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ANX2017-06012AMYO 0 7 -- O (O o f dl 1.715 1-AX6 0 EW �,U. 1715 LAKEVIEW RD ,CLEAR ATTR 'ANX2017-06012 .1W1WA1WMWM1&-A0 MACH 1715 Lake View Road - Matthew Praed & Paula Zoning: LMDR - Low Medium Atlas #: 307B 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): r MAILINGADDRESS: g6q 4 iAd.UbaA <h 0Le&r-ft-2�jPr__Ft- 337 41 PHONE NUMBER: 31-1- EMAIL:nrl AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT PROPERTY: 1-7 &.1j ed (ttParayaft� Ft -3 3 7S7,p PARCEL NUMBER(S): 23— 2� —1 �� if `� �2 7_ -,,)nn -005C> LEGAL DESCRIPTION: �-Ut S tVity V i3 +� 501ncL I/ i, Si_ ,� SOLID WASTE/ CURRENT CITY SERVICES: SANITARYSEWER RECYCLING WATER SOLID WASTE/ REQUESTED CITY SERVICES: P10' SANITARY SEWER RECYCLING WATER (select all that apply) Planning & Development Department,100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727.5624567; 0-4 -47 D.. k A no 49'lnAQ r_ IICLEARWATER 0 kklc:N'1'ANil ltihtlTfS'L�E•SAYT6 t4:Ai'M 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): ?—<-a,; A o tj si, I Lv �,. i LiLL_) REQUESTED (CITY): 1jQ:5�+p'G1 Lo c. i (R.L� ZONING DISTRICT PRESENT (COUNTY): REQUESTED (CITY): 1_1,A n - SITE AREA: C'j 9 2i acres SIZE OF DEVELOPMENT: USE OF PROPERTY: Existing: Existing (currently on site): St Hyl I 'F4,; Iv Proposed: Proposed (new use, if any; (e.g., number of units, hotel rooms or plus existing if to remain): S; r,,,)�� non- residential square footage) If residential use, is unit(s) rental? %no ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY? YES ❑ NO ❑ 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 ci "H" day of M a .► 201-1 by M�-�ew I?rz�cj who is personally known/has Zproduced FL Dr; v e.rs u C e-r.s,c as identification. Signature of property owner or representative �/ TANIAVAS �' �► _ I = _� �.: MY COMMISSION Notary public, My commission expires: Signature of property owner or representative Bonded ThN Notary Planning & Development Department,100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; o ,".. 9 „s 7 0-1-4 n4 40 9114 Q GG 020644 14, 2020 ie UnderwAters r_"-�CLEA RWA1TE11 1R 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.pcgao.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://Ris.r)inellascounty.orp/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 httg://gis.pinellascountv.org/public is/. Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; 12—A.-AA44013n4C NNtC:ttC,WAFF/A�fl'IfV4-MY"1L)NY.LCN 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; D- a s7 n9 40 9144 CLE A --'P--,- WA- . V "w�ElU6HYl5NU MFlUfCIFiSk.��rXS'K]6F+?l:H Planning & Development Department Petition for Annexation Disclosure Statement PROPERTY OWNER (PER DEED): ? roue C MAILING ADDRESS: qOq2 –r FL 7 PHONE NUMBER: 317– 337--55 3 EMAIL: lnraed &a::t .I'lPf' 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:►7(,c_I'C -� e. PARTIES INVOLVED– NAME: l a4her;" L.& -e rS PHONE NUMBER: NAME: 1•Cej� )A- eY'.S PHONE NUMBER: ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY? YES ✓ NO PARTIES INVOLVED – NAME: NAME: ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? PARTIES INVOLVED – NAME: NAME: PHONE NUMBER: PHONE NUMBER: YES PHONE NUMBER: PHONE NUMBER: STATE OF FLORIDA, COUNTY OF PINELLAS ✓ NO 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 9-fk day of NACA4 20l'l . by cL-i--i hew P,,,� , who is personally known/has A produced FL Dr, Signature of property owner or representative 1 /I^ w _ I/ / " 1 COMMISSION ,*_ MY COMMISSION # GG EXPIRES: August 14, My commission Signature of property owner or representative Planning & Development Department, 100 S:. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-5624567; O— 9 ni 7 O'.•A—A AA 40 '2A4C ,,::,..-' CLEARWATER Planning & Development Depa Invent .J eructrr n�a nrnrfeFrv[.-nn�yn rY.�cx Petition for Anne tion Affidavit to Authorize Agent/Repres, tative 1. Provide names of all property owners on deed —PRINT full names: / 2. That (I am/we are) the owner(s) and record title holder(s) of the following describe perty: 3. That this property constitutes the property for which a request for (describe re quest): i 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 rept sentatives in order to process this application and the owner authorizes City representatives to visit and photo/graph the property described in this application; 7. That (1/we), the undersigned authority, hereby certiWthat the foregoing is true and correct. Property Owner Property Owner Property Owner Property Owner STATE OF FLORIDA, COUNTY OF PINELLAS BEFORE ME THE UNDERSIGNED, /A/N OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON THIS DAY OF PERSONALLY APPEARED WHO HAVING BEEN FIRST DULY SWORN DEPOSED AND SAYS'THAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. Notary Public Signature Notary Seal/gamp My Commission Expires: Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; 0...... a -67 0—i. ^A no 4Q ')n4 in LEARWATER �"�` nnutwr �vrr iirnvru7x.� e+�r •ro ararra Planning & Development Department Petition for Annexation Supplemental Statement PROPERTY OWNER (PER DEED): Ma I I lixu MAILING ADDRESS:jby�y�.il�o., CITY OF CLEARWATER CASE NUMBER: I/we, Mccft1,,_LJ _Prc�e,,k , "No1,,_ St -)q rc,,,-,-- ---- -- ------ [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: 19 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): 1/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 1 (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 (lam'' day of Inc....{ 201'1 . by Q, t./ a+irhew P mecf who is personally known/has produced FL Dever $ Uce tSQ as identification. Signature of property owner (individual or authorized representative of corporation, partnership or other entity) Notary public, My commission expires: Signature of co -property owner TANIAYASQUEZ MY COMMISSION # GG Bonded Thru Notary Public Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562.4567; 0--- 7 ni 7 0.....-A Ao 40 9n4C 1715 LAKEVIEW RD �ANX2017-06012 '1715 Lake View Road - Matthew Praed & Paula jZoning: LMDR - Low Medium Atlas #: 307B ALL APPLICATIONS ARE TO. BE. FILLED OUT COMPLETELY AND CORRECTLY,. AND SUBMITTED TO THE PLANNING & DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE HATE. ALL PAGES WITHIN MUST BE SIGNED BY ALL PROPERTY OWNERS LISTED ON THE DEED. N�y 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: $0 IMPACT FEE/ASSESSMENT FEE: TBD Information on Impact Fees. or Assessment Fees is'avadable from the City of Clearwater Engineering Department {552-4740. To Be Completed By City of Clearwater: 7YPEOFANNEX41TION: X CONTIGUOUS NONCONTIGUOUS (TYPE A ENCLAVE). To Be Completed By Property Owner: PROPERTY OWNER (PER DEED): l V l a ew T rued Paa L 6:ckmmm MAILING ADDRE55: 9 q A l l J f--0 j-eAruMGker- FL 33- &Z/ PHONE NUMBER: EMAIL: Man— n%Ad W ft '-ft Y) 2 AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT PROPERTY: j y71 IAC-eizt M . PARCEL NUMBER(S): 23-2c( —j Lj21,7 2--r�p� –pp 50 LEGAL DESCRIPTION: .6 SOLID WASTE/ CURRENT CITY SERVICES. SANITARY SEWER RECYCLING yr WATER SOLID WASTE/ REQUEsTEo c7YSERvICES: i% SANITARY SEWER RECYCLING WATER (select all that apply) Planning & Gevelbpment Department, 100 S Myrtle.Avenue, Clearwater, FL 337W, Tei: 727-662-4567; a--4 4- nvao�n•e Ci PAN!'Na E Planning& DwelopmentDepartment E, R ^tition for Annexation. Data Sheet PLEASE 6MUM THAT THE r0LWWvj1vG v4FOWMTM Is IFILLM MY, IN ITS ENTIRETY. FA WRE TO CONNUUT"Is FORM VAU. RESULT IN YOUR APPUCA7WN BEING FOUND INCOMMWM AND POSSIBLY DEFERRED UNTIL THE FOLLOWING AMIMTION CYCLE FUTURE LAND USE PLAN DESIGNATION PRMT (COU": REQUESTED (am: 26MM DKMCT PRESENT(MUNM-. REQUESTED (CrM: J_MT%SL SITE AWk- t7 Zi acres WE OF DEVIMOPMEMr: USE OF PROPERTY: Existing: Existing (cUrrentiVon$i1te). 'v^f0e-acv-s,. v Proposed. k Proposed (new use, if any, (e-gnumber of urAte howl rooms or plus existing if to remain): non- rmkatw1sWamJboWge) If residential use. Is units) rental? ver ARE THERE AWACTIVEJOPEN PERMITS FOR THE PROPERTY WITM PI LAS COUMM YES NO 0 IF YES, PLEASE USTAX"M STATE OF FWRIIIJ, COUNTY OF P WELLAS I [wel the undersigned,acknowledge that all replesentatiow made in this apprication are true and accurate to the best of my. knowledge and authorize City rep resefttatives to visit and photograph the property desabed in this application- Sworntoand subscnibed before me this _34"" -- day of M&4 Zor)-- by PIA.,CJ who is persainalbi known/has Produced FL C -;,gr _IACr as iden0cation. Signature of property owner or representabwe Notary public. - my commission expires: Signature of property ow"" or 337M. T&- W,862 -456P. "x' n�ctt nr n+�u>xi3nAtut unr nrssr�a'T� Planning & Development Depalx-tment 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: Q 'Signed and sworn (notarized) disclosure of interest statement (form attched). D 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. 0 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. EJ Terms of a proposed Agreement to Annex, if any. LI if the proposed annexation requires .a change in the land use classification and zoning category assigned to the property, a justification for such change most be submitted in writing. if the requeAedzoning is not consistent with the Future Land Use Map of the City of Clearwater Comprehensive Plan, the applicant w.111 be required to.file a companion application to amend the map. Q 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). Q 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 ANDJOR 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. O 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.ncpao.ore (search database by address). GI 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.pcoao.ora. Ci 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://Qis.pinellascountv.org/oublic e'►s/. Search by property address or Parcel I.D. Number and report will appear. LJ 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). Q ZONING DISTRICT (COUNTY) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online at htto://Ris.pi6ellascounty.org/public eis/. © ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's Zoning Atlas, available online at exteis.myclearwater.com/Zoning. 13 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 eis/. Planning $ Development Deparhnent, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tei: 727562-4567, ta....:.a...+ na 40 �n4a ATTENDANCE AT PUBLIC HEARINGS Planning & Development Department Petition for Annexation Information for Applicants The applicant or applicant's representative is encouraged to attend City ; bpncil 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.). O The proposed annexation is consistent with the City of Clearwater Cornprehen-tive'PJon. ❑ 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. Q. Terms of a:proposed Annexation Agreement, if any, promotes the City of Gearwater 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; 11 ❑ 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 It 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 & Myrtle Avenue, Clearwater, FL 33756; Tel: 737-562-4567; 0+..++. A+.i7 pn.rw...t A4 44 7n4 J At- __ _ S; Planning & Development Department AC Petition for Annexation Disdosure Statement ADDRESS:- PHONEa� AGUIT OR R E i MAIUNG ADDRESS: EMAIL NAME- INTEREST IS: SPECIFIC 1NTEIIE.ST HELf3: !DOES A CONTRACF EX>57• FOR SALE OF THE SUBIECr PROPERTY?YES NO CONTRACT IS. PARTIES INVOLVED --NAME: "tiz�l+ttr-:�#.� &1-,L,-YK' PHONE NUMBER NAME: ' tcl T��,,i e� 'r� . PHONE NUMBER ARE THERE AW 0P'iiDl11S TO PURCHASE THE SUM ECr PROPERTY? YES r'~ No PARTIES INVOLVED — NAME: PHONE: NUMBM NAME! PHONE NUMBER: ARE TMEANYMORTGAGESORUENSONi'iWSURJW3PROPERM YES ..�' NO PARTIES INVOLVED — NAME: PHONE NUMBER. NAME: PHONE NUMBER - STATE GY 6 AWDA, C tWTYOf PIXEUAS 1 {we), the undersigned, acknowledge that aN representatIons made ki thus appkawn are true and accurate to the best of my knowledge and authorize City representatives to visit and photograph the property descr'hed in this application_ Sworn to and subscribed before we this �day of i*f1G�t 2corj by P,,xj who is personally knownihas K j, !��/ .'^'� - produced Fl. Signature of property owner or representative MycommdsAwn SWiature of property owner or represemtatAr & De`v Pmmnt _ • m fta- Tek 727-562.4567: z Planning & Development CLE'MPetition for Ana Affidavit to Authorize Agent/RePres 1. Provide names of all property owners on deed —PRINT full names: 2. That (I am/we are) the owner(s) and record title holders), of the following described 3. That this property constitutes the property for which a request for (describe request):. 4. That the undersigned (has/have) appointed and (does/do) appoint: as (his/their) agent(s) to execute any petitions or other documents necessaryto affect such petition; j, 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 repytsentatives in order to process this application and the owner authorizes City representatives to visit and photo"graph the property described in this application; r' 7. That (1/we), the undersigned authority, hereby certify that the foregoing is true and correct. Property Owner Property Owner Property Owner Property Owner l f jSTATE OF FLORtDA,,COUNTY OF PIN€LL.AS BEFORE ME THE UNDERSIGNEEY,`AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON s THIS DAY OFf/ PERSONALLY APPEARED r' WHO HAVING BEEN FIRST DULY SWORN f" DEPOSED AND SAYS'THAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. i Notary Public Signature Notary Seal/"�/M/p My Commission Expires: Planning 8 Development Department, 100 S Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562.4567; CL EA-qVVAi �' -,neurw+wwwcma,rwpnya, PROPiE:R3Y OWNER [MR IMEM MAJUNG ADDRESS: CITY 47xF MARWATER.CASE i1 UAMR: t/we, _ AACC�o -pr.ed . '4x_l-rr"...:, Planning & Development Department x ,Petition for Annexation Supplemental Statement [insert names of all property owners), moving filed a Petition for Annexation regarding the above property/cam number, grant consent; agree and acknowledge that the OW of Clearwater may immediately or at a Liter time process the application t0completion, includingadoption and recordation of related Ordinances, without the necessity to further notice me/us. This Smplementai statement shall supersede any provision in any Agreement to Annex executed by me/us or my/our predecessors in interesL Select One Option Below Which Applies to This Petition for Annexation: IM Annexation of Contiguous Parcells}: 1/we farther agree and acknowledge that ywe shall not rescind the Petition for Annexation or execute any documents attempting such rescission, and that any attempted rescission shall Cue of no force and effect. 0 Anneoration of Noncontiguom Parcel jsj: Vvve understand that this annexation is voluntary, and that 1/we may withdraw this Petition fear Annexation prior to final action on this Petition by the Oty of Clearwater. i/we further agree and acknowletiM however, that receipt of all sewer, solid wasteor 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 fiAB Uk COLM Y OF P1NEt1,AS I {we}, the undersigned, acbmwledge: that all representations tirade in this application are true and accurate to the best. of ney knowledge: and authorise City representatives to 4sit and photograph the property described in this application_ Sworn to and subscribed before me this moi ` day of 201 by ew. Pv-cd , who is personally known/has sa produced 1✓L T3r yirar'S LitenS ax4dkr►tifitrr. Signature of property owner ('xsdhddual or a �••••••••r• • TAf�Itlplt7Ei repreSerriAtdr2 of corporation, parineiahip or other :'����x tilt Ci0Ni4;ra07 entity)i i.t. prs.�f1L'./ '' trf�a�,ostK 2u My commission expires: Signature of co -property 2!a� WWI p�iry,f►nlNt'-tti�le af.i3Nlkllli X/ ifSflC8dt 4 M t fAlr CclrimHtkut Eicplt�s l�idb 1, �02< .. i .%i ... i _ t► /1_ i �Pta 7!l!g}!lllg7!llrllil l l' ' Clar;rmater, KL 3VSS. Tet 727 62 -*W; ^ _ CL Etat R\A,,,ATE F Y,tttcarr nuu arnurn vrnar iu avcn !UN 0 20 8V PLANNING& DEVELOPMEM'b�Pi x o�c�Ea 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. 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 A "110cutNTS OF THE COMMUNITY DEVELOPMENT CODE. APPLICATION FEE: $0 ^ i �A f IMPACT FEE/ASSESSMENT FEE: TBD Information on Impact Fees or, m the City of Clearwater Engineer S i To Be Completed By City of Clearwater: TYPE OF ANNEXATION: X CONTIGUOUS NONCC To Be Completed By Property Owr PROPERTY OWNER (PER DEED): MAILING ADDRESS: PHONE NUMBER: EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT PROPERTY I (�%�.IC1� �. � �� ;L7` ? PARCELNUMBER(S): LEGAL DESCRIPTION: S 4 ) V,'3•1!�J- 501xcA I/ A' SiC,U==4 SOLID WASTE/ CURRENT CITY SERVICES. SANITARY SEWER RECYCLING WATER SOLID WASTE/ REQUESTED CITY SERVICES: I" SANITARY SEWER RECYCLING WATER (select all that apply) Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; o•. .n 4 ns'y n9 40 9n4C anrc:nt mn arn++ntert. rai u:gnc ++ Planning & Development Department Petition for Annexation Disclosure Statement ? PROPERTY OWNER (PER DEED): rhe C MAILING ADDRESS: 2 r r FL 7 PHONE NUMBER: 317- X37--15 3 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: 'Di. llGtse PARTIES INVOLVED— NAME: Cloa v12rr'S PHONE NUMBER: NAME: ()y /x )a#e✓S 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 W 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 944' day of 2-o t'1 . by P'A-C-� , who is personally known/has ! - K Z produced Signature of property owner or representative My commission Signature of property owner or rep resentativ4MO-4111hillb-111111 l mg & Development De rtr»ent!NAf .1{�1�-1SMM61QAdlplltei PaIM F i, 41 IJuau6 J� C� Mir Com mal FionCo"M�F* 1. M4 TAN AVASQUEZ MY COMMISSION # GG EXPIRES: August 14, 4 FL 756, Tel: 727-562-4567; ■■ o --A 00 40 9A4G M11311 -111-11111 unr w arsrx 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.pcoao_ore (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://Ris.pinellascounty.orp,/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://Ris.pinellascounty.orp,/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. D SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online at http://Pis.pinellascounty.org/public gis/. Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tet: 727-562-4567; C.?°%E MGM NO) 1ILAV41MI -KAY II) MACH ATTENDANCE AT PUBLIC HEARINGS Planning & Development Department Petition for Annexation Information for AvInlicants 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,- 0 ity;❑ 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 If 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; D--- A -4 7 no 40 91114R 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):2L ZONING DISTRICT PRESENT (COUNTY): REQUESTED (CITY): j hAT SITE AREA: ,�:>;'Z1-�, acres SIZE OF DEVELOPMENT: USE OF PROPERTY: Existing: ( Existing (currently on site): 5 ,pc_I e FG,; Proposed: k Proposed (new use, if any; (e.g., number of units, hotel rooms or plus existing if to remain): �,;, yl L7F non- residential square faotoge) If residential use, is unit(s) rental? hG ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY? YES ❑ NO ❑ IF YES, PLEASE LIST/EXPLAIN: STATE OF FLORIDA, COUNTY OF PINELLAS I (we), the undersigned, acknowledge that all repMsentations 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 Q -VU day of Signature of property owner or representative Signature of pro erty owner or re kl&w Planning & Dev /-1//7 1z P& LCL S ckb.- X-& /),I M 201-) by er-40-cd who is personally known/has produced Ft -Dry ve✓S UCe_nS& as identification. Notary public, My commission expires: Beau DepartNr ewnt!M94-. Man My Commission Expires Feb 1, 2024 TAMA Bonded Tnru 33756, Tel: 727-562.4567; o....:�...+ns 40 1n4e GG 02ND 14,2020 ��`„� r Planning & Development Department Petition for Annexation Supplemental Statement PROPERTY OWNER (PER DEED): tl tfkAUMAILING ADDRESS: Sby ��iol�ibor, St{ Cle�ntctre- t �L 33,x! CITY OF CLEARWATER CASE NUMBER: I/we,-M4*6_t...3 _PrcaeA , rc.,---,�+� (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 1/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 C( -t+` day of o t`�ca 2011 by � 1 1J(c�H hew Prueq who is personally known/has Cproduced FL- Dryer as identification. Signature of property owner (individual or authorized representative of corporation, partnership or other TANuvASQUEZ entity) V � _ MY COMMISSION # GG 0; Notary public, '':fo . a° DmftdThmNotxyPabftUM My commission expires: Signature of co -property QwrWr_ � NI�VXa NoWy Puh k Stripe of 110”" '/� U/� CommisHaftsion E County �Y f/ My Commission Ezplres Feb 1, 2021 Planni Ctearwate►, FL 33756, Tel: 727-562-4567; ot� C3_EAP�iif� � (`� , Planning & Development Depa ent Petition for Anne tion Affidavit to Authorize Agent/Repres tative 1. Provide names of all property owners on deed — PRINT full names: J f 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 3. That this property constitutes the property for which a request for (describe request): 4. That the undersigned (has/have) appointed and (does/do) appoint: as (his/their) agent(s) to execute any petitions or other document's necessary to affect such petition; 5. That this affidavit has been executed to induce the City of Ctearwater, Florida to consider and act on the above described property; ' 6. That site visits to the property are necessary by City rep4sentatives 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 certif that the foregoing is true and correct. Property Owner Property Owner OF FLORIDA, COUNTY OF PINELLAS Property Owner Property Owner BEFORE ME THE UNDERSIGNEI ;, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON THIS DAY OF/ PERSONALLY APPEARED WHO HAVING BEEN FIRST DULY SWORN DEPOSED AND SAYSTHAT HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. Notary Public Signature Notary Seal/Stamp My Commission Expires: Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; o asp o,..,;e,..+ no we nnea —Lt AR\�_> '= bKK:Hi'A.�U SEAVTIt7+1•M\Y-IU l2ACH 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. 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 RUNG THIS APPLICATION, AGREES TO COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THE COMMUNITY DEVELOPMENT CODE. APPLICATION FEE: SQ 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: TYPEOFANNEXA77ON: X CONTIGUOUS NONCONTIGUOUS (TYPE A ENCLAVE) To Be Completed By Property Owner: PROPERTY OWNER (PER DEED): f MAILING ADDRESS: PHONE NUMBER: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS SURJECT P OPERTY: 1-7/5 5 LakeUi e� ��y�L, FG � 2 7� PROPERTY: / t � �'� �-z— } PARCEL NUMBER(S): 2.3-2=e --jam 117 I7 2"t -,nn –Ob rr LEGAL DESCRIPTION: -' & { LV .>tfk 5olf,aU v: Sim.._, SOLID WASTE/ CURRENT CITYSERVICES: SANITARY SEWER RECYCLING WATER SOLID WASTE/ REQUESTED CITY SERVICES: 1-0" SANITARY SEWER RECYCLING WATER (select all that apply) Planning & Development Department, 100 & Myrtle Avenue, Clearwater, FL 33756, Tei: 727-662.4567; 01;It;t11 -11 b 11111LL, WY 1()—C.11 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): cSPr%o.. jc11 L—,� s C(Z.1-) REQUESTED (CITY): �„�. ; aL Lo'-. t C r?x. ZONING DISTRICT PRESENT (COUNTY):,— REQUESTED (CITY): SITE AREA: ,r:' , 2i -'S acres SIZE OF DEVELOPMENT: Existing: Proposed: k (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? YES ❑ IF YES, PLEASE LIST/EXPLAIN: STATE OF FLORIDA, COUNTY OF PINELLAS NO ❑ 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 q 44, day of M cY4 201-1 . by w Pi -c --cd . who is personally known/has Produced FL Dr. vers uCCnst as identification. Signature of property owner or representative Notary public, My commission expires: Signature of property owner or representative ...... , TANIAVAS EZ '?� MY COMMISSION GG 020844 ;o r 14.2020 •sa!`oi v� '�. BI dW Thru Notary Pu !C Un&rA IItw. Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; 0.,.... ,.4'7 0,...:..,,.+ no -10 ')A44 ^_._--m_-;,j=YY T;,�; ;_ti Planning & Development Department a nxwrnvstntrn:vz-x-rr w�.rn 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 22 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.Q. 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-pcl3ao.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.ocoao.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 htto://Ris.oinellascounty.org/public gi . 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•//eis pinellascounty orpJoublic eis/. ❑ ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's Zoning Atlas, available online at extsis.myclearwater.com/Zonine. ❑ SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online at http://eis.i)inellascounty.org/public eis/. Planning $ Development Departnient,100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; D.,.... '1 ..t 7 no Eillt-'._H1NMI %1A1T11 U -My 111 UUW11 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 & Myrtle Avenue, Clearwater, FL 33756, Tei_ 727-562-4567; o w ..47 0—k. -A no -40 anee �,��:_ axitari n�t>atnvru i:��ssnr'w eu:.c:�� Planning & Development Department Petition for Annexation Disclosure Statement STATE OF FLORIDA, COUNTY OF PINELLAS 1 (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 9"B' day of M!2:4 201'1 . by h-Ao" 1-1-�aw Prxk. d who is personally known/has produced PL Drs „�;�• TANIAdASQUEZ Signature of property owner or representative ( '/ MYCOMMISSIIOON#GG02I :N +_ EXPIRES: ust 14, 20� X My commission expires: � 14 Signature of property owner or representative Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; PROPERTY OWNER (PER DEED): ? ra.e C MAILING ADDRESS: qOq AtidjAhol St2 r r F( 7 PHONE NUMBER: ,31%-3Z'� 3RD EMAIL: d2%lnrCLed &a -f - 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: ry PHONE NUMBER: NAME: felly iA )pJer'S 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 1 (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 9"B' day of M!2:4 201'1 . by h-Ao" 1-1-�aw Prxk. d who is personally known/has produced PL Drs „�;�• TANIAdASQUEZ Signature of property owner or representative ( '/ MYCOMMISSIIOON#GG02I :N +_ EXPIRES: ust 14, 20� X My commission expires: � 14 Signature of property owner or representative Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; CLE ARS, ATEf4 eeucef r nvu nrrvntve - snr •n� srncn Planning & Development Department Petition for Annexation Supplemental Statement PROPERTY OWNER (PER DEED): ljy tkU -Ps'a ea _Py 01 cA SC.. �' r MAILING ADDRESS:C` 9 AUA,_l VD0,-� C, "rn.X,t" ,-V-L- 337, 4 CITY OF CLEARWATER CASE NUMBER: I/we,GtI,J [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. ❑ 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 (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 q+k day of Signature of property owner (individual or authorized representative of corporation, partnership or other entity) Signature of co -property owner 2011 .by t.Aa+IrKew Prised who is personally known/has produced FL Dr.ve'r UcensQ_ as identification. Notary public, My commission expires: TANIA VASOUEZ MY COMMISSION # GG i Bonded Thru Notary Publk Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-552-4567; 0-7–S7 o..e ann-1ooM4c ft = E ,- Planning & Development Dep ent Petition for Anne tion Affidavit to Authorize Agent/Repres tative 1. Provide names of all property owners on deed — PRINT full names: r 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 3. That this property constitutes the property for which a request for (describe request): 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 rep 'sentatives 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 certifylthat the foregoing is true and correct. BEFORE ME THE THIS DEPOSED AND & Notary Seal/Samp Property Owner Property Owner Property Owner Property Owner .STATE OF FLORIDA, COUNTY OF PINELLAS DERSIGNED;AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON r' DAY OF,/ _ PERSONALLY APPEARED WHO HAVING BEEN FIRST DULY SWORN HE/SHE FULLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. Notary Public Signature My Commission Expires: Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; CLEARWATER Bl LIGHT AND BLAUI1FUL • BAY TO BEACH Case # ANX2017-06012 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 City Council first reading. 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: Prirk Name Si n Name City Council Public Hearing Dates: • August 16, 2017 • November 16, 2017 Date Posted August 4, 2017 Photo of sign uploaded into Accela �&,q,rt- Date Deadline to Post August 6, 2017 Ah Annexation Map Request Planner Name: Kyle Brotherton Case Number: ANX2017-06012 Date Request Submitted: 6/2/17 Date Requested for: 6/16/17 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 Descriptionarrant deed or survey) - to be hand delivered El ® Map with Proposee Highlighted ® EDR - no hard copies submitted - all submission material is accessible through Accela Location & Right -of -Way Language (for Ordinance Title) Location: Located on the northwest corner of Lakeview Road and South Duncan Avenue Right -of -Way: [ENGINEERING [NSERT ROW DES PTGQN C)R(J/A HE ] wl����,�� , rJC*tJ 4-16, P LEGAL DESCRIPTION VERIFIED BY: PROVIDED Thomas Mahony, PSM Geo4aphic Tec nology Manager MAP NAME Owner(s): Matthew Praed and Paula Schramm Case: ANX2017-06012 Property 0.213 Site: 1715 Lakeview Road Size(Acres): ROW (Acres): �• yy Land Use Zoning PIN: 23-29-15-49122-000-0050 From : RL R-3 To: RL LMDR Atlas Page: 3078 June 2, 2017 City of Crearwater Clearwater Planning & Development, Post Office Box 4748, Clearwater, Florida 33758-4748 100 South Myrtle Avenue, Clearwater, Florida 33756 Telephone (727) 562-4567 Fax (727) 562-4865 Renea Vincent, AICP General Planning Administrator Pinellas County Planning Department 310 Court Street Clearwater, Florida 33756 Sergeant Beverly Borland Strategic Planning Pinellas County Sheriff's Office P.O. Drawer 2500 Largo, Florida 33778 Re: Notice of Voluntary Annexations (ITEM NO: ANX2017-06012 and ANX2017-06013) Dear Madams: Please be advised that the City of Clearwater is in receipt of applications for voluntary annexation for properties located at 1715 Lakeview Road, 809, 907 and 915 Glen Oak Avenue E, 3053 Grand View Avenue, 3058 Hoyt Avenue, 3040 and 3077 Merrill Avenue, 3136 San Jose Street, 3080 Terrace View, and 3127 Wolfe Road. The subject parcels are located within the City of Clearwater Planning Area and upon annexation into the City of Clearwater will be served by city sanitary sewer when made available and solid waste service. The proposed annexations are consistent with Florida law regarding municipal annexations pertaining to contiguousness with existing city boundaries and compact concentration. A copy of the petition for annexation and related documents are enclosed. The following schedule has been tentatively established for the City's review of the applications. Should a meeting time or location change, you will be contacted immediately. George N. Cretekos, Mayor BillJonson, Councilmember Jay Polglaze, Councilmember Hoyt Hamilton, Councilmember y"`'1`' Doreen Hock DiPolito, Councilmember "Equal Etnployment and Affirmative Action Employer" Vincent & Borland June 2, 2017 Page 2 August 16, 2017 City Council Public Hearing (first reading) 6:00 PM City Hall Council Chambers, 3`d Floor 112 S. Osceola Ave., Clearwater, FL September 7, 2017 City Council Public Hearing (second reading) 6:00 PM City Hall Council Chambers, 3rd Floor 112 S. Osceola Ave., Clearwater, FL Your prompt response will be greatly appreciated. Please contact me at (727) 562-4626 or kyle.brotherton@myclearwater.com if you have any questions. Sincerely, CITY OF CLEARWATER Kyle Brotherton Senior Planner Enclosures: Pinellas County Planning Department: Petition for Annexation, Warranty Deed, Plats of Record or Survey, and House Atlas Map. Pinellas County Sheriffs Office: House Atlas Map. cc: Camilo Soto, Assistant City Attorney Debbie Reid, Parks and Recreation Administrative Analyst Terry Teunis, Code Compliance Manager