-'�ti41 i� j �'�t� who is personally known/has / � / /(/ / . �L ��G� �'/ � L, L YG�/�'O Y� ature property owner ` r representativ� / % a � � _ /� ' � � %%C',1'iQ/�i�' : �' Signa±�.�re of propP�� ^�NIl2f or represer.±ative produced �` �-- S�-�'Z>��' '�`�''�' as identification. `-- _- - --� , .�.---- � NY `°' � ��, Y o Notary Public Sia1e of Florida � �' , James Wagner My commission expires: � ommission FF 6a6309 '��,�,�o° Expires 10I15/201 - _ Ptanning & Development Department, 100 S. Myrtle Aven�e, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Pag2 2 of 7 Revised 03/13 LL ° ��x�arw t r �� a� U Planning & Development Department Petition for Annexation Data Sheet PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETI(. 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): ��Y��_l:��i SIZE OF DEVELOPMENT : Existing: I Proposed: ( (e.g., number of units, hotel rooms or non- residential square footage) acres USE OF PROPERTY: Existing (currently on site); Proposed (new use, if any; plus existing if to remain): If residentiai use, is unit(s) rentai? � S i1� �t �,�� 5�"n„ � � �; �.1 �- ,., 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 know►edge and authorize City representatives to visit and photograph the property described in this application. Sworn to and subscribed before me this �" day of ,_JE�'G�t1'�-�=� , .��i 4 . by �"tQ�"i�,��-[-�Z;,,�c�- , who is personally known/has produced Dl, � ��, --�55 ��i -�� .R � n _ _ ��,.�t;£:�,.:-= �i Signature of property owner or representative /� � � ��r,� � �c � i�, r,�c c � Signature df pro erty owner or representative �{.-'��,�+/1 �i� � I C Notary publi— c,� My commission expires ROSEMARY PADILLA MY COMMISSIOPJ � FF 103357 EXPIRES: P.�,r;! 24, 2018 �f- � �i- �` �U, � Planring �, De✓el�pr�ient Departmeni, iG':1 3. ��?y�tl� .;°��enue, Clearvvat�r, FL 33756, TeL 727-552-4567; �ax: 727-�0"2-4865 Pac�e 2 of 7 Revised 03/ 13 LL � � �arwater 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: ❑ 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: Submit 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. ❑ 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 subm+tted 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. 0 Proof of ownership (e.g., copy of deed, title insurance policy, or other instrument demonstrating ownership). [Note: Submit two copies only) 0 if connection to city services is desired prior to the effective date of the annexation, applicant must provide notarized �etition for Annexation Supplemental Statement (fa� � at:acFed). [Note: Submit original on(y) ❑ 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) ii��v�,i�ir�iTiVi�� aC.a�.�vi�aC.v Tv �v1vAD"T� TU` D`TiTiv�� Cv� �,��i�r�iTivP� AP��i��Tivi�� Ai��v vr�iTr�i .Cii'iEF.T ��P� vE FOUND ON THE FOLLOWING DOCUMENTS AND/OR ONLINE AT THE FOLLOWING WEBSITES. IF THE APPLICANT IS v�i�ER�Aiitii �'VHE�E T� LOC,�^,TE TIi�S iiL�v�ilVi�-iTifllV �f: ":�E.^.� A.^.^�T�rJ►VAL ASSlSTAN��, ?LEASE ��J":T.�^,CT 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). 0 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 Pineilas County's Public GIS Viewer available online at http://�is.pinel(ascountV.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). �� U ZONING DISTRICT (COUNTY} can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available ontine at http://�is.pinellascounty.or�/public �is/. ZON►NG DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's Zoning Atlas, available online at http: j/www. myclearwater.com/Qov/depts% pwa/en�in%pu biications%en�atlas/atlas.asp. SITE AREA (ACRES) can be found by viewing a Property Report using Pineilas County's Public GIS Viewer availabie online at http://�is.pinellascounty.or�/public �is/. Pianning & Development Department, 100 S. Myrtie Avenue, Clearwater, FL 33756, Tei: 72'-562-4567; Fax: 727-562-4865 Page 3 oi 7 Revised "u3/�3 o �::,,. � � ��rwat�r � 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. ❑ 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. 0 Existing or proposed development is consistent with City regulations. D 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 Orclinances; ❑ All residential rental units, including single-family residences must comply with the requirements in the city's residential rental ordinance, which requires the property owner to obtain a Business Tax Receipt upon annexation into the city; 0 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 shall be submitted 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(sj will be done on an assessment basis, consistent with City procedures therefore. Planning & Uevefo�men± �epartmenf i00 S. �tyrtl� Ave��ue, Clean+vater, �L 33756, 7e1: 727-582-4567; Fax: 727-b62-4$65 Page � of 7 Revisad 03/ 13 LL ° _ earwater � � U PROPERTY OWNER (PER DEED): MAILING ADDRESS: PHONE NUMBER: EMAIL: AGE REPRESEN lVE: MAi ADDRESS: P NE � 5ER: EMAI : Planning & Development Department Petition for Annexation Disclosure Statement �-ieoC'�i ��a��a/ °'�''c�1 %ic�✓'�se;hc� TJ �,i►,� f"rcvu i, i� i-� i.�� r v. i � Q n r;.ti.. ��ra�)�1'�Q i ��- �� 7�,� �iER PERSONS HAVING ANY OWNERSHIP INTEREST IN TNE SUBJECT PROPERTY: NAME: INTEREST IS: SPECIFIC INTEREST HELD: �ES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPERTY? rnrvTRnr-r i�� PARTIES INVOLVED— NAME: NAME: ARE THERE ANY OPTIONS TO PURCHASE THE SUBIECT PROPERTY? PARTIES INVOLVED — NAME: �1P,IVit: ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? PARTIES INVOLVED — NAME: �, �i vN_7 �� iyd,e'%,�'4�e NAME: YES � NO PHONE NUMBER: °HONE lUUMBER: YES PHONE NUMBER: F'I-IUtVt IVUMtiEtt: � YES � NO NO PHONE NUMBER: �-�'��' ��C dZ�3Z PHONE NUMBER: STATE OF FLORIDA, COUNTY OF PINELLAS I(we}, the undersigned, acknowiedge that all representations made in this appiication 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 ana subscribea berore me this --� day or` ;� j�l�`,: C':� ��i -bY , � ��v;2C; � fi� 1✓�v'�v� , who is personally known/has ``�:"`� �-'�cirr�� 1� <�i �'��' / produced i�L l�l..- as identification. Signature o property owner or representative ��----� � t„^i,r; _;Gfj,, / ' i /.CCG��> Signature of property owner or representative s Notary Nunirc; a�a.a .,, . ._._ Notary p�t ' , ;� �Q4• ,fames Wagner � M Commission FF t�16309 My commission expires: �� - P .Y_:..,� �n��512017 ?lanning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 3375&, Tel: 727-562-4567; Fax: 727-562-4865 Page 5 of 7 Revised 03/13 o f'� + Planning & Development Department � !l� s ��i��at��r Petition for Annexation � Af� davit 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; 7. That (1/we), the undersigned authority, hereby certify that the foregoing is true and correct. 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 Public Signature Notary Seal/Stamp My Commission Expires: Planning &(3evelopment DepartmenL i�',;; �5. P��,�if. Avenue. Clearwater, FL 33756. 7e1: i27-562-4567; Fax: 127-562-4�65 Page 6 t>f 7 +�evised 03;�13 LL "...' :�';."::; ,.. O � � ��rwater U PROPERTY OWNER (PER DEED): MAILING ADDRESS: PHONE NUMBER: EPAAIL: AGENT OR REPRESENTATIVE: 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? CONTRACT IS: PARTIES INVOLVED - NAME: NAME: ARE THERE ANY OPTIONS TO PURCHASE THE SUBIECT PROPERTY? PARTIES INVOLVED - NAME: ��nnnr. IVHIVIC. ARE TFIERE l�hll( MC�Fi I(iACit$ OR LIENJ 171V I I-It Jl1aJtLl F't�UYtRI lf? PARTIES INVOLVED - NAME: �Q}�o� 5�� Mo�fi�i..�u NAME: YES � NO PHONE NUMBER: PHONE PJUMBER: YES PHONE NUMBER: rfiVIVC IYVIVIDCn. %t �' C j �_ N O �l l� PHONE NUMBER: l.:.c6��_ y�j_Zy3Z PHONE NUMBER: STATE OF FLORIDA, COUNTY OF PINELLAS I(we), the undersigned, acknowledge that all representations made in this appiication are true and accurate to the best of my knowledge and authorize City representatives to visit and photograph the property described in this applicatiqn. �.•. �^.0 u^u SJuS..� �NOUI hof�ro mo �hl` 'Lt GZ Cf r .%�'`=e,t-,-,he.-V- ZtJt L}- . by �Cti'1�['a �nG;�� -i-r-t�J�,-who is personally known/has produced DL � " -S`j� � - ' . Si nature of ro ert owner or re resentative (� ;,e.;�Y'P��;c,, RoSEMARYPADILLA g ,p p Y p �c3Se�,.�C� t'G�-, 1 � .? hAY COMMISSION # FF 103357 ! ! `��'`„�'°_� I ��c..�t.�-t-- ". ,,�, a; EXFIRES: April 24, 2018 //%� � 1 'i`- ::�•..,.•o?� [�, P�ThruNotaryPuh6cUnderwrite �� j � � i Notary public, � [�-�"� � ��0:'iti i��li�'�I ��ily��1�1/c� � My commission expires: `� ��"� �; Signa— tu�re,bf praperty owner or representative Planning & Development Department, 100 S. Myrtie Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 5 of 7 Revised 03/13 o , �`� ° � � .��r�vater U Planning & Development Department Petition for Annexation Supplemental Statement PROPERTY OWNER (PER DEED): C�,e�i �I �vA�v �nd� l�c�,(' i�h cn 17 i vno ��'rovc� MAILING ADDRESS: �,�r�� 3�r�ict �t^i».o , Clturwutr� , FL 3376u CITY OF CLEARWATER CASE NUMBER: s ), ��- I/we, ��die� i� v• f l�c�'G i� L��/r�.� r��ti'�i ��.�i�'T,�t'1/�j [insert names f 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 � day of ' i '�`L/� ��C, � i y by �� , /�/' 1 ��' �� Z �eL-�ec� � ��.�c�� Sighature of pr perty o' ner (individua or authorized representative of corporation, partnership or other entity) �� / ti"/ / /`l�'`�''��ni _�i.�-it Signat re of co-property owner C%-L�:�cZa� � /��✓� , who is personally known/has produced �� -- as identification. Nota .� �t My commission expires: � c �or Notary Pubiic State of Florida My Commission FF 046309 Expires 10/15l2017 Planning 8 Dev2lc�p�n?ni Oe;��rtm�n?, �ir)�� ,�. P.�yr*I = R.�ni.�e. Glean�vater, r?_ 3375ti. �l'el: �27-b62-�567; Fax: 727-�62-A865 °age 7 of ; Ftevised 03i i 3 LL � � �:arwater � PROPERTY OWNER (PER DEED): Planning & Development Department Petition for Annexation Sunnleme�tal Statement MAILING ADDRESS: '� ; S2 �,,,;� t-,;. -;T �:z�� - CITY OF CLEARWATER CASE NUMBER: 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 Supplementai 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 knowiedge and authorize City representatives to visit and photograph the property described in this application. Sworn to and subscribed before me this � day of .—� ��C�'�v,�fi��:� , � i �� - bY ii�� r��i i[J;l�'v ��—i'r l� �'w ,`v'v'ii^v iS Nc^i50ii2IIj! ,�iivtiJi�jiia5 Signature of property owner (individual or authorized representative of corporation, partnership or other entity} � ) � v v l /��%1 �Pi'G�� i'r�i i`��'l��. Signature�property owner , produced �- �� Notary publi�, My commission expires: ��.- � Z`�' li as identification. ROSEMARY PADILLA MY COMMISSI6N C FF 103357 EXPIRES: April 24, 2018 ,rded Thru Notan PuMk Undeiwriters �v i 2? Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tei: 727-562-4567; Fax: 727-5b2-4865 Page 7 of 7 Revised 03/13 I#: 2004004156 BK: 13280 PG: 2131, O1/07/2004 at 02:55 PM, RECORDING 1 PAGES $6.00 D DOC STAMP COLLECTION $959 KARLEEN F. DE BLAKER, CLERFC OF COTJi' PINELLAS WUNTY, FLORIDA BY DEPli �LERK: CLKDM85 Prepazcd By: 7i(ftny �� / F[RST C17Y TITLE, INC. 1545 S. BELCHER RD. CLEARWATER FL incidrntal to the issuance of a Htle inwrance policy. File Numbtr:1203-043 ParceIID #:24/29/15/31050/000/0080 WARRANTY DEED `, ', (INDIVIDUAL) 2116 BURNICE DR _ , , ANX2014-12026 - - = = _ �' `� . _ ., ., 3elcher Area - Multipie Properties ; % ` ?oning: Low Medium Density Re Atlas #: 308B This WARRANTY DEED, dated 12/29/03 by HARIS iYICK HAROKOPOS, a single person whose post office address is: ' 100 SOUTH CORONA AVE CLEARWATER FLA. 33765 �'�' " i � � �, hereinafter calted the GRANTOR, to GEORGI V. �VANOV and MARfANp DIMITROVA, husbaod and wife whosa post office i:�, �� address is: • � � � , 2152 BURNICE DRTVE, CLEARWATER, FL 33764-4860 _;�� `� �� hereinafter called the GRANTEE: , .�, • �_ , (Wherever used herein the temu "G[antor" and "Grantce" include all parties to this inshument and the heirs, legal represe�ntapves and �� assigns of individuals, and the successors and assigns of coiporetions.) �� WI"TNESSETH: That the GRANTOR, for and in consideration of the sum of $10.00 and other valuable consideratioA�,�receipt �'�' whereof is hereby aclmowledged, hereby gants, bazgains, sells, aliens, remises, releases, conveys and confimis unto the GRAYJTEE„ � all that certain land situate in PINELLAS County, Florida, viz: Lot 8, ELLYN ESTATES, according to the plat thereof, recorded in Plat Book 34, Page 32�o(ihe Public I;ecords ot PINELLAS County, Florida. , � �� .� � \ � .. � � � , � �, , SUBJECT TO covenanu, conditions, resaiclions, reservationc, limitations, easements ant�agreemCnty of record, if any; taxes and assessments for the yeaz 2003 and subsequent years; and to all applicable zonirfg-oidinan�Fs and%or kestrictions and prohibitions imposed by govemmental authorities, if any. ,' " �, � r \> TOGETHER with all the tenements, hereditazcents and appurteaances thereto belonging or in anywise appertaining. � �, TO HAVE AND TO HOLD, the same in fee simple forever. _, AND THE GRANfOR hereby covenants with said GRANfF,E that except as a�o� noted, the GRANTOR is lawfully seized of said Ia:td Fn fPP S� Yt�� rt;�r +h� �rz,e��p xy,a,.. s� �� u �awiul duiaozi'ry ro seii Evid convcy said land; that the GRAN'TOR hereby fiiliy warrants thc tide ro said land and will defend the samL,ag3insP Ehe,iawful claims of all persons whomscever. IN W IT'NESS WHEREOF, GRANI'OR Las'signedeqd'seatecj these presants tl�e date set forth above. �. SIGNED IN T�HE PRESENCE OF THE OLLOWINC'�VI�NESSES: ` 1 � ,�-: _ �. � �;�Q��_� s�gnan,Te: . �. � , ', Print Name: ' �� ` " �CK HAROKOPOS � 1 1 ;C � i ii Signature: (A�' , � PrintName: �,/4i;.(�i'�E !�►i��'-- ( . \ � � '> State of Flo�i�a, �� County of PIN�I;bAS � , 11-IE FOREGOING IN�S�'IiUMENT was swom and aclmowledged before me on 12l29/03 y HARIS NICK IiAROKOPOS, a single person who is/are personally known to me or who has/have produced C V� L i� as 'd ntifica 'on. l � ` �� i Signature: ✓ L. c�, .�:'y.• d71FFANYHEFUN N Public �':' �" MY COMMISSI�! t 0� 117434 Print Name: ' �.p: EXPIRES: May 14, 2006 ',�.��.: B�n,,,Hwnv�ercu�dem��