ANX2016-030111491ROVE CIRCLE CT
ANX20M-03011
Doran, Kevin D and Marcy
LL Zoning: Low Medium Density Re Atlas #: 261A
1�., L1 „ inter Planning & Development Department
Petition for Annexation
ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED IN PERSON (NO FAX OR
DELIVERIES) TO THE PLANNING & DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE DATE. ALL
PAGES WITHIN MUST BE SIGNED BY ALL PROPERTY OWNERS LISTED ON THE DEED.
A TOTAL OF 6 COMPLETE SETS OF APPLICATION AND SUPPLEMENTAL MATERIALS (1 ORIGINAL AND 5 COPIES) AS
REQUIRED WITHIN ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. APPLICATIONS
AND SUPPLEMENTAL MATERIALS ARE REQUIRED TO BE COLLATED AND STAPLED INTO SETS.
IT IS INCUMBENT UPON THE APPLICANT TO SUBMIT COMPLETE AND CORRECT INFORMATION. ANY MISLEADING,
DECEPTIVE, INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION.
THE APPLICANT, BY FILING THIS APPLICATION, AGREES TO COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE:
IMPACT FEE/ASSESSMENT FEE:
To Be Completed By City of Clearwater:
TYPE OF ANNEXATION: X
$0
TBD Information on Impact Fees or Assessment Fees is available from
the City of Clearwater Engineering Department (562-4747).
CONTIGUOUS NONCONTIGUOUS (TYPE A ENCLAVE)
To Be Completed By Property Owner:
PROPERTY OWNER (PER DEED): Kevin D. Doran and Marcy Doran
MAILING ADDRESS: 1491 Grove Circle Court, Clearwater, FL 33755
PHONENUMBER: 727-7�j)-12-77 (A) 727-7NN-3(o8l0� �
EMAIL:yblafc�, j%�a'A yl -m-' covet
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
ADDRESS OF SUBJECT 1491 Grove Circle Court, Clearwater, FL 33755
PROPERTY:
PARCEL NUMBER(S): 02-29-15-33750-000-0150
LEGAL DESCRIPTION: Grove Circle Sub Lot 15
CURRENT CITY SERVICES:
REQUESTED CITY SERVICES:
(select all that apply)
SANITARY SEWER SOLID WASTE WATER
X SANITARY SEWER X SOLID WASTE
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 1 of 7 Revised 04/15
Clearwater
Planning & Development Department
Petition for Annexation
Data Sheet
PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAILURE TO COMPLETE THIS
FORM WILL RESULT IN YOUR APPLICATION BEING FOUND INCOMPLETE AND POSSIBLY DEFERRED UNTIL THE FOLLOWING
APPLICATION CYCLE.
FUTURE LAND USE PLAN DESIGNATION
PRESENT (COUNTY): Residential Low (RL)
REQUESTED (CITY): Residential Low (RL)
ZONING DISTRICT
PRESENT (COUNTY): R-3, Single Family Residential
REQUESTED (CITY):' Low Medium Density Residential (LMDR)
SITE AREA: 0.234 acres
SIZE OF DEVELOPMENT:
Existing: 1
Proposed: 1
(e.g., number of units, hotel rooms or
non- residential square footage)
USE OF PROPERTY:
Existing (currently on site):
Proposed (new use, if any;
plus existing if to remain):
If residential use, is unit(s)
rental?
ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY?
IF YES, PLEASE LIST/EXPLAIN:
STATE OF FLORIDA, COUNTY OF PINELLAS
Single Family Home
Single Family home
No
YES ❑ NO ❑
(we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my
knowledge and authorize City representatives to visit and photograph the property described in this application
Sworn to and subscribed before me this !O day of
Fi%1300+0/ 2,01 t* by
Signature Uf property(o*ner or representative
Signature of property owner or represe
Planning & Development
Page 2 of 7
/►��rLC:`� I ILE�4IrV �DZJQ, who is personally known/has
Notary publiL'
My commission expires
Notary Public : State of Florida
My Comm. E,xplree Aug 18, 2018
as identification.
i, Tel: 727-562-4567; Fax: 727-562-4865
Revised 04115
LL
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r,,Clearwater
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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. City staff will review proposed plans to determine their
compliance with the City's Community Development Code.
❑ 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 effective date of the annexation, applicant must provide notarized
Petition for Annexation Supplemental Statement (form attached). [Note: Submit original only]
❑ If applicant is designating an agent/representative to work with City, applicant must provide notarized Affidavit to
Authorize Agent/Representative (form attached). [Note: Submit original only]
INFORMATION REQUIRED TO COMPLETE THE PETITION FOR ANNEXATION APPLICATION AND DATA SHEET CAN BE
FOUND ON THE FOLLOWING DOCUMENTS AND/OR ONLINE AT THE FOLLOWING WEBSITES. IF THE APPLICANT IS
UNCERTAIN WHERE TO LOCATE THIS INFORMATION OR NEEDS ADDITIONAL ASSISTANCE, PLEASE CONTACT THE
PLANNING AND DEVELOPMENT DEPARTMENT, LONG RANGE PLANNING DIVISION AT 727-562-4567.
❑ PARCEL NUMBER (Parcel I.D. Number) can be found on the Warranty Deed. It can also be found by searching the
Pinellas County Property Appraiser's Office website at www.pcpao.org (search database by address).
❑ LEGAL DESCRIPTION can be found on the Warranty Deed. It can also be found by viewing the property record online at
the Pinellas County Property Appraiser's Office website at www.pcpao.or .
❑ FUTURE LAND USE PLAN DESIGNATION (COUNTY) can be found by viewing a Property Report using Pinellas County's
Public GIS Viewer available online at http://Pis.pinellascounty.org/public gis/. 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.org/public gis/.
❑ ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's
Zoning Atlas, available online at ,
http://www. myclearwater.com/gov/depts/pwa/engin/pu blications/engatlas/atias.asp.
❑ SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online
at http://gis.pinellascounty.org/public gis/.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756; Tel: 727-562-4567; Fax: 727-562-4865
Page 3 of 7 Revised 04/15
°_(karwater
U
ATTENDANCE AT PUBLIC HEARINGS
Planning & Development Department
Petition for Annexation
Information for Apulicants
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.
❑ Existing or proposed development is consistent with City regulations.
❑ Terms of a proposed Annexation Agreement, if any, promotes the City of Clearwater Comprehensive Plan.
PROPERTY OWNER AGREEMENT
Please be advised that, in consideration of the annexation, the property owners do hereby agree that:
❑ All structures and improvements which are erected upon said property subsequent to the date of this petition for
annexation shall comply with all applicable City of Clearwater regulations and ordinances as set forth in the City
Community Development Code;
❑ 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;
❑ 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(s) will be done on an assessment basis, consistent with City procedures therefore.
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 4 of 7 Revised 04115
o(` Planning & Development Department
l� aster Petition for Annexation
.:
Disclosure Statement
PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE 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 SUBJECT PROPERTY? YES NO .
CONTRACT IS:
PARTIES INVOLVED— NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
ARE THERE ANY OPTIONS TO VURCHASE THE SUBJECT PROPERTY? YES
PARTIES INVOLVED — NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? YES
PARTIES INVOLVED — NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
STATE OF FLORIDA, COUNTY OF PINELLAS
NO
Em
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 I o4q day of
via 2,vt110 by
AA 4" l I-1tN N441\4 , who is personally known/has
rod ed as identification.
Inn o P IPw& p _ o
Signature of propertn6r or representative \
Notary publi ,
My commission expires: (�
Signatu f property owner or representat e,
,,.o:►s` v� ; J. M. ANDREWS
=• « '_
o ary u c- tate o Florida
Planning & Development Departme t.�y` 1�E'0 56, Tel: 727-562-4567; Fax: 727-562-4865
Page 5 of 7 •' 10 �� omm s§Ion 1 j Revised 04/15
°,Clearwater
Planning & Development Department
.Petition for Annexation
Affidavit to Authorize Agent/Representative
1. Provide names of all property owners on deed —PRINT full names:
Kevin D. Doran
Marcy Doran
2. That (I am/we are) the owner(s) and record title holder(s) of the following described property:
1491 Grove Circle Court
3. That this property constitutes the property for which a request for (describe request):
Annexation of single family home for 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;
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;
That (I/we), the undersigned a/olbority, hereby certify that the foregoing is true and correct.
Prop rt Owner Property Owner
Property Owner Property Owner
STATE OF FLORIDA, COUNTY OF PINELLAS
BEFORE ME THE UNDERSIGNED, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON
THIS DAY OF 1'1`J� Z� PERSONALLY APPEARED
WHO HAVING BEEN FIRST DULY SWORN
�DFiPOSED AND SAYS THAT HE/SHE FULLY UNDE
�oi►Rr o�4c ..
J. M. ANDREWS
I ; Notary Public - State of Florida
y cc My Comm. Expires Aug 18, 2018 —
%�o� 'Co mmisslori # FF 152160
Notary Seal/Stamp
DS TH
OFT AFFIDAVIT THAT HE/SHE SIGNED.
Notj,Public Signature
MyCommi/ionExpires:
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 6 of 7 Revised 04/15
(Clearwater
0
PROPERTY OWNER (PER DEED): Kevin D. Doran and Marcy Doran
Planning & Development Department
Petition for Annexation
Supplemental Statement
MAILING ADDRESS: 1491 Grove Circle Court, Clearwater, FL 33755
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
Supplemental Statement shall supersede any provision in any Agreement to Annex executed by me/us or my/our
predecessors in interest.
Select One Option Below Which Applies to This Petition for Annexation:
X Annexation of Contiguous Parcel(s): 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.
❑ Annexation of Noncontiguous Parcel(s): I/we understand that this annexation is voluntary, and that I/we may withdraw
this Petition for Annexation prior to final action on this Petition by the City of Clearwater. I/we further agree and
acknowledge, however, that receipt of all sewer, solid waste or other city service is contingent upon completion of the
Petition for Annexation process, and that any withdrawal of this Petition prior to final action by the City, may result in a
discontinuance and termination of all City -provided services.
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 10 day of
2,6 I 1p . by
IV1A4?X–q � t� X012 s 1 who is personally known/has
produced" j�—I as identification.
Signature of pXf
perty w er (in ividual or authorized
representativ cor ora ion, partnership or other
entity)
ofX--property owner
Notary riss'04xpires: ic, I V (
My com Ig 6
My Comm. Expires Aug 18, 2018
Commission #t FF, 152160
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 7 of 7 Revised 04115
Annexation Map Request
Planner Name: Katie See
Case Number: ANX2016-0301 1
Date Request Submitted: March 2, 2016
Date Requested for: March 16, 2016
Maps Needed
® Location Map
® Aerial Photograph
® Proposed Annexation
® Future Land Use Map
® Zoning Map
® Existing Surrounding Uses Map
® 2" x 2" PDF Map (for Newspaper)
M
Required Documents
Legal Descriptionwarranty d d or survey)
® Map with Propose lighted
® EDR - no hard copies submitted - all submission material is accessible through Accela
Location & Right -of -Way Language (for Ordinance Title)
ILocation: Located on the south side of Grove Circle Court, approximately 95 feet west of North I
Highland Avenue.
I Right -of -Way:
PROVIDED LEGAL DESCRIPTION VERIFIED BY: U KzkV'-" b H
Tomas Mahony, AfA, 6eo�g4philc Tect4nology Manager
MAP NAME
Owner(s): Kevin D. and Marcy Doran
Case:
ANX2016-03011
Site: 1491 Grove Circle Court
Property
Size(Acres):
0.234
ROW (Acres):
Land Use Zoning
PIN:
02-29-15-33750-000-0150
From : RL R-3
To: RL LMDR
Atlas Page:
261 A
S:\Planning Department\C D B\Annexations (ANX)\Active Cases\Up for DRC\Grove Circle Ct 1491 ANX2016-
03011 - Doran\Maps\ANX2016-03011 Map Request.docx
CLEARWATER
BRIGHT AYU BEAUTIFUL• SAY ID BEACH
Case # ANX2016-03011
SIGN POSTING ACKNOWLEDGEMENT
I hereby acknowledge that the sign required for this case being considered by the
City of Clearwater for annexation was posted a minimum of 10 days before the
first City Council meeting. The sign was posted on the subject property in a
location where it is capable of being read from the most significant adjacent
street.
Planning & Development Department Staff:
P int Name Date
Sign Name
City Council Public Hearing Dates:
• May 19, 2016 (1St reading)
• June 1, 2016 (2nd reading)
Date Posted I Deadline to Post
May 6, 2016 1 May 8, 2016
Photo of sign uploaded into Accela