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ANX2016-07022°CIeArwater U 3031 HOYT AVE ANX2016-07022 '3031 Hoyt Avenue - Multiple Properties Zoning: Low Medium Density Atlas #: 283A 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. 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: TYPE OF ANNEXATION: X CONTIGUOUS NONCONTIGUOUS (TYPE A ENCLAVE) To Be Completed By Property Owner: PROPERTY OWNER (PER DEED): William K. and Holly K. Wirgau MAILING ADDRESS: 3031 Hoyt Avenue, Clearwater, FL 33759-3410 PHONE NUMBER: 7Z7-,g�_ �3y3�N) 7Z? -5=/2-0397 EMAIL: chareers0102@yah6o.com AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT 3031 Hoyt Avenue, Clearwater, FL 33759-3410 PROPERTY: PARCEL NUMBER(S): 09-29-16-45144-014-0010 LEGAL DESCRIPTION: Kapok Terrace 15` Add Blk N, Lot 1 SOLID WASTE/ CURRENT CITY SERVICES: SANITARY SEWER RECYCLING X WATER SOLID WASTE/ REQUESTED CITY SERVICES: X SANITARY SEWER X RECYCLING 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 02/16 °:Clearwater 0 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) REQUESTED (CITY) ZONING DISTRICT PRESENT (COUNTY): REQUESTED (CITY): SITE AREA: 0.21 SIZE OF DEVELOPMENT: Existing: 1 unit Proposed: 1 unit (e.g., number of units, hotel rooms or non- residential square footage) Residential Low (RL) Residential Low (RL) Residential Single Family (R-3) Low Medium Density Residential (LMDR) 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 Residence Single Family Residence Im ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY? YES ❑ 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'" day of ZT& /A—e �0I tv . by W ifAs&tJ. J.A. 4C-0 who is personally known/has produced -f L-- D 4- as identification. Signature of property owner or representative /w a 01 Notary pu c, VICKI JO MORAHAN My commission expires r�" Notary Public - State of Florida Signature of roper y owner oT representative�: •-;�K�df°�' My Comm. Expires Mar 4, 2019 Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, Fl- 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 2 of 7 Revised 02/16 Dir �1 C earwater 0 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://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 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 httr)://gis.pinellascounty.org/public eis/. Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-5624567; Fax: 727-562-4865 Page 3 of 7 Revised 02/16 °Clearwater 0 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 02/16 o� .�, earwater 0 Planning & Development Department Petition for Annexation Disclosure Statement PROPERTY OWNER (PER DEED): William K. and Holly K. Wirgau MAILING ADDRESS: 3031 Hoyt Avenue, Clearwater, FL 33759-3410 PHONE NUMBER: EMAIL: chargers0102@vahoo.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: FDOES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPER TY5 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: Cji ,Q j�e, ',tr+Mep PHONE NUMBER: NAME:�q-� 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 � ay of :S7u ri1 r 9co- to . by LQLU &or •1- 110t&4 who is personally known/has produced P L Q L- as identification. Signature of property own -T -of -representative Notary polic,- •• ►x""�d''. VICKI JO MORAHAN Notary Public - State of Florida My commission expires: :' • "'i . commission# FF 199054 Signature of 6toperTy owner o representative My Comm. Expires Mar 4, 201E Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 5 of 7 Revised 02/16 o, Planning & Development Department C1e'Arwater Petition for Annexation Affidavit to Authorize Agent/Representative 1. Provide names of all property owners on deed —PRINT full names: / William K. Wirgau Holly K. Wirgau 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 3031 Hoyt Avenue 3. That this property constitutes the property for which a request for (describe request): / �e0 Annexation of single family home 4. That the undersigned (has/have) appointed and (does/do) appoint: as (his/their) agent(s) to execute any petitions or other documents nec6ssary 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 representat` ives in order to process this application and the owner authorizes City representatives to visit and photogr p`h the property described in this application; 7. That (I/we rity, hereby certify that the foregoing is true and correct. Property Owner Property O ner VlJ1LU>FFi�I 1�I (G/h IA A1D �r i`j, Z=V Property ner Property d6ner 'ATE OF FLORIDA, COUNTY OF PINELLAS BEFORE ME THE UNDERSIGN D; AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON A THIS DAY O',� Cf/7-f o�� `o PERSONALLY APPEARED DEPOSED AND Notary Se�!Stamp WHO HAVING BEEN FIRST DULY SWORN ,T HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. My Commission Expires: VICKI JO MORAHAN Notary Public - State of Florida 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 oK CIeArwater U PROPERTY OWNER (PER DEED): William K. and Holly K. Wirgau Planning & Development Department Petition for Annexation Supplemental Statement MAILING ADDRESS: 3031 Hoyt Avenue, Clearwater, FL 33759-3410 CITY OF CLEARWATER CASE NUMBER: I/we, / A l 1 t2 � /K (41�aiz i -f- i�1c o % 1Ah YCiQQ [insert names of all property owners], hAng filed a Petition fdr Annexation r garding 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 /3"— day of �trt t .�o / 4� by - .11allae od. x0e 4d who is personally known/has produced >F L P as identification. Signature of property owner (individual or authorized representative of corporation, partnership or other entity) Notary polic, c"08"y"„mfr, VICKI JO MORAHAN My commission expires: :: .°� Notary Public - State of Florida Signature o o -property owner - Commission #t FF 19902F__ My Comm. Expires Mar 4, 2019 Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 7 of 7 Revised 02/16 3ZX2016-07022 31 HOYT AVE o �� ear�ater �- 13031 Hoyt Avenue -Multiple Properties - iZoning: Low Medium Density Atlas #: 283A ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED -1u- rnm 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: TYPE OF ANNEXATION: CONTIGUOUS X NONCONTIGUOUS (TYPE A ENCLAVE) To Be Completed By Property Owner. PROPERTY OWNER (PER DEED): Todd M. and Robin A. Swenson MAILING ADDRESS: 3077 Grand View Avenue, Clearwater, FL 33759-3446 (PHONE NUMBER: 727-643-7961 EMAIL: 8rswensonl5@msn.com AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT 3077 Grand View Avenue, Clearwater, FL 33759-3446 PROPERTY: PARCEL NUMBER(S): 09-29-16-45126-001-0020 LEGAL DESCRIPTION: Kapok Terrace Sub Blk A, Lot 2 SOLID WASTE/ CURRENT CITYSERVICES: SANITARY SEWER RECYCLING X WATER SOLID WASTE/ REQUESTED CITY SERVICES. X SANITARY SEWER X RECYCLING WATER (select all that apply) Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-5624865 Page 1 of 7 Revised 02h6 LL U 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): Residential Single Family (R-3) REQUESTED (CITY): Low Medium Density Residential (LMDR) SITE AREA: 0.20 SIZE OF DEVELOPMENT: Existing: 1 unit Proposed: 1 unit (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 Residence Single Family Residence E ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY_.; YES ❑ IF YES, PLEASE LIST/EXPLAIN: STATE OF FLORIDA, COUNTY OF PINELLAS =I I (we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my knowledge and authorize City representatives to visit and photograph the property described in this applicationA6Sworn to and subscribed before me this 23 day of J'jNe ale .by SIMOVSoN , who is personally known/has produced /�'� QRaVgtJ b as identification. f�v Signature of property owner or representative Notary pu My coma of property owner or representative ti ,d,,` expires: V 1 1$ Planning & Development Department,j"O�'IAA tIIL�MSC�l: arL ilEF,9 E Tel: 727-562-4567; Fax: 727-562-4865 Page 2 of 7 y Comm: Expires �q 18, 2018 Revised 02116 �,f, !JF Flu`,•' Commission #� FF 152160 :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-S62-4567. ❑ 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 Zoning Atlas, available online at 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 02/16 o` ear ater U ATTENDANCE AT PUBLIC HEARINGS Planning & Development Department Petition for Annexation Information for Aunlicants 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: 727-5624865 Page 4 of 7 Revised 02116 o� Arwater 0 Planning & Development Department Petition for Annexation Disclosure Statement PROPERTY OWNER (PER DEED): Todd M. and Robin A. Swenson MAILING ADDRESS: 3077 Grand View Avenue, Clearwater, FL 33759-3446 PHONE NUMBER: 727-643-7961 EMAIL: 8rswensonl5@msn.com AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: IVTHER 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 X NO CONTRACT IS: PARTIES INVOLVED — NAME: PHONE NUMBER: NAME: PHONE NUMBER: ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY? YES X NO PARTIES INVOLVED — NAME: PHONE NUMBER: NAME: PHONE NUMBER: WARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY X YES NO PARTIES INVOLVED — NAME: Suncoast Schools FCU PHONE NUMBER: 813-621-7511 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 23 day of 3tJ NE 20 1 b . by °t'p 4' I`OAl'i 'Sw='A°►•-'E who is personally known/has produced R-+A°t bptwegs +d as identification. Signature of property owner or representative Notary p I My commission expires: �1 of property owner or representati a` `"" `'e.,'•. J. M. ANDREWS 4.1 Notary Public - State of FloridaPlanning 8, Development Departmen a lls; 000m6rjak1208er , Tel: 727-562-4567; Fax: 727-562-4865 Page 5 of 7;ZyaCommla$16n # FE,152160 Revised 02/16 ,r o(' Planning & Development Department �1�1earwater Petition for Annexation Affidavit to Authorize Agent/Representative 1. Provide names of all property owners on deed —PRINT full names: Todd M. Swenson Robin A. Swenson 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 3077 Grand View Avenue 3. That this property constitutes the property for which a request for (describe request): Annexation of single family home 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 rsigned authority, hereby certify that the foregoing is true and correct. J 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 23 12-14 DAY OF V N�� 1�� PERSONALLY APPEARED .SWAe-vS0 WHO HAVING BEEN FIRST DULY SWORN DEPOSED AND SAYS THAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. 0,11 kill% �•.w` :Public-- . ANDREWS Notary Stete'.of Floriday Coinxpires Aup 18, 2 DFF.Comtori Ar FF 152160 No ry Public Signature Notary Seal/Stamp My'Commission Expires: o 11t 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 o� Cla ater U Planning & Development Department Petition for Annexation Supplemental Statement PROPERTY OWNER (PER DEED): Todd M. and Robin A. Swenson MAILING ADDRESS: 3077 Grand View Avenue. Clearwater. FL 33759-3446 CITY OF CLEARWATER CASE NUMBER: I/we, Todd & Robin Swenson [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 2 3&24 day of Signature of property owner (individual or authorized representative of corporation, partnership or other entity) Signature of co -property owner Js , _,?" . by O1�A <� 12'lg1^j' °� , who is personally known/has produced r -_"0400r J�>ZW—'04 1-6 as identification. Notary public, My commission expires: �::Irly Comm. Expires Aug 18, 2018 `=CommiWon # FF 152160 t Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-5624567; Fax: 727-5624865 Page 7 of 7 Revised 02116 Alk Annexation Map Request Planner Name: Kyle Brotherton Case Number: ANX2016-07022 Date Request Submitted: 711116 Date Requested for: 7/16/16 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 Descriptio (warra�deeor survey) - to be hand delivered Map with Propose i ed ® EDR - no hard copies submitted -'all submission material is accessible through Accela Location & Right -of -Way Language (for Ordinance Title) Location: Generally north of Drew Street, west of McMullen Booth Road, south of SR 590, and east of US 19. Right-of-Way:[ENGINERING INSERT ROW DESCRIPTION 4RN/A HERE] PROVIDED LEGAL DESCRIPTION VERIFIED BY: AOAA�v Thomas. Mahony, PW, eogophic*76chhology Manager MAP NAME Owner(s): Multiple Owners Case: ANX2016-07022 Property 0.400 Site: 3031 Hoyt Avenue Size(Acres): 3077 Grand View Avenue ROW (Acres): Land Use Zoning PIN: 09-29-16-45144-014-0010 09-29-16-45126-001-0020 From : RL R-3 To: RL LMDR Atlas Page: 283A