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ANX2016-04014Clearwater 1739 E E TRI N I DAD DR ► ANX2016-W14 1739 EI Trinidad Drive - Steven J. Peterson Zoning: Low Medium Density Re Atlas #: Planning & Development Department Petition for Annexation ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED 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. ONE (1) COMPLETE SET (1 ORIGINAL APPLICATION AND SUPPLEMENTAL MATERIALS) AS REQUIRED WITHIN IS TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. ITIS 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): Steven J. Peterson and Jane L. Peterson MAILING ADDRESS: 1739 EI Trinidad Drive E, Clearwater, FL 33759-1907 PHONE NUMBER: EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT PROPERTY: PARCEL NUMBER(S): LEGAL DESCRIPTION: CURRENT CITY SERVICES: REQUESTED CITY SERVICES: (select all that apply) 727-389-1970 (Steven) 1739 EI Trinidad Drive E, Clearwater, FL 33759-1907 05-29-16-94320-001-0090 Virginia Grove Terrace Blk 1, W 100 Ft of Lot 9 SOLID WASTE/ SANITARY SEWER RECYCLING WATER SOLID WASTE/ X SANITARY SEWER X RECYCLING WATER Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 1 of 7 Revised 02J16 Xlearwater 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): Residential Single Family (R-3) REQUESTED (CITY): Low Medium Density Residential (LMDR) SITE AREA: 0.16 SIZE OF DEVELOPMENT: Existing: 1 Proposed: 1 (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 residential use, is unit(s) rental? Single Family Residential Single Family Residential No ARAB H RE ANY ACTIVE/OPEN -_FERMITS FOR_THEPROPE W THIN PINELLAS COUNTY?; YES ❑ NO ❑ IF YES, PLEASE LIST/EXPLAIN: STATE OF FLORIDA, COUNTY OF PINELLAS (we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my knowledge and authorize City representatives to visit and photograph the property described in this application. Swornto and subscribed before me this day of 0'01 by .tel MCW 4-J4KA� N who is personally known/has produced _, 1- 4j� qt P?140.J 116 as identification. Signature of property owner or representative Notary ubl' , / — — My co fission expires: �/) Signature of property owner or representative : J. M ANDREWS Notary Public-- Sta4of Florida Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, T � 62?,liFg". 18.2018 Page 2 of 7 �PaP, Comm1� 4F1d*21`3f160 h `;Clearwater 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. ❑ 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/or engineering plans are required. 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). ❑ 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). ❑ If applicant is designating an agent/representative to work with City, applicant must provide notarized Affidavit to Authorize Agent/Representative (form attached). 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.org. ❑ 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://gis.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:/Igis.pinellascountyorg/public gis/. 0 ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's Zoning Atlas, available online at exteis.mvclearwater.com/Zoning. ❑ 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 02/16 °Clearwater 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. ❑ 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 11 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 33766, Tel: 727-662-4667; Fax: 727-662-4866 Page 4 of 7 Revised 02/16 LL rc� arwater PROPERTY OWNER (PER DEED): Steven J. Peterson and Jane L. Peterson Planning & Development Department Petition for Annexation Disclosure Statement MAILING ADDRESS: 1739 EI Trinidad Drive E, Clearwater, FL 33759-1907 PHONE NUMBER: 727-389-1970 (Steven) 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 PURCHASE THE SUBJECT PROPERTY?' YES NO PARTIES INVOLVED — NAME: PHONE NUMBER: NAME: PHONE NUMBER: ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? YES NO PARTIES INVOLVED — NAME: PHONE NUMBER: NAME: PHONE NUMBER: STATE OF FLORIDA, COUNTY OF PINELLAS I (we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my knowledge and authorize City representatives to visit and photograph the property described in this application. Sworn to and subscribed before me this % day of DP1 % by 57 who is personally known/has produced, 64,-bAll9%X as identification. Signature jafproperty owner or representative Notarrission lic, My co expires: Signature of property owner or representative Planning & Development Department, 100 S. Myrtle Avenue; Clearwater, FL 337569 Page 5 of 7 J.M.ANDREWS I-fWary Public - State of Florida r,**;q7r-9if49d@g 18.2018 'r C c mftsondrW11621160 04� Pl& Development Department arwanningater Petition for Annexation Affidavit to Authorize Agent/Representative 1. Provide names of all property owners on deed —PRINT full names: Steven J. Peterson Jane L. Peterson 2. That (I am/we are) the owner(s) and record title holder(s) of the following described propert 1739 EI Trinidad Drive N 3. That this property constitutes the property for which a request for (describe request Annexation of single family residence 4. That the undersigned (has/have) appointed and (does/do) appoint: as (his/their) agent(s) to execute any petitions or other documen necessary to affect such petition; 5. That this affidavit has been executed to induce the City of Cl rwater, Florida to consider and act on the above described property; 6. That site visits to the property are necessary by City rep esentatives in order to process this application and the owner authorizes City representatives to visit and pho graph the property described in this application; 7. That (1/we), th and ned authority, hereby ce that the foregoing is true and correct. Prop wner Property Owner Property Owner Property Owner STATE OF FLORIDA, COUNTY OF PINELLAS BEFORE ME THE UNDERSIG ED, IAN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON THIS l DA OF ' (��u� Zd Y/ PERSONALLY APPEARED 7 WHO HAVING BEEN FIRST DULY SWORN Notary D AND SAYS THAT HE/SHE FULLY UNDERSTAN :.J: M: ANDREWS. `+' ? Notary Public •State of, Florida My Comm. Expires Aup;16, 2018 Commissio'n #r FF .152160 I tamp CONTENT$ Qf THE AFFIDAVIT THAT HE/SHE SIGNED. j/ Notary Public Signature My Coission Expires: � /�/ B Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 6 of 7 Revised 02/16 LL� �w °_ Arwater U PROPERTY OWNER (PER DEED): Steven J. Peterson and Jane L. Peterson Planning & Development Department Petition for Annexation Supplemental Statement MAILING ADDRESS: 1739 EI Trinidad Drive E, Clearwater, FL 33759-1907 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 % l day of .. XW 611 2"216, by / 57_O,4/ �ow ,who is personally known/has produced ?.yRIAH c�8"S as identification. Signature of property owner (individual or authorized representative of corporation, partnership or other entity) Notary u lic, My co ssion expires: Signature of co -property owner Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL.33766, Page 7 of 7 '9//6//* J. M. ANDREWS Notary Publlo - State of Florida %ConV;4��l k418. 2018 ENGINEERING DEPARTMENT March 11, 2016 CITY OT CLEARWATER POST OFFICE BOX 4748, CLEARWATER, FLoRmA 33758-4748 MumciPAL SEmcFs BuILDING, 100 Sours MYRTIEAvIIv m, SurIE 220, CuARWATm, FLORIDA 33756 TELEPHONE (727) 562-4750 FAX (727) 562-4755 Mr. Larry G. Goldman, Bureau Director Development and Review Services 315 Court Street Clearwater, Florida 33756-4623 Re: ANNEXATION Sanitary Sewer Service: Parcel No. 05/29/16/94320/001/0090 1739 El Trinidad Drive East Clearwater, Florida 33769 Dear Mr. Goldman: (Atlas Page 264A) Please be advised that the owner of the above referenced property has applied for sanitary sewer service from the City of Clearwater to serve the above referenced property. The following fees have been paid: Date: March 11, 2016 9$ 00.00 Sanitary Impact Fee 9$ 35.90 Sanitary Assessment Fee Receipt: ENG2016-03001 The City of Clearwater will provide sanitary sewer -service to aforesaid property and applicable impact fees have been paid. The City of Clearwater Utility Customer Service will collect the applicable water meter fee and/or utility deposit fees when applied for by the applicant. Sincerely, Donald D. Melone Engineering Specialist I cc: Building Official: Kevin Garriott Engineering: Tom Mahony Engineering. Donald Melone Planning & Development Services Clearwater Customer Service: Lynne Priester Present Owner S:\engin\word\penza\El Trinidad Dr East 1739 03eterson).docx "EQUAL EMPLOYMENT AND AFFIILNATIVE ACTION EMPLOYER" Annexation Map Request Planner Name: Kyle Brotherton Case Number: ANX2016-04014 Date Request Submitted: 4/4/16 Date Requested for: 4/18/16 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) Required Documents ❑ Legal Descriptionarrancy dee or survey) - to be hand delivered ® Map with Proposed hied ® EDR - no hard copies submitted - all submission material is accessible through Accela Location & Right-of-Way Language (for Ordinance Title) Location: Located on the east side of EI Trinidad Drive E approximately 570 feet north of SR 590. Right-of-Way ,[ENGINEERING INSERT ROW DESCRIPTION OR N/A:HEREJ PROVIDED LEGAL DESCRIPTION VERIFIED BY: �4 Th mas Mahon PSM, Ge raphic Technology Manager MAP NAME Owner(s): Steven J. & Jane L. Peterson Case: ANX2016-04014 Property 0.161 Site: 1739 EI Trinidad Drive E Size(Acres): ROW (Acres): Land Use Zoning PIN: 05-29-16-94320-001-0090 From : RL R-3 To: RL LMDR Atlas Page: 264B