ANX2016-06019"C 4 ED 2155 BELL CHEER DR
Date
ANX2016-06019
nkc
Uearw � 3 2016
MAY 2
2155 Bell Cheer Drive -Goetz
UgD� artmeiA Zoning: Atlas #: 308B
Engineerila—=
ALL APPLICATIONS ARE TO BE FILLED O 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.
IT IS INCUMBENT UPON THE APPLICANT TO SUBMIT COMPLETE AND CORRECT INFORMATION. ANY MISLEADING,
DECEPTIVE, INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION.
THE APPLICANT, BY FILING THIS APPLICATION, AGREES TO COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE: $0
IMPACT FEE/ASSESSMENT FEE: TBD Information on Impact Fees or Assessment Fees is available from
the City of Clearwater Engineering Department (562-4747).
To Be Completed By City of Clearwater:
TYPEOFANNEXATION: x CONTIGUOUS NONCONTIGUOUS (TYPE A ENCLAVE)
To Be Completed By Property Owner.
PROPERTY OWNER (PER DEED): Nelda G. Goetz, Tre
MAILING ADDRESS:
2155 Bell Cheer Drive, Clearwater, FL 33764
PHONE NUMBER':
y677
EMAIL:
johnandlinda24283@gmail.com
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
ADDRESS OF SUBJECT
2155 Bell Cheer Drive, Clearwater
PROPERTY:
PARCEL NUMBER(S):
24-29-15-06408-000-0140
LEGAL DESCRIPTION:
Lot 14, Bell -Cheer Sub
CURRENT CITY SERVICES: SANITARY SEWER SOLID WASTE WATER
REQUESTED CITY SERVICES: x SANITARY SEWER x SOLID WASTE WATER
(select all that apply)
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 1 of 7 Revised 03/16
J
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):
REQUESTED (CITY):
R-3 Single Family Residential
Low Medium Density Residential (LMDR)
SITE AREA: 0.24 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): Single Family
Proposed (new use, if any;
plus existing if to remain): Single Family
'If residential use, is unit(s)
rental?
ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLA5 COUNTY?; YES El
IF YES, PLEASE LIST/EXPLAIN:
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 13 y'` day of
Si
Si
C1. Lo VAP by
% fV f✓� c�A G GB e z who is:p:e:rsonally knos
produced as identification.
KRISTIN A. BOREMAN �
Notary Public - State of Florida Notary public, Sg—t,.� A,
My Comm. Expires Feb 13, 2018
Commission # FF 076269 1 My commission expires: � 10 1,3 2_o 1 g
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 2 of 7 Revised 03/16
°Clearwater
0 � Z
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 engineering plans shall be submitted. 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://gis.pinellascounty.org/public gis/.
❑ ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's
online Zoning Viewer
extgis.myclearwater.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: 727-5624865
Page 3 of 7 Revised 03/16
e rwater
�T TT - �' T
18
lw
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 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 03/16
;Clearwater
PROPERTY OWNER (PER DEED):
MAILING ADDRESS:
PHONE, NUMBER.
EMAIL:
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
Planning & Development Department
Petition for Annexation
Disclosure Statement
Nelda G. Goetz, Tre
2155 Bell Cheer Drive, Clearwater, FL 33764
c ---moi/ L✓' ,.1� �
VAWlLSiil
OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBJECT PROPERTY:
NAME: \w
Z 0 l to . by
INTEREST IS: \�
�(e-1Lo" G. Gel&* -z
, who is persona�know��/as
SPECIFIC INTEREST HELD:
produced
as identification.
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 13`''h day of
KRISTIN A. BOREMAN
Notary Public - State of Florida
My Comm. Expires Feb 13, 2018 Notary public, 1XV—, 0—t 3o
Commission # FF 076269 My commission expires: F-e—t� , j 3 20 1
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 6 of 7 Revised 03/16
t -A. -, 1
Z 0 l to . by
�(e-1Lo" G. Gel&* -z
, who is persona�know��/as
produced
as identification.
KRISTIN A. BOREMAN
Notary Public - State of Florida
My Comm. Expires Feb 13, 2018 Notary public, 1XV—, 0—t 3o
Commission # FF 076269 My commission expires: F-e—t� , j 3 20 1
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 6 of 7 Revised 03/16
LL
o Planning & Development Department
. C 6mater Petition for Annexa
0 o tion
Affidavit to Authorize Agent/Representative
1. Provide names of all property owners on deed —PRINT full names:
Nelda G. Goetz
2. That (I am/we are) the owner(s) and record title holder(s) of the following described property:
2155 Bell Cheer Drive, Clearwater, FL 33764
3. That this property constitutes the property for which a request for (describe request):
Annexation in order to receive solid waste and sanitary sewer service from the City.
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.
Nelda G. Goetz lm&
Property 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 l �°Y� DAY OF N1 a\ 2-0k6 PERSONALLY APPEARED
I��t G• Go e -4—z- WHO HAVING BEEN FIRST DULY SWORN
P S =State
NDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED.
C4PNV PUB(iREMAN
°�: ate of Florida n
Feb 13, 2016FF 076269Sq �� (a ,
Notary Public Signature t�%pie
Notary Seal/Stamp My Commission Expires: Ftt_-,. i 3 Z O 1 Fi
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 6 of 7 Revised 03/16
`Clearwater
Planning & Development Department
Petition for Annexation
Supplemental Statement
PROPERTY OWNER (PER DEED): Nelda G. Goetz, Tre
MAILING ADDRESS: 2155 Bell Cheer Drive, Clearwater, FL 33764
CITY OF CLEARWATER CASE
NUMBER:
I/we, _Nelda G. Goetz
[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:
0 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 \ 3 day of
NLA 2f➢) b . by
i'l eA a a personally known as
produced
Signature of property owner (individua'6r5ut orized
representative of corporation, partnership or other
entity)
Signatu
KRISTIN A. BOREMAN
Notary Public • State of Florida
# FF 076269
as identification.
0 • (11 V__Q -4,
Notary public, i/�{,Sf-ire (A-,
My commission expires: F� t,::, , IS 2() 1 g_ _
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 7 of 7 Revised 03/16
I#: 2015132601 BK: 18777 Pr- 440, 05/12/2015 at 03:04 PM, 7ORDING 2 PAGES
$18.50 D DOC STAMP COLLECT $0.70 KEN BURKE, CLERK OF C .tT AND COMPTROLLER
PINELLAS COUNTY, FL BY DEPUTY CLERK: CLKDM08
X11 ,11
This instrument prepared by
and return to:
A. T. COOPER III, Esq. '
1230 Myrtle Avenue South, #102
Clearwater, FL 33756
Parcel Number: 24-29-15-06408-000-0140
Title Not Examined
QUIT -CLAIM DEED -
THIS QUIT -CLAIM DEED, executed this day of May, 201�, by-l4elda G.
Goetz, unremarried widow, Grantor, to Nelda G. Goetz, as Trustee U/T/612/13182,
or her Successor, Grantee. The Trustee and any Succe$�sor Trustee shall have the
full power and authority to protect, conserve, sell, convey, lease, ene(lmber, assign,
mortgage and otherwise dispose of the real property`d �ribedbloin, Grantees post
office address is: 2155 Bell Cheer Drive, Clearwater, PL
(wherever used herein the term "Grantor" and "Grantee"shih jncludY,e\�ingular and plural, heirs, legal
representatives, and assigns of individuals, and the.tuccessors and hssigns of corporations, wherever
the context so admits or requires). ;
WITNESSETH, That the said,6rant6 ,;for'd in consideration of the sum of
$10.00 and other good and valuable considerations in hand paid by the said Grantee,
the receipt whereof is hereby 6�knowjedged,'does hereby remise, release and quit-
claim unto the said Grantee;fb 6e i;,all the right, title, interest, claim and demand which
the said Grantor has in ar d to the folf6wing described lot, piece or parcel of land,
situate, lying and being in.tha;Countj of Pinellas, State of Florida, to -wit:
Lot Fourteen (44), BEhC-,, WEER SUBDIVISION, according to the map or plat
thereof as recptded in Plat Book 30, Page 60, Public Records of Pinellas County,
Florida
THIS'CQNir _�NCE IS FOR THE USE, BENEFIT AND ENJOYMENT OF THE
GRANTOR UNDER THE TERMS OF THE EDWIN G. GOETZ and NELDA G.
GOES QEOLARATION OF TRUST AGREEMENT DATED DECEMBER 13,
',;1982, AS THE SAME MAY BE AMENDED FROM TIME TO TIME.
TO HAVE AND TO HOLD the same together with all and singular the
appurtenances thereunto belonging or in anywise appertaining, and all the estate, right,
title, interest, lien, equity and claim whatsoever of the said Grantor, either in law or
equity, to the only proper use and benefit of the said Grantee forever.
PINELLAS COUNTY FL OFF. REC. —K 18777 PG 441
IN WITNESS WHEREOF, the said Grantor has signed and sealed these
presents the day and year first above written.
Signed and sealed in the presence of:
Print Witness Name:!
Print Witness N 1 5 n�s
STATE OF FLORIDA
Nelda G. Goetz ;
„
COUNTY OF PINELLAS )
HEREBY CERTIFY that on this day, before mo;,artoffider duly authorized in the
State aforesaid and in the County aforesaid to ta'kp,ackh�vledgments, personally
appeared Nelda G. Goetz, (check one) j whaj-perso�rally, known to me, or 0 who
produced as iqentification,'ar a who is known to be the
person described in and who executed tho foregoing instrument and who acknowledged
before me that she executed the same
WITNESS my hand and' Icia1;seal'in>the County and State last aforesaid this
day of May, 2015.
NOTARY PUBLIC — Signature
My Commission Expires: A.T Coope>,M
CM.
a>�:FFor� FApirer Feb. 26,2018
'Clearwater
2155 BELL CHEER DR
ANX2016-06019
12155 Bell Cheer Drive - Goetz
Zoning:
Atlas #: 3086
ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED TO THE PLANNING & J
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.
IT IS INCUMBENT UPON THE APPLICANT TO SUBMIT COMPLETE AND CORRECT INFORMATION. ANY MISLEADING,
DECEPTIVE, INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION.
THE APPLICANT, BY FILING THIS APPLICATION, AGREES TO COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THE
COMMUNITY DEVELOPMENT CODE.
APPLICATION FEE: $0
IMPACT FEE/ASSESSMENT FEE: TBD Information on Impact Fees orAssessment Fees is available from
the City of Clearwater Engineering Department (562-4747).
To Be Completed By City of Clearwater:
TYPE OF ANNEXATION: CONTIGUOUS x NONCONTIGUOUS (TYPE A ENCLAVE)
To Be Completed By Property Owner:
PROPERTY OWNER (PER DEED): John W. and Linda S. Pearson
MAILING ADDRESS:
2013 Sandra Drive, Clearwater, FL 33764
PHONE NUMBER:
-72,7- yy2-HS77
EMAIL:
iohnandlinda24283@gmail.com
AGENT OR REPRESENTATIVE:
MAILING ADDRESS:
PHONE NUMBER:
EMAIL:
ADDRESS OF SUBJECT
0 Bell Cheer Drive, Clearwater, 33764
PROPERTY:
PARCEL NUMBER(S):
24-29-15-06408-000-0150
LEGAL DESCRIPTION:
Lot 15, Bell -Cheer Sub
CURRENT CITY SERVICES: SANITARY SEWER SOLID WASTE WATER
REQUESTED CITY SERVICES: x SANITARY SEWER x SOLID WASTE WATER
(select all that apply)
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-5624865
Pagel of 7 Revised 03/16
LL t,
0
arwater
U
Planning & Development Department
Petition for Annexation
Data Sheet
PLEASE ENSURE THAT THE FOLLOWING INFORMATION IS FILLED OUT, IN ITS ENTIRETY. FAILURE TO COMPLETE THIS
FORM WILL RESULT 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: 0.24
SIZE OF DEVELOPMENT:
Existing: Vacant
Proposed: Vacant
(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?
Vacant
Single Family
N/A
ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELI.AS COUNTY? YES ❑
IF YES, PLEASE LIST/EXPLAIN:
NO ❑
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 1�3 day of
/
i
18ft`, by
Sign, tur of property owner or representative
Signature of property owner or representative
'who is personally known/has
produced L qU \L) as identification.
Rotary public,'
MyCOmmIS510ne IreS:rj;&P,I�. otary 'FPuA,bcli
ublic State o(Fbrida
rdan
My Commission FF 189911
?of �d` Expires 02/13/2019
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 2 of 7 Revised 03/16
0
.'/Clearwater
U
�-- -1
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 engineering plans shall be submitted. 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://gis.pineIlascounty.org/public gis/.
❑ ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's
online Zoning Viewer
extgis.myclearwater.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 03/16
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 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 03/16
°Clearwater
PROPERTY OWNER (PER DEED): John W. and Linda S. Pearson
Planning & Development Department
Petition for Annexation
Disclosure Statement
MAILING ADDRESS: 2013 Sandra Drive, Clearwater, FL 33764
PHONE NUMBER:
EMAIL: johnandlinda24283@gmail.com
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 %3 day of
by
who is personally known/has
produced — — as identification.
Sigr to of property owner or representative
Notary pub'
QWOW Public State 0'7 Florida
My commissio expire Scott E Jordan
Signature of property owner or representative pim(ssi 201 189911 ,
M 0. Expires 0 211 312 01 9
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-5624567; Fax: 727-5624865
Page 5 of 7 Revised 03/16
'_,,"Clearwater
Planning & Development Department
'_,C earwater
Petition for Annexation
Affidavit to Authorize Agent/Representative
1. Provide names of all property owners on deed - PRINT full names:
John W. Pearson
Linda S. Pearson
2. That (I am/we are) the owner(s) and record title holder(s) of the following described property:
0 Bell Cheer Drive, Clearwater, FL 33764
3. That this property constitutes the property for which a request for (describe request):
Annexation in order to receive solid waste and sanitary sewer service from the City upon development of
the property.
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), theun ign aut o P/;
y certify that the foregoing is true and correct.
John W. Pearson
perty Owner Property Owner
Linda S. Pearson
operty 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 n a �/ LPERSONALLY APPEARED
DEPOSED AND SAYS THAT HE/SHE FULLY UNDERSTANDS THE CONS€-PK�F Ti*
I-
5tr
0ea
c State of Florida
dan
sion FF 189911
3/2019
WHO HAVING BEEN FIRST DULY SWORN
DAVIT THAT HE/SHE SIGNED.
Notaryyublic Signature
My Commiss x ires:-I -�
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 6 of 7 Revised 03/16
`Clearwater
PROPERTY OWNER (PER DEED): John W. and Linda S. Pearson
MAILING ADDRESS: 0 Bell Cheer Drive, Clearwater, FL 33764
CITY OF CLEARWATER CASE
NUMBER:
Planning & Development Department
Petition for Annexation
Supplemental Statement
I/we, _John W. and Linda S. Pearson
[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:
❑ 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.
❑x 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 13 day of
of property owner (individual or authorized
ative of corporation, partnership or other
Signature of co -property owner
J�. by
n �^ wh'oI is personally known/has
produced 11+ffA as identification.
rvotary PUD""
My commission ex ' e 4WO&Notary Public State of Florida
tt E dardeft—
'%� My Commission FF 189911
?pip Expires 02113/2019
Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865
Page 7 of 7 Revised 03/16
g)� J• . �-rw1.b
WARRANTY DEED (Statute"
For -
GJ -4-559 PACE2.16y j9j8�n
3
Sur
Yt1 Jet p,
aS
.`93 Int _ . wnare,er da d ne gym, the tam n.rtr" =h.n mmnd. m. h.lr., xr,ah.l an..nnur<..
^�^^ aveeesson and/or nnlgna of the respective ,artl.. ha=elo; the of the singular, w trar
Y aha 11 includC the plural. and the plural the singular: the ase of any [ender hall Include
. ,: :... Tot 2 all 6endo-
M
Made this 10 day of June A. D. 19 77
�eflnEcn
JAMES B. BRATTON and ROSE A. BRATTON, hiswife
of the County of Pasco in the State of Florida "
party of the first part, andPETER.,'TO: JOHIQ W. PEARSON and LINDA S. PEARSON, his wife '
10.08 Normandy Road, Clearwater
of the County of Pinellas in the State of Florida -"51:6 `
party of the second part
Witnesseth that the said party of the first part, for and in considerabon of the Suit
of Ten dollars and other valuable consideration, to him in hand paid by the \said party of It*
second part, the receipt whereof is hereby acknowledged, has granted, bargained eild sold W the
said .party of the_ second part his heirs and assigns forever; the fallowing described jin , 3ate
lying and being in the County of Pinellas State of Florida, to wit:
Lot 15, BELL -CHEER SUBDIVISION, according`ta the map or plat'
thereof as recorded in Plat Book 30, Page 6Q,;\PubZiG'�ecords -'
of Pinellas County, Florida:
- This Conveyance is made subject to ria �L'].41,c�ns, reservations _
and easements of record, '
nr 1 1 \ \
J
`gCNMi ;ANY P ,;.
STATS,
��T_71TT3A
t, f j \n STA -NCR FA
oetl Y ', T
�tAX �. � DEPj OF.7tEVEHpE-
1041 '
And the 4ia party pf the first part does hereby fully warrant the title :to said land,.and will defend
the same aggws't the lawful claims of all persons whomsoever,
$ /,' �Ist itttess?Eghereof, .the said party of the 'first part has hereunto set his hand and
^�
teal the day\aqd year.ffrst above written.
0.
0 11w; J
a Wu !-' 1 Jtames Be Bratton .
Fo
�B nose A. Bratton,
r
noa
STATE OF Florida
opal COUNTY OF �.
�I perebg (4ettifix That on this day personally appeared before me, an officer duly
authorized to administer oaths and take acknowledgments,
JAMES B. BRATTON and ROSE A. BRATTON, his wife
to me well known and known to me to be the individuals described in and who executed the
foregoing deed, and they acknowledged before me that they executed.
-the sdlAd freely and voluntarily for the purposes therein expressed.
k a, Izi itne o my hand and official seal at Clearwater
County ofi Pinellas and State of Florida , this . —1
day -of e June A. 3). 19 77.
Commissiop'Expires�- C�r�
;x t"
"r r NOTARY PUBtIC',STATE Of 1'LORa)A AT (ARf3E Notary Public '
,�✓MY COM11155ION EXPIRES DEC. 13, 1W
-BONDED THRU GENERA[ INSURANCE UNbFRWRITE't
1
1 ,
+ 1
+ 1
J.
ri
i=
f
Annexation Map Request
Planner Name: Kyle Brotherton
Case Number: ANX2016-06019
Date Request Submitted: 6/7/16
Date Requested for: 6/21/16
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 Description (warranty dee or survey) - to be hand delivered
® Map with Propose Site-Highlighted
® EDR - no hard copies submitted - all submission material is accessible through Accela
Location & Right-of-Way Language (for Ordinance Title)
Location: Generally south of Druid Road, east of South Hercules Avenue, north of Lakeview
Road, and west of South Belcher Road.
Right-of-Way ?[ENGINEERING INSERT ROW°DE R TION OR N/A 11E
PROVIDED LEGAL DESCRIPTION VERIFIED BY: A,zi
T mas Mahon SM, Geogr ihic Technol gy Manager
MAP NAME
Owner(s): Multiple Owners
Case:
ANX2016-06019
Site: Unaddressed (0) Bell Cheer Drive
Property
Size(Acres):
0 `/
2155 Bell Cheer Drive
ROW (Acres):
Land Use Zoning
PIN:
24-29-15-06408-000-0150
24-29-15-06408-000-0140
From : RL R-3
To: RL LMDR
Atlas Page:
308B