FLD2015-04012� 152 DEVON DR & Development Department
� C�earwat' FLD2015-04012 ment A lication
, p pp
� �lazas Dock ed Accessory Use/Structures
?oning: Low Medium Density Re Atlas #: 276A
IT IS INCUMBENT UPON THt Hrrul.HN i TO SUBMIT COMPLETE AND CORRECT INFORMATION. ANY MISLEADING, DECEPTIVE,
INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION.
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 11 COMPLETE SETS Of PLANS AND APPLICATION MATERIALS {1 ORIGINAL AND 10 COPIES) AS REQUIRED WITH►N
ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. SUBSEQUENT SUBMITTAL FOR THE
COMMUNITY DEVELOPMENT BOARD WILL REQUIRE 15 COMPLETE SETS OF PLANS AND APPLiCATION MATERIALS (1 ORiGINAL
AND 14 COPIES). PLANS AND APPLICATIONS ARE REQUIRED TO BE COLLATED, STAPLED AND FOLDED INTO SETS.
THE APPLICANT, BY FILING THIS APPL�CATION, AGREES TO COMPLY WITH ALL APPLICABLE REqUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
FIRE DEPT PRELIMARY SITE PLAIV REVIEW FEE: $200
APPLICATION FEE: 300
PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
HUCIVI VI�(lCrf�CJCiVIF111VC.
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
�Fi� a..a �PtS � � �1C• ►+ViA2J}S
� Sa� �C�lO�r1 ^i�Q. L_�C4i�C.94kd�� �. .].� ��0�
'7 �'1 b'�� • �-8�$
�mAZas �0��, caw.
�Pct.� l� �R nS�r• - S� o c,ICS s'n, c..
(.,c.. '��.1 cf 1"',a 1'�.�.c.l �S �►� P iC i�G 33"7 'S 1
� �� 53t� - � � '�4
�,�o�Ce [J 1� c.1GS �nc.A �R,P o R. A'�'E 1� • Gc w�.
ADDRESS OF SUBIECT PROPERTY: I S� �� tBL.I p+l�. ^i�L• C.IeQf�6.1k��'� F�C� Z31 L�]
PARCEL NUMBER(S): O�j ' w—� — j S `�� q I�l " v�'a � O ���
LEGAL DESCRIP710N: '�Q�y� � �C,s� t�� �� p,,.d (,q,�..�( �o ��• � IG�t.� ,
PROPOSED USE(S}: 'j�p ��t,d �(,,y(,�� �n+� � 2�C�{�ai '9o�,1C p•.s� ' .�-i' S�[w�+��,e � ,
DESCRIPTION OF REQUEST:
Specifically identify the request
(include all requested code flexibility;
e.g., reduction in required number of
porking spoces, height, setbocks, lot
size, lot width, specifrc use, etc. J:
�f�naStc� 'Ud C.1C �J 1�� �Yilar �F'i1.� e7C � S�' •'�1 S �.. c.1�.r< S: n
�
�[I�� __�t�c�1 1�r�..� 6i� i ^ �.lk .
Planning & Developrnent Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 1 of 7 Revised 01112
��
� �learwater
�
Planning & Development Department
Flexible Development Application
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.
ZONING DISTRICT:
fUTURE LAND USE PLAN DESIGNATION:
EXISTING USE (currently existing on site}
.� •� .
RcS�cle�� �a� t,tc-�-aar�
'� c �aC�„�d. �w c.l � � %� y
PROPOSED USE (new use, if an g, if to remain : � � � �� �
y; plus existin )
SITE AREA: (y� �(Q p� sq. ft.
GROSS fLOOR AREA (total square footage of all buildings):
Existing: � `� sq. ft.
Proposed: (J� �} sq. ft.
Maximum Allowable: �j % �t sq. ft.
--�--
`J
p, � �j j acres
GROSS FLOOR AREA (total square footage devoted to each use, if there will be multiple uses):
First use: sq. ft.
Second use: sq. ft.
Thirri ii5a: � Sa. ft.
FLOOR AREA RATIO (total square footage of all buildings divided by the total square footage of entire site):
Existing:
Proposed:
Maximum Allowable: ��
BUILDING COVERAGE/FOOTPRINT (l�` floor square footage of all buildings):
Existing: sq. ft. (�� % of site)
Proposed: sq. ft. ( % of site)
Maximum Permitted: sq. ft. ( % of site)
GREEN SPACE WITHIN VEHICULAR USE AREA (green space within the parking lot and interior of site; not perimeter buffer):
Existing: sq. ft. ( % of site)
Proposed: sq. ft. ( % of site)
VEHICULAR USE AREA (parking spaces, drive aisles, loading area):
Existing: sq. ft. (�� % of site)
Proposed: sq. ft. ( % of site)
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 2 of 7 Revised 01112
IMPERVIOUS SURFACE RATIO (total square footage of impervious areas divided by the total square footage of entire site):
Existing: _�_
Proposed: /�%
Maximum Permitted:
DENS�TY (units, rooms or beds per acre):
Existing:
Proposed: /(�
Maximum Permitted:
OFF-STREET PARKING:
Existing:
Proposed:
Minimum Required:
�
. �i
BUILDING HE16HT:
Existing:
Proposed:
Maximum Permitted
►
�
a
t :
Note: A parking demand study must be provided In conjunction with any request
Yo reduce the amount of required off-street parking spaces. Pleose see the
adopted Parkinq Demand Study Guidelines for further information.
WHAT IS �.iE ESiIf1f�,1TE6 TOTAL VALUE OF THE PROJECT UPON COMPLETION? $� S� p.'�C>. p0
ZONING DISTRI
North:
South: �
East: �
West: (
FOR ALL ADIACENT PROPERTY:
'7
1�
STATE OF FLORIDA, COUNTY OF PINELLAS
I, the undersigned, acknowledge that all Sworn to and subscribed before me this 3� day of
representations made in this application are true and
accurate to the best of my knowledge and authorize M�`�"�' , 2��'s or by
City representatives to visit and photograph the _�4L.s Sa....x� � , who is rsonally known h s
pr�perty described in this application.
� produced iication.
Signatur$ of pye�erty owl� or representative Notary public,
My commission expires: �j/ Z( / Zp 1
'��`"'�:''• BRUCE NESTI
��� �'' MY COMMISSION A FF 153207
:•; :•:
_�'• �o; EXPIRES: August 21, 2018
�%F, oF ��°�' Bonded Thru Notary PuNic Underwriters
Pianning & Development Departrnent, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 3 of 7 Revised 01(12
o Planning & Development Department
� C earwater Flexible Develo ment A lication
p pp
`J Site Plan Submittal Package Check list
IN ADDITION TO THE COMPLETED FLEX�BLE DEVELOPMENT (FLD) APPLICATION, ALL FLD APPLICATIONS FOR A SINGLE-FAMIIY
DETACHED DWELLING, DUPLEX, OR ACCESSORY USE/STRUCTURE ASSOCIATED WITH EITHER A SINGLE-FAMILY DETACHED
DWELLING OR DUPLEX SHALL INCLUDE A PLOT PLAN WITH THE FOLLOWING INFORMATION:
� Responses to the General Applicability criteria as set forth in Section 3-914.A. The attached Flexible Development Application
General Appiicabiliry Criteria sheet shall be used to provide these responses.
U Responses to the flexibility criteria for the specific use�s) being requested as set forth in the Zoning District(s) in which the
subject property is located. The attached Flexible Development Application Flexibility Criteria sheet shail be used to provide
these responses.
� A signed and sealed survey of the property prepared by a registered land surveyor including the location of the property,
dimensions, acreage, location of all current structures/improvements, location of all public and private easements including
official records book and page numbers and street right(s)-of-way within and adjacent to the site.
a\PD If the application would result in the removal or relocation of mobile home owners residing in a mobile home park as
provided in F.S. § 723.083, the application must provide that information required by Section 4-202.A.5.
hd if this application is being submitted for the purpose of a boatlift, catwalk, davit, dock, marina, pier, seawall or other si milar
marine structure, then the application must provide detailed pians and specifications prepared by a Florida professional
engineer, bearing the seal and signature of the engineer, except signed and sealed plans shall not be required for the repair
or replacement of decking, stringers, railing, lower landings, tie piles, or the patching or reinforcing of existing piling on
private and commercial docks.
�\�] A tree survey showing the location, DBH (diameter at breast height), and species on the parcel proposed for development
with a DBH of four inches or more and identifying those trees proposed to be removed.
❑ A site plan with the following information:
�.d North arrow, scale, location map and date prepared.
Gi Location of the Coastal Construction Control Line (CCCL), whether the property is located within a Special Flood Hazard
Area, and the Base Flood Elevation (BFE) of the property, as applicable.
Q( Location, setbacks and use of all existing and proposed building and structures.
❑ Location of all existing and proposed parking areas, sidewalks and driveways.
❑ Location, type of material and height of all existing and proposed fences.
❑ Location of all existing and proposed utilities, including water, sewer, gas, and stormwater.
❑ Location of all existing utility easements, including Official Records book and page numbers, and any proposed utility
easements.
❑ Building or structure elevation drawings that depict the proposed building height, building materials, and concealment of
all mechanical equipment located on the roof.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 4 of 7 Revised 01/12
°Clearwater Planning & Development Department
_ Flexible Development Application
� General Applicability Criteria
PROVIDE COMPIETE RESPONSES TO EACH Of THE SIX (6) GENERAL APPLICABILITY CRITERIA EXPLAINING HOW, IN DETAIL, THE
CRITERION IS BEIN6 COMPLIED WITH PER THIS DEVELOPMENT PROPOSAL.
1. The proposed development of the land will be in harmony with the scale, bulk, coverage, density and character of adjacent
properties in which it is located.
l��J�o`� c� �\wnS �R ;r, �na�� M a��l w��1� a►d���.��r �.� `��� kS c, �..J� �• �� j
b n �t S,R 1�- `��ct e.x � l0 0�' %� 1 O 17 �G -��.C.� � i t� -c S [ � 05¢5 ��o
-('I1:S Qct�O.eC"�-� at-� �+� �{�d -�c��Cl.� c�'I,w�, f1,(vn��� c�.oCaC.
2. The proposed development will not hinder or discourage the appropriate development and use of adjacent land and buildings
or significantly impair the value thereof.
�
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44- kl�.. �C.,da,�,�..e . `J -J `� � '
The proposed development will not adversely affect the heaith or safety or persons residing or working in the neighborhood
of the proposed use.
___J'��r�c,�,l; c,�.�rK c.ycl� n�k c�Sc �A�� he.a,l� .� SAC�c4h G,ncsrr.S. i1tieK c.��il
bc �n� raadS .r ncg�r}�tS S.�ocked �r �ca�w� S�ti� g5 �� hA�'z�rrl�n.,.S �N4�e<<glS
p r �,-� � ra•• S AtJ�-w � �t3 he � ��, nn r �orw..�.� �., �t� �_ � "�ti �i .
4. The proposed development is designed to minimize traffic congestion.
� �,� �, �d oc�..�r �"� bo�►-�-
ac r��-�., c �''1 Vwt► . -•S �v @� � �� �.�t�tT oV'c�..� n.�l pC' t�t � �' �r0� G � i l �n �
� �se a5l.c � t�c[.�ss e1F�ut� bo-.� 1: F.�-. flc�.1 �S �.� �..� i II A►lo�..� �"��F- e���
A('.CeSS o•• a�...l. a � '4�� � , : �r � �Su �-t Sa� � o � 'C�.e t.���.t t' . •
5. The proposed development is consistent with the community character of the imm diate vicinity of the parcel proposed for
development.
�� �t ��►�S an c.�r..S�Sk•.� t,� ri'� er � s�-�%..,, 'Dat.IC Sr}-r�..�.�.ur*,s �y�i
�st : rt rx�. �- ►'.�S _ o r_ 1a.•o. �r ,N� � � � i ••c► . (o af 1 � t vr�+►�1 c d �a �•�t h� ���, 6� �
l�wv� 1,.�..� � e�i,c.,.�i, '�CiC` �.� ���S -�a� ir�..,� r�.,, n�--na'SR.eI '�I �., i�o rKoo r
� w�S, � � -
6. The design of the proposed development minimizes adverse effects, including visual, acoustic and olfactory and hours of
operation impacts, on adjacent properties.
: S C,S. t `� �� � �l.u� � (L d 1 St Q� • � � � -1 r-.,{, �'e 5 !1 ��.J
1ng�+-f �CV �e�,r C,,J o..� ��v A�cs-eSS 1 ��� o� JKa� bo��- ;., -�-�.,+ ,�f' A�c
�x�-�wS. o� ( �x.J I.JA��[.�' �
Planning 8 Development Department, 100 S. Myrtle Avenue, Ciearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 5 of 7 Revised 01/12
° Clearwater
�,
Pianning & Development Department
Flexible Development Application
Flexibility Criteria
PROVIDE COMPLETE RESPONSES TO THE APPLICABLE FLEXIBILITY CRITERIA FOR THE SPECIFIC USE(S) BEIN6 REQUESTED AS SET
FORTH IN THE ZONING DISTRICT(S) IN WHICH THE SUBJECT PROPERTY IS LOCATED. EXPLAIN HOW, IN DETAIL, EACH CRITERION
IS BEING COMPLIED WITH PERTHIS DEVELOPMENT PROPOSAL (USE SEPARATE SHEETS AS NECESSARY).
(�> � doc_l� a�i. �,��- o� �csse� 1c••4k� r��� a�-c�� ��,r•�►t
�v •�. 5 s5 �, �. a r� . T � n � A�C.C�esS
C� �oQ� \ T�'f � n S�.a 1 � w.J l,J Pr 4¢ C d � S�-� � y5 T�t SA+�.� . A�"5� s G�•,� �.t'� Mt
Ar1.�.wiS », �IK arCa t� �^� ��t �•c�' Wtoo� t� CJ�QA•t-C WPr�� W� (+
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�� .... s �L kti'. s
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1��.-� �.�, �e.s� Prko rt is .�,,, S�� r►-. dc�; �,,.o a, �-r ti� �I�I�►'�S �rda-Q r� n��w,�4-
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�v�rynvY�r�..�� �.�nAa.t+�^S oe� S�w��o�nJ ��..015 4� S+Q.o�hSSS.
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lw9 1��1 Q!C( �7� .^ p _�G�%S . r► i'�4 4�A _ f'��5� • L.2 f �_! � 1� o!� �Gs SS � O�Ce. �
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4��c a�-�SS :-► ��.. � a�-- s�i,., � 0•►4 � . F� . -ri.', � nc� des ��•� t�a � 1 I �1 �o�..�
S�1 ACCeSS �� SA� r C.�. '�"�. n.S -�o� o�'�^t t' �/J�1� C� i� -[ ►�e C�
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 6 of 7 Revised 61/12
o Planning & Development Department
�� earwater Flexible Develo ment A lication
P pp
`� Affidavit to Authorize Agent/Representative
1. Provide names of all property owners on deed — PRINT fuli names:
1� i 1� tYl�t zflS
�,1�5 i \ ���(,� �'1AZP�S
2. That (I am/we are) the owner(s) and record title holder(s) of the following described property:
� S�d. ' i�Z J a n �2. C �C�aCtrJ a�c ��L v,3�'�
3. That this property constitutes the property for which a request for (describe request):
E,�c�e�.d �� a d►�c,K ...�.. �-�� ko d►aQf}e< wa �e C.
4. That the undersigned (has/have) appointed and (does/do) appoint:
�C�1�i—!� ' 1P�I�Seii e,..�l ��r��,� 5 � Tn-� .
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 appiication;
7. That (I/we), the undersigned au ority, hereby certify that the foregoing is true and correct.
Property wner Property Owner
Property Owner
STATE OF FLORIDA, COUNTY OF PINELLAS
Property Owner
BEFORE ME THE UNDERSIGNED, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON
;' /� � �-
THIS � � ��'� < DAY OF /°"1 ,1-1� I�- �L� , �,.�'�.('�� L� , PERSONALLY APPEARED
� I t- L- L'i..�° + �� (-- �� WHO HAVING BEEN FIRST DULY SWORN
DEP ��H�_1P9�ERSTAN
��,^p\ p�ei4
HAYDEE VEIEZ
�� �s Not�ry Public • State of Florida �
� Mr Comm. Expires Jan 31, 2017 �� w.-�
, ���, Commission # EE 870424 k-.
Notary SeaUStamp
THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED.
My Commission Exp
Notary Public Signature
�-��1-1 �
Planning 8� Development Department, 100 S. Myrtle Avenue, Ciearwater, FL 33756, Tei: 727-562-4567; Fax: 727-562-4865
Page 7 of 7 Revised 01/12
SECTIDN . . .B. . . . TOWWSHIP . . 2g . . SIXl1H. RAN6E . . 15 . . EAST� . . . . . PINELLAS. . . . . . COUNTY� FLORIDA
I'fGtiVfILJ t�J1'1�G 1
._ _ _ _ _ _ _._ — .__ — _ ` _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ r
SENCN MARK
LPiQBM�i
ELEV= 3.84' N.A.V.a. 88
o--
flR i/2"
S.W. CORNFR
OF LQT 17
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OF C
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(P.O.L)
W, 3.254C
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+��' - EIEVATION
• - POWER POLE
� - RECIAINED WATER METER
o - TELEpHQNE PEDESTAL
I� - WATER ASE'fER
--- — - OVERHEAD N9RES
N89'473U'E 60�R 589'4330'W 75'R
N89'41YYE 59.67'M FCM 4'x4' FCM 4'x4' ggg51'45'W 75.0511
_.. .._..�.. .._.. N ..—
— - — • S89'43'30°W — 60'R; 60.23'M --Q---- - - - --
y � 9RG. REi. lR1E � INLET
� � ✓.� � 7 WR8
N �— . . . . . . . . . �, . . �'\. ON-SI1E iBM
a'i-�� � . • . . . w�.�, w�� . . . . El� 1�0f 0.AVIl BB
SET NkT v� �w � u��
a. a�s xAV.o. �s � iv�� vr�� ✓�
--- -------�--�----------�-- ------
50' R/W : (20' ASPHALT) � ��ET
mr uFV.. aro
LEGAL DESCRIP110N nmmT a= ua
—O
Fql 4'x4'
SE. CIXINER �
THE WEST 15'
OF LOT 2!i
LOt 18, REPLAI OF BAYSWE SU�141�ON, ACCORDING TO THE NAP IXt PLAT 1HEREOf AS RECORDED IN PLAT BOOK 23, PAGE518 AMD 19, OF THE PUBLIC
RECORDS OF PINELIAS COUNTY, ROR�A, TOf�itffR WIiH, BU? 4NIHOUT WARRANTY, All 4F GRAN70R'S RIGHT,IITLE AND INTQiEST W AND TO 1HAT CERTAMt
PARCEL OF LAND LYING �iNIEEN TFIE NORIHERLY AND SOU1t1ERLY PROJECII�IS � LOT 18 AND TNAT POR110N � 1HE BUXHEAD L�iE LYING NOR1HERlY
11#fiEUF, BEWG MORE PARTIqJLAt�.Y �BFD AS iHAT P7IRCEL OF LAND LY� NOR1H OF SAID LOT 18 Al�1 BOUI�ED fAi THE l�RTH BY THE BUUWEAD IJNE
SHOMN OFl PLAT OF SA� Sl1�iN51�1 LYING NIN2TH OF SAHT LOT 18, OF! 1F� SOIJTN BY iHE NORiH BOUNDARY OF SAID LOT 18, ON 1kIE WEST 8Y API EX1EN510N
NINi1HERLY OF iHE WESi BWNDARY OF lOT 18 1WD ON 1NE EAST BY AN EXiENSION NORiHERLY OF TNE EAST BOU�ARY OF SIUD L4T 18.
�
TF� A805�E DESCRIBED PROPERTY APPEARS TO BE �i ZONE AE (B.f.E.= 11'). IN ACCORdMICE WITN THE FlRM YAP OF THE CITY OF CLEARWAiER. PINELLAS COUNTY,
COr111UNiTY NUf�ER 125096 (MAP NUMBFR 12103C�-0102-6j, blpP DATEO SEPTEMBQt 3, 20D3.
PREPARED FOR: �u. va uatas
CER1NiCADQk 1 NEAF$'! CERI±Y TO 7NE �ST OF YY � N16 9Fl,ff
7HAT lla SURYEY SIID�N IffPEON S65fANIfN1.Y MFE75 iNE 6mtlYUM iECFtliCAI
STPND�ADS FOR IAND SAtVf1RIG � IN iFIE SUIE OF FtORDA RIAE 5J-17,
F.AC. FlIHINEAYq1E, iH5 CFR7IFIClt110N StIALL N0T E%1EtA1 i0 ANY 01116t PERSONS
OR PI�N1�S O1fIER 1Nk7 7N0`� NAIEO dl MS 91k�iY RND SHALL NOi BE
vnw un ewwc acu+sr n� �amo�sa€n �ra� wnian n� a�mu
wusm seu uu s a vmtrors am w�vvcn.
CEORGf A. S!&MP A, Fl.q2DA REpS LANp SURVEYIXt No. 2512
GEORGE A. SIWAP M, PROFESSIONAL SURVEYOR & MAPPER No. 6137
1HI5 SUAYEY IS NOT �IEIE OR VHIki UMf55 AtUCF1EU i0 9JRYfY0R5 tffPORi.
s-�a2o�z
LAST REVISION: N/A X REfERENCE 080117
GSORGE A. SEflIP ll
AND ASSOCIATBS, INCORPOR9TIsD
_ LAND SURVEYORS LAND PlANNERS
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ittp://ais.pinellascountv.ora/nublic pislmwf/publicais nad27.mwf Mondav. March 30. 2015 3:58 PI�
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Direct all correspondence to:
Clerk, Water and Navigation, 5`h Floor
315 Court Street
Clearwater, FL 33756
���0��_1
Application #
(OFFICAL USE ONLY)
PRIVATE DOCK PERMIT APPLICATION
PINELLAS COUNTY WATER AND NAVIGATION
I. PROPERTY OWNER INFORMATION:
A. Applicant's Name BILL MAZAS,
B. Mailing Address: 152 DEVON DR
CLEARWATER FL 33767-2438
Telephone No. 772-688-2828 E-mail Address:bmazas@me.com
II. AGENT INFORMATION:
A. Name: DOCKS, INC.
B. Address:
City, State, Zip
C. Telephone No. (727) 536-6786
6634 �2'� AVE N.
PINELLAS PARK, FL 33782
E-mail address: docksinc(a�tampabav.rr.com
dockssalesnu,tamuabav.rr.�com
i ake(a�docksincorporated.co m
III. SITE INFORMATION:
A. Construction Site Address: as above
City,
State: FL Zip
B. Parcel ID Number �g°29-15-04914-0��-0 l go
C. Incorporated [x] Unincorporated [] CLEARWATER
D, Affected Water Body: CLEARWATER HARBOR
E. Previous Permits: P3484504 P42742-13
F: Date applicant assumed property ownership; A.ug 12 2005 --
G. Obstructions: (dogs, fences, etc. j ience
H. Attach 8-1/2"xl1" vicinity rnap showing specific project location.
I. All other information pursuant to Section 166-329 and 166-330, Pinellas County Code, as
J. For projects requiring a public hearing, attach a copy of the complete legal description.
.
) -e._.v t S c �.�-> .
IV. PROJECT DESCRIPTION:
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Application #
(OFFICIAL USE ONLY)
A. Nature and Size of Project: REPLACE EXISTING DOCK 6'X38' WALKOUT 22'X10'HEAD
3'x10'Lower dock move existing lift out 15',add boat lift on riQ,ht side of dock.
Square Feet 254 Existing
227 New
481 Total
B. Variance: Yes X No
Amount in variance: Length: 33.5' Width:
Setbacks: Left: 3' Right:l7'
Other:
NOTE: It is the applicant's responsibility to clearly demonstrate that any requested variances are consistent with the
variance criteria of Section 166-291 of the Pinellas County Code. The applicant must demonstrate that a literal
en}a?r�.�;==E,3_ :�f the regulations would result in an extreme hardship due to the unique nature of the project and the
applicanY s properiy. The hardship must not be created by action(s) of the project owner(s). The granting of the
variance must be in harmony with the general intent of the regulations and not infringe upon the property rights of
others. The variance requested must be the minimum possible to allow for the reasonable use of the applicant's
property. Should the applicant fail to demonstrate that any variance request is consistent with the criteria outlined in
the regulations, staff cannot recommend approval of the application.
V. CONTRACTOR INFORMATION:
I, WII.,LIAM R. JANSEN/JACOB H. 7ANSEN , a certified contractor,
state that the dock has not been constructed and that it will be built in compliance with all requirements and
standards set forth in the Pinellas County Code, and in accordance with the attached drawings which accurately
represent all the inforrnation required to be furnished. In the event that this dock is not built in accordance with the
permit or tlte informatiou�furnished is not correct, I agree to either remove the dock or correct the deficiency.
Signed:
N
City:
CertNo.:C-3879: SCC13 1 1 50932
Telephone No: 727 536-6786
State: FL Zip:33782
E-mail Address: docksine,cni,tampabav.n•.com; jake�dacksincorporated.com; dockssales c�,tampabay.r�•.com
VI. OWNER'S SIGNATURE:
I hereby apply for a permit to do the above work and state that the same will be done according to the map or plan
attached hereto and made a part hereof, and agree to abide by the criteria of the Pinellas County Code far such
construction and, if said construcrion is within the corporate limits of a municipality, to first secure approval from
said municipality. I further state that said construction will be maintained in a safe condition at all times, should this
application be approved, that I am the legal owner of the upland from which I herein propose to construct the
improvements, and that the above stated agenticontractor may act as my representative. I understand that I, not
Pinellas County, am responsible for the accuracy of the information provided as part of this application and that it is
my responsibility to obtain any necessary permits and approvals applicable for the proposed activities on either
private or sovereign owned submerged land.
Owner's Signature
Date -��aE/��
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I cer.i;c t�,at 1 am 1� c��,�•n_r oi Lo. �7 u'.�ich adjci�.; th;: ;�ropert; oN:ned by the applicant wt �� proposcs ;o consulicr
a ducic at !he ;�l}o�, in� -:ddress_
iSa �e r�o�v. t2� �Ce.c�.2GvR-�crL �� 3�.?��?_ __...----- —
i hl� e scen tre platts oi �h� propos�:d �tructure{s) aleng with an}� requeste�l �, aziances (see 5ection 1\'.S of rhe
apnli_aiian) .-.nd: Dp OBJc:CT ❑ D��'�'OT OB7LCT C "� d�e propo �ed consmuuion,
C3i�'NF,A'S S).CtiA'�'t"f?E:
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40T4RY:
�T=TE GF I-LORIDA, PI'tiELL.aS COU�ti'T`r', BFPORE ;v�,; the undenianed authc,.ih:, peraonally appeared
_._ . well known to m.e, or who provided a vaiid Ffa-ida Driver's Licen>e to
be the per:or, wfzo execut�:d the ioregoing insmunent and #hai I��she acknrni�ledged to me, under oazh, thai he,�she
signec� thc x:rne ?reely and voluntat�ly forihe purposes e:cpressed therein.
V. itriess mp hsnd and officiat seal this ___ ____ _ day of __ __ ___, �p
Notary Public
h4y commission e,:pirc:s:
S3��a�° ,.:,; .^-,.s ;
[tisl�t Lot Owner's N�ne �/�O� _,,%%U�i�t L.� T ---- — -
`,lailing Address ��J`��-s(�Ci/R-/l% �C[X � �C� �.%� �i%L Zip._3 �!,�, �
I certifi� that I am the owner of Lot / 9 which adjoins the pruNzrty o�med by the applicant �vho proposes to constn�ct
a dock at ehe iol}owing addr�ss:
/5 a ��er/�o�/ T.�/T', G��c.g-2t,c�.g-f� .G'G 3 37�?
I have seen the pfans of U�e proposed structure(s) along with any requested variances (see Seccioi� IV.B of tl�e
ap�licatian) ��d: DO UBJECT ❑ DO NOT dBJECT ❑ �o the proposed construction.
O!§�:YER'S SICNAT'LRE��r �, as Oow+t r r�ilarn r^ �Atal S. 1li�o.l+i�atd.�
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S'i".�;TE OF �LORID.a. PT`;ELLAS CvUNTY, BEFORE ME_ the �ndersigned authority, personally appeared
7el.�e Ri. /ftwra�u�.t,t , well known to me, or wFo provided a vaiid Florida I3river's I_icense to
be itte person who execu,e.; the foregoing uistrument and that heishe acknowledged to rne, under oaih, that he-she
sign�d th: same ti�,;l; .J�d vo;untarily for dle putpos:s expressed therein.
Wimess my hand :uid oi�'icial seai tnis o�� �� da oi. � ,,�
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�� Notary Public Stafe d Fiorida i j,
. . Kimberly M Taulbee ' �j' i� } , _ �`� � �
M iY'(y c0;711nt55iG1 �\�3iiC5: ---_-;C_...! �'_.._..__. _...�
• y Commisslun FF 035718
�qn� ExpiroaD811N2017
Application #
(OFFICIAL USE ONLY)
DISCLOSURE FORM
In arder to alleviate any potential conflict of interest with Pinellas County staff, it is required that the County be
provided with a listing of PERSONS being parry to a trust, corporation, or partnership, as well as anyone who may
have beneficial interest in the application which would be affected by any decision rendered by the County (attach
additional sheets if necessary).
A. PROPERTY OVJNERS:
Name : BILL MAZAS,
152 DEVON DR
CLEARWATER FL 33767-2438
B. REPRESENTATIVES:
Name: DOCKS INC. Name:
Address: 6634 92� AVE Address:
PINELLAS PARK, FL 33782
Name:
Address:
Name:
Address:
C. OTHER PERSONS HAVING OWNERSHII' INTEREST IN THE SUBJECT PROPERTY:
Interest is: contingent ❑ absolute ❑
Name: N/A specific interest held:
D. DOES A CONTRACT FOR SALE EXIST FOR THE SUBJECT PROPERTY7 YES �J NO
If so, the contract is: contingent ❑ absolute ❑
Name of parties to the contract:
E. DOES AN OPTION TO PURCHASE EXIST FOR THE SUBJECT PROPERTY? YES � N
Name of parties to the option:
F. OWNER'S SIGNATURE:
I hereby certify that the information stated above is complete, accurate, and true to the best of my
knowledge.
X Date
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