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ANX2017-12024na ��-1�C)cz y �31 kc, w 6 LSE Rb . 1(3120 WOLFE RD --iANX2017-12024 r—"'1CL-EARi ANNEXATION BR[GHTANDBEA John W. Gentry Inning & Development Department Zoning: Atlas #: 283A Petition for Annexation J ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED TO THE DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE DATE. ALL PAGES WITHIN MUST-BE-SIGNED--BY— ALL UST BESIGNED}-BYALL 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. a i 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): John W. Gentry MAILING ADDRESS: 3120 Wolfe Road, Clearwater, FL 33759 PHONE NUMBER: 412-3084 EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: — - ADDRESS OF SUBJECT 3120 Wolfe Road, Clearwater PROPERTY: PARCEL NUMBER(S): 09-29-16-05310-000-0130 LEGAL DESCRIPTION: Bayview Bluff Lot M 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 JBRIGHT AND BEALITIML• BAY TO BEACH 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 Urban (RU) REQUESTED (CITY): Residential Urban (RU) ZONING DISTRICT PRESENT (COUNTY): R-3 Single Family Residential REQUESTED (CITY): Low Medium Density Residential (LMDR) SITE AREA: 0.219 SIZE OF DEVELOPMENT: Existing: 1 Proposed: 1 (e.g., number of units, hotel rooms or non- residential square footage) acres USE OF PROPERTY: Existing (currently on site): Proposed (new use, if any; plus existing if to remain): If residential use, is unit(s) rental? Single Family Single Family A 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 applicati°°�� Sworn to and subscribed before me this a�AZ day of a O /4- by who is personally known/has produced ! z- DL s as identification. of ptopekt> owner or representative Notary puhlic, V My commission expires: Signature of property owner or representative MYRA JAMES �jetaFy Dw aIle - state of Florida of Florida Commission N GG 088045 My Comm. Expires Mar 28, 2021 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 r-!�CLEARWATER BRIGHT AND BEAUTIFUL•BAYTO BEACH 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://Ris.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 extsis.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:Hgis.pinellascounty.org/public eis/. Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 3 of 7 Revised 02/16 CLEARWATER 1 I BRIGHT AND BEAU"FU4• BAY TD BEACH 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 r-- `�CLEARWATER BRIGHT AND BEAUTIFUL- BAY TO BEACIi PROPERTY OWNER (PER DEED): John W. Gentry Planning & Development Department Petition for Annexation Disclosure Statement MAILING ADDRESS: 3120 Wolfe Road, Clearwater, FL 33759 PHONE NUMBER: 412-3084 EMAIL: AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBJECT PROPERTY: -- NAME: INTEREST IS: SPECIFIC INTEREST HELD: DOES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPERTY? YES NO CONTRACT IS: PARTIES INVOLVED— NAME: PHONE NUMBER: NAME: PHONE NUMBER: ARE THERE ANY OPTIONS TO PURCHASE THE SUBJECT PROPERTY? YES PARTIES INVOLVED — NAME: PHONE NUMBER: NAME: PHONE NUMBER: ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? ��YES NO PARTIES INVOLVED — NAME: PHONE NUMBER: NAME: PHONE NUMBER: STATE OF FLORIDA, COUNTY OF PINELLAS I (we), the undersigned, acknowledge that all representations made in this application are true and accurate to the best of my knowledge and authorize City representatives to visit and photograph the property described in this application. Sworn to and subscribed before me this '29 day of Sit cZ,O /-�- by who is personally known/has produced /" t✓ U t! as identification. Sigma f property ner or repres tat, YRAJAMES Notary public, """ 4 �'•, Notary Public -State offlorld� My commission expires: .; » •- 4 5 Commissions mare .2 45 21 Signature of property owner or representative ''�' SFr;,.'Bonded throughNationalNotaryAM Planning 81 Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 5 of 7 Revised 02/16 i -") CLEA RWATER I BRIGHT AND BEAUTIFUL- BAYTO BEACH Planning & Development Department Petition for Annexation Affidavit to Authorize Agent/Representative 1. Provide names of all property owners on deed —PRINT full names: John W. Gentry 2. That (I am/we are) the owner(s) and record title holder(s) of the following described property: 3120 Wolfe Road, Clearwater, FL 33759 3. That this property constitutes the property for which a request for (describe request): Annexation in order to receive solid waste and sanitary sewer service from the City. 4. That the undersigned (has/have) appointed and (does/do) appoint: as (his/their) agent(s) to execute any petitions or other documents necessary to affect such petition; 5. That this affidavit has been executed to induce the City of Clearwater, Florida to consider and act on the above described property; 6. That site visits to the property are necessary by City representatives in order to process this application and the owner authorizes City representatives to visit and photograph the property described in this application; 7. That (1/we), the undersigned authority, hereby certify that the foregoing is true and correct. John W. Gentry Property Owner THIS Property Owner STATE OF FLORIDA, COUNTY OF PINELLAS Property Owner Property Owner BEFORE ME THE UNDERSIGNED, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON 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 Seal/Stamp Notary Public Signature My Commission Expires: 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 �(- �CLEARWATER V BRIGHT AND BEALMFUL• BAYTO BEACH PROPERTY OWNER (PER DEED): John W. Gentry MAILING ADDRESS: 3120 Wolfe Road, Clearwater, FL 33759 CITY OF CLEARWATER CASE NUMBER: Planning & Development Department Petition for Annexation Supplemental Statement I/we, _John W. Gentry [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 [/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 0� 91 day of SP,d a D ! by , who is personally known/has produced FL 0 L as identification. re of property owner (in (ividual or uthorized ntative of corporation, partners tp or other entity) Notary publiff My commiss(iion expires: Signature of co -property owner _ NotaryPublic- StateofFlorida Commission At GG 088045 My Comm. Expires Mar 28, 2021 Bonded through NatlonaI Notary Assn. 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 °..Clearwater Planning & Development Department Petition for Annexation ALL APPLICATIONS ARE TO BE FILLED OUT COMPLETELY AND CORRECTLY, AND SUBMITTED IN PERSON (NO FAX OR DELIVERIES) TO THE PLANNING & DEVELOPMENT DEPARTMENT BY NOON ON THE SCHEDULED DEADLINE DATE. ALL PAGES WITHIN MUST BE SIGNED BY ALL PROPERTY OWNERS LISTED ON THE DEED. A TOTAL OF 6 COMPLETE SETS OF APPLICATION AND SUPPLEMENTAL MATERIALS (1 ORIGINAL AND 5 COPIES) AS REQUIRED WITHIN ARE TO BE SUBMITTED FOR REVIEW BY THE DEVELOPMENT REVIEW COMMITTEE. APPLICATIONS AND SUPPLEMENTAL MATERIALS ARE REQUIRED TO BE COLLATED AND STAPLED INTO SETS. IT IS INCUMBENT UPON THE APPLICANT TO SUBMIT COMPLETE AND CORRECT INFORMATION. ANY MISLEADING, DECEPTIVE, INCOMPLETE OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPLICATION. THE APPLICANT, BY FILING THIS APPLICATION, AGREES TO COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THE COMMUNITY DEVELOPMENT CODE. APPLICATION FEE: $0 IMPACT FEE/ASSESSMENT FEE: TSD 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 OFANNEXATION: X CONTIGUOUS NONCONTIGUOUS (TYPE A ENCLAVE) To Be Completed By Property Owner: PROPERTY OWNER (PER Thomas H. and Thea Kinseher DEED): MAILING ADDRESS: 3124 Wolfe Road, Clearwater, FL 33759-3541 PHONE NUMBER: 727-687-2344 EMAIL: tkinseher@gmail.com AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: ADDRESS OF SUBJECT 3124 Wolfe Road, Clearwater, FL PROPERTY: PARCEL NUMBER(S): 09-29-16-05310-000-0120 LEGAL DESCRIPTION: Bayview Bluff Lot L CURRENT CITY SERVICES: SANITARYSEWER X SOLID WASTE Rec Only WATER REQUESTED CITY SERVICES. SANITARY SEWER X SOLID WASTE (select all that apply) Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727562-4865 Page 1 of 7 Revised 04!15 or� 0 earwat�r Planning & Development Department - - Petition for Annexation U 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 Urban (RU) REQUESTED (CITY): Residential Urban (RU) ZONING DISTRICT PRESENT (COUNTY): Single Family Residential (R-3) REQUESTED (CITY): Low Medium Density Residential (LMDR) SITE AREA: 0.22 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 Residential Single -Family Residential ARE THERE ANY ACTIVE/OPEN PERMITS FOR THE PROPERTY WITHIN PINELLAS COUNTY? YES 11O 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 applicati n Sworn to and s`u,�bscr_ibbed before me this O' LA -M day of V Q5�(�Vk. ( CL�. by -TXM 6-s T1>CL who is personally known/has , 9,roduced �\V�5 UC-,Wc6Q as identification. Sigfieture of property owner or representative Notary public, xs Z a.0a Signature of property owner or representative ;�e►l�y �t >Hi,� DANIEU.E SHIRE °:'� e3i'i�:a� EXPIRES: April 13, 2021 1 yhnn Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-662-1865 Page 2 of 7 Revised 04/15 Planning & Development Department Petition for Annexation Submittal Package Instructions & Checklist IN ADDITION TO THE COMPLETED ANNEXATION PETITION FORM, ALL PETITION FOR ANNEXATION PACKAGES SHALL INCLUDE A SUBMITTAL PACKAGE THAT INCLUDES THE FOLLOWING: ❑ Signed and sworn (notarized) disclosure of interest statement (form attached). ❑ If the property is not a platted lot of record, a current survey identifying the dimensions, area and location of the property having been prepared, signed and sealed by a land surveyor currently registered in the State of Florida within the most recent 12 months. [Note: Submit two copies only] ❑ If development is to be initiated prior to submission of an annexation petition and/or prior to the effective date of the annexation, requisite site plans, plat, and engineering plans. City staff will review proposed plans to determine their compliance with the City's Community Development Code. ❑ Terms of a proposed Agreement to Annex, if any. ❑ If the proposed annexation requires a change in the land use classification and zoning category assigned to the property, a justification for such change must be submitted in writing. If the requested zoning is not consistent with the Future Land Use Map of the City of Clearwater Comprehensive Plan, the applicant will be required to file a companion application to amend the map. ❑ Proof of ownership (e.g., copy of deed, title insurance policy, or other instrument demonstrating ownership). [Note: Submit two copies only] ❑ If connection to city services is desired prior to the effective date of the annexation, applicant must provide notarized Petition for Annexation Supplemental Statement (form attached). [Note: Submit original only] ❑ If applicant is designating an agent/representative to work with City, applicant must provide notarized Affidavit to Authorize Agent/Representative (form attached). [Note: Submit original only] INFORMATION REQUIRED TO COMPLETE THE PETITION FOR ANNEXATION APPLICATION AND DATA SHEET CAN BE FOUND ON THE FOLLOWING DOCUMENTS AND/OR ONLINE AT THE FOLLOWING WEBSITES. IF THE APPLICANT IS UNCERTAIN WHERE TO LOCATE THIS INFORMATION OR NEEDS ADDITIONAL ASSISTANCE, PLEASE CONTACT THE PLANNING AND DEVELOPMENT DEPARTMENT, LONG RANGE PLANNING DIVISION AT 727-562-4567. ❑ PARCEL NUMBER (Parcel I.D. Number) can be found on the Warranty Deed. It can also be found by searching the Pinellas County Property Appraiser's Office website at www.pcpao.org (search database by address). ❑ LEGAL DESCRIPTION can be found on the Warranty Deed. It can also be found by viewing the property record online at the Pinellas County Property Appraiser's Office website at www.pcpao.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:Hgis.pinellascounty.org/public_gis/. ❑ ZONING DISTRICT (CITY) can be found by contacting the Planning and Development Department or viewing the City's Zoning Atlas, available online at http://www. myclearwater.com/gov/depts/pwa/engin/publications/engatlas/atias.a sp. ❑ SITE AREA (ACRES) can be found by viewing a Property Report using Pinellas County's Public GIS Viewer available online at http://gis.pinellascounty.org/public—gis/. Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727-562-4865 Page 3 of 7 Revised 04/15 Planning & Development Department Petition for Annexation Information for Applicants ATTENDANCE AT PUBLIC HEARINGS 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: 727-562-1567; Fax: 72756211865 Page 4 of 7 Revised 04/15 'Clearwater PROPERTY OWNER (PER DEED): Thomas H. and Thea Kinseher Planning & Development Department Petition for Annexation Disclosure Statement MAILING ADDRESS: 3124 Wolfe Road, Clearwater, FL 33759-3541 PHONE NUMBER: 727-687-2344 EMAIL: tkinseher@gmail.com AGENT OR REPRESENTATIVE: MAILING ADDRESS: PHONE NUMBER: EMAIL: OTHER PERSONS HAVING ANY OWNERSHIP INTEREST IN THE SUBJECT PROPERTY: NAME: INTEREST IS: SPECIFIC INTEREST HELD: DOES A CONTRACT EXIST FOR SALE OF THE SUBJECT PROPERTY? YES 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: ARE THERE ANY MORTGAGES OR LIENS ON THE SUBJECT PROPERTY? i/ YES NO PARTIES INVOLVED— NAME: PHONE NUMBER: gq-6--i 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 aday of LkWbe-Y-- . aOk'l_. by k1�cwn/ha °�hRC� k� t1gQ�lQ f who is personally known/ha roducedr1�%��S C-QYIS-� as identification. / tea✓ P of property owner orepresentative Signature of property owner or representative Civ Notary public, DANIELLE SHIRE ' MY COMMISSION # GG 94 EXPIRES: April 13. 2021 Planning & Development Department, 100 S. Myrtle 62-4567; Fax: 727-562-4865 Page 6 of 7 Revised 04/15 °:Clearwater 0 �' -�- �� �� �� �� 1. 2. 3. 4. 5. 6. 7. Planning & De, Petition Affidavit to Authorize V ent Department Annexation iresentative Provide names of all property owners on deed — PRINT full names: Thomas H. Kinseher Thea H. Kinseher That (I am/we are) the owner(s) and record title holder(s) of the followi described property: 3124 Wolfe Road That this property constitutes the property for which a request fo (describe request): Annexation of single family residence That the undersigned (has/have) appointed and (does/d appoint: as (his/their) agent(s) to execute any petitions or That this affidavit has been executed to induce described property; ier documents necessary to affect such petition; City of Clearwater, Florida to consider and act on the above That site visits to the property are necessa by City representatives in order to process this application and the owner authorizes City representatives to v' it and photograph the property described in this application; That (1/were undersigne0aulhprity,fiereby certify that the foregoing is true and correct. Property 6wner Property O ner STATE OF FLORIDA, COUNTY OF PINELLAS Property Owner Property Owner BEFORE ME THE UN RSIGNEED`,, AN OFFICER DULY COMMISSIONED BY THE LAWS OF THE STATE OF FLORIDA, ON THIS DAY OF 1VC��Ia�Y ►� �V�,i 17C5U, PERSONALLY APPEARED DEPOSED AND SAYS THAT H DANIELLE SHISE MY COMMISSION # GG 94068 EXPIRES: April 13, 2021 Notary S96l/Stamp WHO HAVING BEEN FIRST DULY SWORN LLY UNDERSTANDS THE CONTENTS OF THE AFFIDAVIT THAT HE/SHE SIGNED. y Public Signature My Commission Expires:( Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727562-4865 Page 6 of 7 Revised 04/15 PROPERTY OWNER (PER DEED): MAILING ADDRESS: CITY OF CLEARWATER CASE NUMBER: Planning & Development Department Petition for Annexation Supplemental Statement Thomas H. and Thea Kinseher 3124 Wolfe Road, Clearwater, FL 33759-3541 I/we,-7-knrync 4, cZ✓1d 1 Veo- F+- k!i7Strk [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): 1/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 �;yy- day of Kkx-n � a�_l . by n17�ly�i_S // "4 who is personally known/has roduced \r';kj"5 LSC as identification. Signature of property owner (individual or authorized representative of corporation, partnership or other entity) Signature of co -property owner Notary public, My commission expires: Ay-'; MY G9MMMIpN # 00 94058 EXPIRES: April 13, 2021 Planning & Development Department, 100 S. Myrtle Avenue, Clearwater, FL 33756, Tel: 727-562-4567; Fax: 727562-4865 Page 7 of 7 Revised 04/15 �;'�M A55WlAl5fV!'hlyjNj�. ............ . E V TER BRIGHT AND BEAUTIFUL • SAY TO BEACH Case # ANX2017-12024; ANX2017-12025; ANX2018-01002 SIGN POSTING ACKNOWLEDGEMENT I hereby acknowledge that the signs required for this case being considered by the City of Clearwater for annexation were posted a minimum of 10 days before the City Council First Hearing meeting. The signs were posted on the subject properties in a location where they are capable of being read from the most significant adjacent street. Planning & Development Department Staff: Piinf Name St'g-n Name City Council Public Hearing Dates: • March 15, 2018 (1St reading) • April 4, 2018 (2nd reading) Date Posted March 2, 2018 Photo of sign uploaded into Accela 3 -2— to Date Deadline to Post March 5, 2018 Annexation Map Request Planner Name: Kyle Brotherton Case Number: ANX2017-12024 Date Request Submitted: 12-12-17 Date Requested for: 12-22-17 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 Description ranty d d or survey) - to be hand delivered ® Map with Propose ighlighted ❑ EDR - no hard copies submitted - all submission material is accessible through Accela Location & Right -of -Way Language (for Ordinance Titie) Location: North side of Wolfe Road approximately 390 feet east of McMullen Booth Road. Right -of -Way: [ENGINEERING INSERT ROW DES R PTION OR N HER PROVIDED LEGAL DESCRIPTION VERIFIED BY: 4,0 111 Thomas ahony, PSM, eographi T chnolody Manager MAP NAME Owner(s): Multiple Owners Case: ANX2017-12024 Site: 3120 Wolfe Road Property Size(Acres): 0.440 3124 Wolfe Road ROW (Acres): Land Use Zoning PIN: 09-29-16-05310-000-0130 Residential Urban 09-29-16-05310-000-0120 From : (RU) R-3 Single Family Residential Urban Low Medium To: Atlas Page: 283A (RU) Density Residential