ANX2006-08030
APPLICANT, PROPERTY OWNERS, AND AGENT INFORMATION
J It JYlQj L, uJ P\'\\:. (U
~L\5 \ BOVlC\ Qut CjvJ I ~L ~ ~15~
l'd, - 5raJ- 3>5L\S fAXNUMBER 1,),1- ,c,J -01051_
PROPERTY OWNERS \.-- ~~e.:z L I - \.A.l..l \~
(lis! all owners) _
AGENT NAME ~ -van'ttj Wq t ~) 01V ~/'-
MAJLlNGADDRESS &L\5\ B\SYvd_Q~ U2w l n 33151
y'l - ,~--05~J FAX NUMBER ~ -lLi \ --6105 ~
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APPL.ICANT NAME
MAJLlNG ADDRESS
PHONE NUMBER
PHONE NUMBER
~
CITY OF CLEARWATER
PETITION FOR ANNEXATION
PLANNING DEPARTMENT
MUNICIPAL SERVICES BUILDING, 100 SOUTH MYRTLE AVENUE, 2nd FLOOR
PHONE (727)-562-4567 FAX (727) 562-4576
PROPOSED DEVELOPMENT,INFORMATION ,~ tV r:J\ :..'
LO CAll ON \ ~ \ \0 L \ Cl\;(~ \)\\,~ CQuJ I r 133155
I
STREET ADDRESS
LEGAL DESCRIPTION
PARCEL. NUMBER
EXISTING CATEGORIES
5kveN\su~ ~~~\:~ BlocK ~ ~r 7
fO- ~g - f.) - r-~ ~ Ie DO 1 007D
~c/evvluJ LAND USE ~~de1/lha-f
fLu l d ~b rr-t LAND USE Re", l cUl/1 fu~
ZONING
PROPOSED CATEGORIES ZONING
EXISTING USE AND SIZE
PROPOSED USE AND SIZE
SIZE OF SITE
(number of dwelling umts, hotel rooms or square footage of nonresldenllal use)
(number of dwelling umts hotel rooms or square footage of nonresJdenllal use)
~:; '.,. I tV .s'
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STATE OF FLORIDA. COUNTY OF PINELLAS
Sworn to and subSCribed before me thIS \ I day of
~t,AD,18,~tome
by ~.e c... L~ W 6-.+e.-'12~ ,who I ersonally
k. own has produced
ld lfi atl
I (we), the underSIgned. ack.nowledge that all
representatIons made In thIS applicatIon
are true and accurate to the best of my
knowledge
Signature of property owner or representallve
my commission expire
Annexation (AN X) Petition and Disclosure Statement docPage 3 of 4
.:;-
...
PROPERTY OWNER NAME
CITY OF CLEARWATER
PETITION FOR ANNEXATION
DISCLOSURE STATEMENT
PLANNING DEPARTMENT
MUNICtPAL SERVICES BUILDJNG, 100 SOUTH MYRTLE AVENUE, 2nd FLOOR
PHONE (727)-562-4567 FAX (727) 562-4576
'1, sS--
ADDRESS
l~ \ to c... \ C\ \ Q..<L
PHONE NUMBER
REPRESENTATIVE(S) NAME
ADDRESS
PHONE NUMBER I ~ 1- :J
ANY OTHER PERSONS HAVING A
NAME
INTEREST IS
SPECIFIC INTEREST HELD
.-35C( J FAX NUMBER 1;L 1- "7 cr ,.-0(0
Y OWNERSHIP INTEREST IN THE SUBJECT PROPERTY
DOES A CONTRACT EXIST FOR THE SALE OF THE SUBJECT PROPERTY? YES
CONTRACT IS
ALL PARTIES TO CONTRACT
NAME
NAME
ARE THERE ANY OPTIONS TO PURCHASE SUBJECT PROPERTY? YES
LIST ALL PARTIES TO OPTION
NAME
NAME
LIEN HOLDER(S) NAME
NO
STATE OF FLORIDA, COUNTY OF PINELLAS
Sworn to and s bscnbed before me this ( I day of
k ~1.AD.~O'e
by fl ~ Y::cte , who personally
known as produced
Identification -
I (we), the undersIgned, acknowledge that all
representations made m thiS applicatIOn
are true and accurate to the best of my
knowledge
51) WVfIv
Slgnatu re of prop e rty owne r or rep Ie senta \J ve
~{j1t/dvJA/Y'
,~'Ji<i."'" -, MICHELE T WJWAMS
t.~' @. "lft;;~ MY COMMISSION # DD 552269
~ &.lE EXPIRES Ju1y31, 2010
~1,Ri: ~~. Bonded Tluu Nolary Public Undllnvrilll..
Annexation (ANX) Petition and Disclosure Statement docPa
Pmellas County Pubhc GIS Vwwel
Parcel Report for
@r-,
1 \
;t; -11 ~ ,:
Effi.QertY...8Q~
MUnicIpality
Zoning
Comp land Use.
Acreage
Tax DIstrict
Voter Precinct
FI re DI strict
Evac level
Census Block
Census Tract
Zlpcode
wIthin 330ft of Eagle Nest
wIthin 660ft of Eagle Nest
1216 CLAIRE DR
10/29/15/85446/001/0070
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(:";~;rn;V
Tax Collector
Plliellas County
R-3
Rl
0156
CTF
569
05 - Clearwater
E
407E
0262
33755
No
No
Page 1 of 1
181 Close Wmdow
http //pubgls co pmellas fl us/public gis/web/parcel report2 cfm?TYFE=ADDRESS&ST
- - ,
8/30/2006
Pmellas County Propel ty Appr;l1ser InformatIon 1029 15 85446 001 0()7f}
Page 2 of 4
10 / 29 /
15 / 85446 / 001 / 0070
30-Aug-Z006 J HI) 5rrri th , CFA Plne11as County Property Appralser 08'38 35
Ownershlp InforMatlon Residentlal Property Address. Use, and Sales
""AYERS, JAMES L aSK' 89168 OPG 0851
2451 BOND AUE
C L EARl,JATER fL 33159-IZOO
EVAC, E EUAC
COlYlparab 1e sales value as Prop Addr' IZIli CLAIRE OR N
of Jan 1, 2006, bas8,j on Census Trae t Z62 DO
sales frOM 2004 - 2005
106. ODD Sale Date OR Book/Page Prlce (Qual/UnQ) Vac/IfYlp
Plat InforMation II/I. 995 9.168/ 851 18,500 (U) I
1954, Book 034 Pg,s 013- 1 /1.981 5. Z16/ 401 35,508 (Q) I
0800 Book Pgs - 0 11,918 4,154/2,049 21,500 (Q) I
0000: Book Pgs - 0 11.91Z 3.1601 399 15,300 (Q) I
2006 Value EXEMP no NS
Just/Market' 86,800 HOlYlestead' NO Ownershlp % 000
Govt Exer'l tW Use :t 080
Assessed/Cap 86,800 Instltutlona1 ExeM, NO Tax ExelYlpt %, 000
Hlstorlc Exer'l 0
Taxable, 86.800 Agrlcultural, 0
2005 Tax Inforrlatlon
Dlstrlct' ClF Seawall' Frontage'
Clear'water f 1. r-e Vlew:
05 Mlllage, 2Z 1812 Land Size Unlt Land Land Land
Front x Depth Price Unlts Meth
05 Taxes 1,32:5 81
1) 65 x 105 800 80 liS 00 f
5peclal Ta} 00 2) 0 x 8 00 00
3) 0 x 0 00 .00
Wl thou t the Save-Our-HofYles 4) o x 0 .00 00
cap, 2005 ta es ,...nll be 5) 0 x 0 .00 ,00
I. 3Z5 81 6) 0 x 0 .00 , 00
Wlthout any exeMptlons,
2005 taxes wlll be
1.32:5 81
Short Legal STEUEtISOII'S HEIGHTS BLK A, LOT 1
Descrlption
Building Information
http 1/136 174 ] 87 13/htbm/cgl-scr3?o=1&a=1&b=1&r=&s=1&u=0&p=10+29+ 15+85446
8/30/2006
Pmellas County Propel ty Appr;:lI'ier Information 1029 15 85446 001 or"f)
Page 3 of4
Progerty and Land Use Code descnghons
10 / 29 / 15 / 85446 / 001 / 0070
:01
30-Aug-2006 Jl~ S~lth, C~A Plnellas County Property Appralser 08,38:35
Residentlal Card 01 of I Prop Use Z10 Land Use 01 Llvlng Units, 1
IMp Type S~ ngle r arlJi ly Prop Address' 1 Z 1 6 CLAIRE OR tl
Stru.ctural
Elements
~oundatlon
~loor 5yste~
Exterlor Wall
Roof ~raMe
Roof Cover
Contlnuous Wall
Slab on Grade
ConcBk
6able-H~p
Compo51te Sh1ngle
Quah ty
Year BU11t
Effectlve Age
Heatlng Unit/Spc/WI/Fl
Coo ling
~lxtures
Other Depreclatlon
~unctlonal Depreclatlon
EcononoMlc Depreclation
Average
1.954
35
Furn
None
3
o
o
o
~ Stories 1 0
~loor Flnlsh Crpt/Unyl/SftWd/Terr
Interlor ~lnl8h Drywall/Plaster
Sub
Areas
Descrlptlon ~actor Area Descrlptlon ~actor Area
1) Base Area 1 00 972 7) .00 0
2) Ut111ty 25 66 8) .00 0
3) Open Po,'ch 15 56 9) 00 0
4) Carpo rt 15 110 10) 00 0
5) 00 0 11) ,DO 0
6) 00 0 12) 00 0
Residential Extra Features
Descrlptlon OlPISn910ns Prlce Unlts Value RCD Year
1) ,00 0 0 0 0
2) 00 0 0 0 0
3) ,00 0 0 0 0
4) ,00 0 0 0 0
5) ,00 0 0 0 0
6) 00 0 0 0 0
TOTAL RECORD VALUE 0
Pinellas County Property Appraiser
Parcel Information
http //136 174 187 13/hlb1l1/cgl-scr3?o=1&a=1&b=I&r=&s=1&u=0&p=10+29+15+85446
8/30/2006
DIane Nelson - Pmellas Countv Tax Collector
Page 1 of 1
Plnellas County Webslte
HOME PAGE I TAXCOLLECTOR WEB SITE I ONLINE PAYMENT HELP I CONTACT
(7'\ Diane Nels,on..CfC
J 0. ~j ,
~'tA-, ~~
WM-'W t(t(COTlcct.Com
CO/llllllltca iO C'lIU,f Cemeret/ G8<u>
"~f"I1mf'l1i
NOTiCE OF AD VALOREM TAXES & NON-AD VALOREM ASSESSMENTS
AD VALOREM TAXES PINELLAS COUNTY TA>l
2005 REAL ESTATE TAX/NOTiCE RECEIPT FOR PiNELLAS COUNTY RE 058359-1
PAY IN U 5 FUNDS TO DIANE NELSON TAXCOLLECTOR. POBOX 10832 . CLEARWATER, FL 33757-8832. n
GROSS TAX AMT I DATE PAID I RECEIPT NO I REGISTER I VALIDATI
$1,325.87 1 11/29/05 I 004431 I 68 I $1,27.
Mise Code
TAXING AUTHORITY
COU NTY -AGG REGA TE
FIRE
SCHOOL-STATE LAW
SCHOOL-LOCAL BD
MSTU
liBRARY SVC
SW FLA WTR MGMT
PINELLAS ANCLOTE
PIN CO PLN CNCL
)UV WELFARE BD
SUNCST TR AUTH
Millage Rate
22 7812
Assessed Value Taxable Value
58 200 58 200
Parcel # 10/29/15/85446/001/0070
Site Address 1216 CLAIRE DR N
WATERS, JAMES L
2451 BOND AVE
CLEARWATER, FL 33759-1200
ZIP 337
legal DeSCription
STEVENSON'S HEIGHTS
BLK A, LOT 7
MILLAGE RATE TAX
6 8010
24410
5 1910
3 1990
2 3560
5000
4220
4000
0218
8117
6377
rVGlsuarVISUalGOV com .\:Qp--Y.r!9.b1@1999-2005VlsuaIGovSolutlons,LLCAllflghtsreservedl Pflvacv Polley I Term
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http / /www vlsllalgov com/ptnellascountylbcc aspx?pm= 10/29/15/85446/001/0070
8/30/2006
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Fidelity National Title Insurance Co.
Proceeds from Real Estate Transactions as reqUired by the Internal Revenue Service
Agenl name and address
FIDELITY NATIONAL TITLE INS
2515 COUNTRYSIDE BLVD., SUITE C
CLEARWATER, FLORIDA
BRANCH #:08-19352
Substitute Form 1 099-S
Tax IdentificatIOn number
23-1290668
ThIs ,.; Important lal< information and IS being furnished 10 lhe Inlernal Revenuc
SelV1ce, as reqUIred by sccllOn 1521 of the lax Reform Act of 1986 If you U~
reqlll red to l1Ie a return, a negligence penalty or other sanctIOn WIll be nnposed If
this llIcome IS ta:>:able and Ihe IRS detennmes [hat IS has not been reported
TYPE OR MACHINE PRINT ONLY
Escrow Number 9551393
(If none, U~e date of closmg & sellers last name - Example 010393smllh)
2 Dale of c10srng November 15, 1995
Month/Day /y ear
PROPERTY ADDRESS - SEE SIDE 2 FOR EXAMPLES
3
1216 CLAIRE DR. N.
102915854460010070
Slreet Address (For V<lcallllalld see SIde 2)
Accessor< Parcel Number (ArN)
Slate
34615
Z'p
CLEARWATER
CIty (If none, lisl county)
FL
Aceessors l'arcel Number (Af'N)
PROCEEDS FOR THIS SALE WENT TO: (MULTIPLE SELLERS-Use one form for eac..h seller Treat husband and Wife
as one seller (fihngJoint tax returns) unless requested othelWlse, than separate forms must be used)
See side 2 before complefmg .
4 a WILLIE M. BREWTON 71 J~ QJtQ. )1/l., ~ IJ.~~~ I ;2. & L/ - 3 ~ - q 7 ::J. :2..
Sellers Name (flrsl, MI, Last) Federal Tax ID for IhiS seller
b KDS{. (YJ, 8K!.ee-JrurJ
Spouse or Personal Represenlatlve (FOR INFORMAl ION PURPOSES ONLY)
I ')&:<~S'f- '-115 S
Sp01!se Federal 1 ax ID (optIOnal)
TOTAL CONSIDERATION
(SEE SIDE 2 TO CALCULATE)
5 Tax Credit to Seller $
8
$
18,430.00
Tolal Conslderal1on
60
7D
Exchange (If checked)
9
$
Gross Allocated Proceeds
Check here If the maXimum determinable
proceeds cannot be dctermllled wIth certainty
MAILING ADD& .
10 / / /!J d/2/2vo
Stre/! L
L-.A a/'LI',v-! pZeA-' >'
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q~f
Slate
~~;;lere If the addless
IS outSide of lhe USA
3V6/&
Zip
I hereby certify, under penalty of perjury, that I have read the above information and It IS true and correct
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Date
T'fttn;
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MORTGAGE DEED
INS" I 96- 294 2 41
MOV 17, 19'35 2 03PM
PINELLAS COUNTY ~LA.
OFF REC SK 9168 pG 852
~N\Ill8S\
DATE OF Hem:
1oU.1IJ1I:ITY ~'M
PfIINClP-M. AMOUNT
NOInGNlEE"INaJM.IHCW.~
OF HOU.YmlOO. RA-IIC.
~ .362 66th Btr..t M
___ at. p.u~lIburq. plOTida 33709
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Fidelity NAonal Title Insura1'ice Company
Of Pennsylvania
TITLE AFFIDAVIT
STATE OF FLORIDA
[ To be executed by Seller (or Mortgagor II no sale Involved) J
FilE NO 9551393-MW
COUNTY OF PINELLAS
Before me, the undersigned authority, personally appeared WILLIE M. BREWTON AND ROSE M. BREWTON,
HIS WIFE
who, being duly sworn according to law, deposes and says as follows (as used In this Affidavit, the term "Affiant" shall Include
all parties executing this Affldavll)
1
That AffIant Is the owner of, and
a Has agreed to sell to JAl1ES LEE WATERS
b Will execute a mortgage to Avr.n PTMJHlr.TlJ.T. sRRVrrP..<;
the followmg described property In the Counly of PTNRT,T./J..<; , State of PT.
LOT 7 IN BLOCK A OF STEVENSON'S HEIGHTS, ACCORDING TO THE PLAT THEREOF, AS
RECORDED IN PLAT BOOK 34, ON PAGE 13, OF THE PUBLIC RECORDS OF PINELLAS COUNTY,
fi\'atWlMht has been In full, continuous, open, exclUSive, peaceable and undisputed possession of said property since
tile trme of vestmg of tItle to sard property In AffIant, that there are no parties who have any rnterest or right to clal m an
Interest In said property other than Affiant, and that there are no facts known to Affiant whIch could give nse to a claim
bemg asserted agamst saId property, except
or
encumbering,
2
3
NONE
That, other than as shown In Item 1, Affiant has not entered IOta any agreement, contract, commitment or option for the
sale, lease or mortgage of the property, or any agreement, contract, commItment or option whIch otherwise affects
said property, except
4
NONE
That there are no taxes, liens or assessments which are due or about to become due or WhIch have attached or could
attach to saId property, except
Taxes accru~ng subsequent to the current year.
5 That Affrant IS a CItizen of the Un ited States, of legal age, und er no legal disabilities and has n ever been known by any name
olher than as shown above
6 Mantal status (check appropnate box)
lHx a That AffIant IS mamed, has been contlnously mamed dUring the entire term of the ownership of said property,
has never been divorced and has not entered In any separallon agreementor property settlement agreement
o b That Affiant is not marned and has never been mamed dunng the time of ownershIp of said property
7 That, If title to said property Is being held by a corporation, partnershIp or trust, such corporation, partners hi p or trust I sin
good standing under applicable laws and the contemplated sale or mortgage of said property by saId entIty IS pUlsuant to
proper authority
8 That there are no actions or proceedings now pending In any State or Federal Court to which the Affiant IS a party including,
but not limited to, proceedIngs in bankruptcy, receivershIp or Insolvency, except
NONE
9 That there are no Judgments, mortgages, encumbrances or liens of any nature affectmg said property, except
NONE
10 That there have been no Improvements, repairs, addltrons or alteratIons performed upon saId property Within the past
90 days That Affiant has nol entered Into any agreement or contract WIth any party for the
furnrshings of any labor, services or matenalln connection WIth any Improvements, repairs, additions or alterations
wlthm the referenced time penod, and that there are no partIes who have any claim or right to a lien for services, labor
or matenalm connection With any Improvements, repairs, additIons or alterations to said property
11 That, to the knowledge of Affiant, the commItment of Fidelity National TItle Insurance Company under N0.95513 93
correctly and accurately reflects the stalus of the title to saId property
Affiant recognizes thai FIdelity National TItle Insurance Company will rely on the statements m this AffidaVit and
Affiant makes this Affidavit for the purpose of indUCing FIdelity National TItle Insurance Company to Issue Its pollcy or
pollcres of title msurance m the above referenced transactlon
SWORN TO AND SUBSCRIBED before me
this
15
day
~)dL~ JfJl4 c/lJ ~
WILLIE M. BREWTON
r,;~t:-: ---;-,-,~-:--~--__ __~~E M. BREWTO~'7?J7,rm4/~
..... (". r ,~ r I'" f I ." I
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--_ ~___ 1) I L j j IJ Ir
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NOTE IF THIS AfFIDAVIT DOES NOT PROVIDE SUFFICIENT SPACE TO COMPLETE ANY OF THE ABOVE ITEMS, SAID
ITEMS SHOULD BE SET FORTH IN THEIR ENTIRETY ON A SCHEDULE WHICH IS ATTACHED TO THIS AFFIDAVIT
AND WHICH IS INITIALED AND DATED BY THE AFFIANT
o
! -'
My commiSSIon expires
TAX PRORATION AGREEMENT
ATIC#- 9551393-MW
CLOSING DATE:
November 15, 1995
PROPER7.'Y: 1216 CLAIRE DR.
CLEARWATER, FL
LENDER: AVCO FINANCIAL SERVICES
N.
34615
We, the unders~gned buyers and sellers of the above descr~bed property hereby
acknowledge that a pror~~on of the real estate taxes has been made and appears on
the clos~ng statement.
We furtller acknowledge that such prorat~ons have been based on the best ava~lable
informat~on w~thout benef~t of the tax b~ll or property assessment for the current
year.
If further adjustments or prorat~ons are requ~red after the ~ssuance of the current
year's tax b~ll, same w~ll be made by us. We hereby agree to hold F~del~ty Nat~onal
T~tle Insurance Company harmless for any change ~n the taxes, the prorat~ons, or the
payoff thereof.
BaSlS for Prorat~ons $0.00.
FURTHER ASSURANCE AGREEMENT
For and ~n cons~derat~on of the Lender th~s date fund~ng the clos~ng of ~ts loan
and/or Clos~ng Agent d~sburs~ng proceeds of th~s sale and/or loan, the unders~gned do
mutually agree to cooperate, adjust, ~n~t~al, reexecute and redel~ver any clos~ng
documents deemed necessary or des~rable ~n the reasonable d~scret~on of Lender and/or
Clos~ng Agent. It ~s the intent~on of the unders~gned that all documentat~on for
th~s transact~on and all payments or d~sbursements made shall be an accurate
reflect~on of the partIes' agreement; that each party should pay all costs and
expenses contemplated by theIr agreement and/or d~ctates by custom and usage ~n th~s
area; and that Clos~ng Agent shall be rel~eved of the burdens of sect~on 697.10 F.S
by th~s assurance.
The unders~gned do hereby so agree and consent to assure that th~s transact~on and
~ts documentat~on w~ll conform to the part~es agreement and/or the Lender'S
requ~rements and Jt ~s understood that Lender and Clos2ng Agent w~ll rely upon thIS
agreement and the covenants hereIn ~n clos~ng this transact~on.
Sellers:
/~ A' ~Q,J)/2 .0 ~J.-;l6~
WILLIE 11. BREWTON
;6;/~ 77). V41'-(t:/~/
ROSE 11. BREWTON
1~e foregOIng ~nstrument was acknowledged
November ,1995 by the above sellers.
Ny Comm~ssLon ExpIres:
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--=--__L____'_:, ~~~_~I_ _ __
S~gned, sealed and del~vered
In the presence of:
Buyers:
flt/,?;nh
?ES L
Jv~~~
ATERS
The forego~ng ~nstrument was aclmowledged before me th2s
November ,1995 by the above Buyers.
15
day of
11y Comm~ssion Exp~res:
tYn NOTARY
PUBLIC
... t I 11II
Fidelity National Title Insurance Co.
Proceeds from Real Estate Transactions as requIred by the Internal Revenue Service
Agent name and address
FIDELITY NATIONAL TITLE INS
2515 COUNTRYSIDE BLVD., SUITE C
CLEARWATER, FLORIDA.
BRANCH #:08-19352
Substitute Form 1099-5
Tax IdentificatIOn number
23-1290668
11lls IS Important lax Informahon and IS being furmshed to the 1IIIemal Revenue
SeNlce, as reqUired by sechon 1521 of the lax Reform Act of 1986 If you an..
required 10 file a return, a negllgence penalty or other sanchOll Will be unposed If
thiS Income IS taxable and the IRS detemuncs thall~ has not been reporled
TYPE OR MACHINE PRINT ONLY
Escrow Number 9551393
(If none, use date of dOSing & seller<; last name.. Example 010393Sl11lth)
2 Date of clOSing November 1 5 I 1995
Month/Day /Y cae
PROPERTY ADDRESS ~ SEE SIDE 2 FOR EXAMPLES
3
1216 CLAIRE DR. N.
Street Address (For vacant land see Side 2)
102915854460010070
Accessor<; Parcel Number (AI'N)
Slate
34615
ZIp
CLEARWATER
City (If none, list county)
FL
Aceessors Parcel Number (APN)
PROCEEDS FOR THIS SALE WENT TO: (MULTIPLE SELLERS-Use one form for ea{.h seller Treat husband and Wife
as one seller (Hlingjoint tax returns) unless requested olheTWlse, than separate forms must be used)
See Side 2 before compleling .
4 a WILLIE M. BREWTON 7-< /; Q{G, )'1/{, S2?,"P-L~~ I ). to L/ - J ;< - q 7 ;) J..
Sellers Name (first, MI, Last) Federal Tax ID for thiS ~eller
b KDS-c (Y), [jeeeJ)T1..Jr)
Spouse or Personal Representative (FOR INFORMA 110N PU RPOSES ONLY)
I ').. {,:2.- S'f- '-If 5 S
Spouse Federal Tax ID (opllOllal)
TOTAL CONSIDERATION
(SEE SIDE 2 TO CALCULATE)
5 Tax Credit to Seller $
8
$
18,430.00
Total CoIl~lderal1oll
6D
7D
EJ<ch an ge (1 r ch e ckc<.1)
9
$
Gross Allocated l'roceed~
Cheek here If the maximum detemunable
proceeds cannot be detenmned Wllh certainty
MAILING ADD~ .
10 / / / ff .4/2/2<-0
StIee/'] L
LA d/)L-f~pk"
Clry I
~~
qff
Slate
~;;lere If tbe addless
IS outSide of the U S ^
3v6/0
ZIp
I hereby certify, under penalty of perJury, that I have read the above Information and it IS true and correct
~~
~~/.J)1f!>-'1/15/95
Date
T'"'Jt:.nature
. ~
Spouse
/ZtrY~UA/
/ S--/
,
/.;1 fI S
Date
C&ll~ (J.nu.'Y 1993)
Side 1
90 . 3Ell:ld
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MQRTGAGE DEED
AaXlUNTN\IM8ER
NOTE
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PRlJIClPAL AMOUNT
UDA'\'CABEE -1IlICO RIIAHCW. SEIMCB
OF HCU.'mUQO. FU--IC.
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MOV 17, 1995 1.0JPM
'IH2LLAS cOUNTY ,~.
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. Fidelity Na~lonal Title Insura~ce Company
01 Pennsylvania
TITLE AFFIDAVIT
STATE OF FLORIDA
[ To be executed by Seller (or Mortgagor 11 no sale Involved) J
FILE NO. 9551393-l1W
COUNTY OF PINELLAS
Before me, the undersigned authorIty, personally appeared WILLIE 11. BREWTON AND ROSE 11. BREWTON,
HIS WIFE
who, being duly sworn according to law, deposes and says as follows (as used In this AffidaVit, the term "Affiant" shall mclude
all parties executmg this AffidaVit)
2
That Afffant IS the owner of, and
a Has agreed to sell to J AHES LEE WATERS
b Will execute a mortgage to Jtvrn l"TNJtNrTJtr, RRRVTrp..",
the follOWing described property In the County of PTNRr,r.Jt.'" , State of Fr.
LOT 7 IN BLOCK A OF STEVENSON'S HEIGHTS, ACCORDING TO THE PLAT THEREOF, AS
RECORDED IN PLAT BOOK 34, ON PAGE 13, OF THE PUBLIC RECORDS OF PINELLAS COUNTY,
~1Afflant has been In full, continuous, open, exclusive, peaceable and undisputed possession of said property since
the time of vestmg of title to said property In Affiant, that there are no parties who have any mterest or right to clal m an
Interest In said property other than Affiant, and that there are no facts known to Affiant which could give rise to a claim
being asserted against said property, except
or
encumberrng,
3
NONE
That, other than as shown In Item 1, Affiant has not entered IOta any agreement, contract, commitment or optIon for the
sale, lease or mortgage of the property, or any agreement, contract, commitment or optIOn which otherwise affects
said property, except
NONE
That there are no taxes, liens or assessments which are due or about to become due or whIch have attached or could
attach to said property, except
Taxes accru~ng subsequent to the current year.
4
5
That Affiant IS a cItizen of the United States, of legal age, under no legal dlsabdlUes and has never been known by any name
other than as shown above
Marrtal status (check approprrate box)
lID{ a That Affiant IS married, has been contlnously marrred dUring the entire term of the ownership of said property,
has never been divorced and has not entered In any separatIon agreement or property settlement agreement
o b That Affiant IS not married and has never been marned durrng the time of ownership of saId property
6
7
That, If title to said property IS bemg held by a corporation. partnership or trust, such corporatIon, partnershl p or trust IS In
good standing under applicable laws and the contemplated sale or mortgage of saId property by said entity IS pursuant to
proper authority
That there are no actions or proceedmgs now pendrng in any State or Federal Court to which the Affiant IS a party mcludmg,
but not I1mlted to, proceedings In bankruptcy, receivership or Insolvency, except
NONE
8
9
That there are no Judgments, mortgages, encumbrances or hens of any nature affecting said property, except
NONE
10
That there have been no improvements, repairs, additIons or alterations performed upon said property wlthm the past
90 days That Affiant has not entered Into any agreement or contract With any party for the
furmshings of any labor, services or malenal in connection With any Improvements, repairs, additions or alteratIons
Within the referenced tIme period, and that there are no parties who !lave any claim or right to a lien for servlces, labor
or matenal rn connection with any improvements, repairs, additions or alterations to saId property
11
That, to the knowledge of Affiant, the commitment of Fidelity NatIonal TItle Insurance Company under No.9551393
correctly and accurately reflects the status of the tllle to said properly
AffIant recognIzes that Fidelity National Title Insurance Company WIll rely on the statements m thIS AffidaVit and
Affiant makes thiS AffidaVit for the purpose of inducing Fidelity Nallonal Title Insurance Company to Issue Its policy or
policies of title insurance in the above referenced transaction
SWORN TO AND SUBSCRIBED before me
'2 UJ":JL >>;. qfj 4..f?<~
thiS
15
day
WILLIE H. BREWTON
BREWTO~ 'n)f~A./~
o
r--:;-: -- -- - --- ROSE 11.
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L' - .... I t t.. DIll I I )nll I ~ ~.. _..I,g I
__-. ~~ \ l ~ I j tJ...IC
-- -__J
NOTE IF THIS AFFIDAVIT DOES NOT PROVIDE SUFFICIENT SPACE TO COMPLETE ANY OF THE ABOVE ITEMS, SAID
ITEMS SHOULD BE SET FORTH IN THEIR ENTIRETY ON A SCHEDULE WHICH IS ATTACHED TO THIS AFFIDAVIT
AND WHICH IS INITIALED AND DATED BY THE AFFIANT
,
/
~ ~
My commiSSion expires
TAX PRORATION AGREEMENT
ATIC#- 9551393-MW
CLOSING DATE:
November 15, 1995
PROPERTY: 1216 CLAIRE DR.
CLEARWATER, FL
LENDER: AVCO FINANCIAL SERVICES
N.
34615
We, the undersigned buyers and sellers of the above described property hereby
acknowledge that a pror&t~on of the real estate taxes has been made and appears on
the clos~ng statement.
We further acknowledge that such prorat~ons have been based on the best ava~lable
~nformat~on w~thout benef~t of the tax b~ll or property assessment for the current
year.
It further adjustments or prorat~ons are requ~red after the issuance at the current
year's tax b~ll, same w~ll be made by us. We hereby agree to hold F~delity Nat~onal
T~tle Insurance Company harmless for any change ~n the taxes, the prorat~ons, or the
payoff thereof.
Bas~s for Prorat~ons $0.00.
FURTHER ASSURANCE AGREEMENT
For and ~n cons~deration of the Lender th~s date fund~ng the closing of its loan
and/or Clos~ng Agent d~sburs~ng proceeds of th~s sale and/or loan, the unders~gned do
mutually agree to cooperate, adjust, ~n~t~al, reexecute and redel~ver any Closing
documents deemed necessary or des~rable ~n the reasonable d~scret~on of Lender and/or
Clos~ng Agent. It ~s the ~ntent~on of the unders~gned that all documentat~on for
th~s transact~on and all payments or d~sbursements made shall be an accurate
reflect~on of the part~es' agreement; that each party should pay all costs and
expenses contemplated by the~r agreement and/or dictates by custom and usage 2n th~s
area; and that Clos2ng Agent shall be rel~eved of the burdens of sect~on 697.10 F.B.
by this assurance.
The unders~gned do hereby so agree and consent to assure that th~s transact20n and
2ts documentat2on w~ll conform to the part2es agreement and/or the Lender's
requ2rements and 2t 2S understood that Lender and Clos~ng Agent w2ll rely upon th2s
agreement and the covenants here~n 2n clos2ng th2S transact2on.
Sellers:
I~ ^\~~ flu. );2 ,0 ~6~
WILLIE M. BREWTON
;f};/- 77). ~4~/~J
ROSE M. BREWTON
My Comm2ss~an Expires:
[, '~~~1 --'-:-:-;";7, r- j - \'
1;. I ~ r I \ ! I .
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----=:....._L__~__ ~ \ ~=- ~::_ __~ ~_
15
day of
The forego2ng 2nstrument was acknowledged
November ,1995 by the above sellers.
S~gned, sealed and de12vered
2n the presence of:
Buvers:
(lMJ'h
FES L
jJdlV~
ATERS
The forego2ng ~nstrument was acknowledged before me th2S
November ,1995 by the above Buyers.
15
day of
Ny Comm2SS2on Expires:
~ NOTARY
PUBLIC
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CITY OF CLEARWATER PUBLIC HEARING NOTICE
ANNEXATION, LAND USE PLAN AND ZONING ATLAS AMENDMENTS
'. NOTE All persons wlshmQ to address an Item need to be present at the BEGINNING of the Commumtv
Development Board meetmQ Those cases that are not contested bv the applicant. staff. nelghbormq property
owners, etc will be placed on a consent aQenda and approved bv a sinqle vote at the beQmmnQ of the meetinq
The City of Clearwater, Florida, proposes to adopt the following ordinances
ORDINANCE NO 7743-07
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, ANNEXING CERTAIN REAL PROPERTY LOCATED
APPROXIMATELY 160 FEET EAST OF STEVENSON'S DRIVE AND 185 FEET WEST OF STOCKTON DRIVE,
CONSISTING OF LOT 7, BLOCK A, STEVENSON'S HEIGHTS, WHOSE POST OFFICE ADDRESS IS 1216 CLAIRE
DRIVE, INTO THE CORPORATE LIMITS OF THE CITY, AND REDEFINING THE BOUNDARY LINES OF THE CITY TO
INCLUDE SAID ADDITION, PROVIDING AN EFFECTIVE DATE
ORDINANCE NO 7744..07
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, AMENDING THE FUTURE LAND USE PLAN ELEMENT OF
THE COMPREHENSIVE PLAN OF THE CITY, TO DESIGNATE THE LAND USE FOR CERTAIN REAL PROPERTY
LOCATED APPROXIMATELY 160 FEET EAST OF STEVENSON'S DRIVE AND 185 FEET WEST OF STOCKTON
DRIVE, CONSISTING OF LOT 7, BLOCK A, STEVENSON'S HEIGHTS, WHOSE POST OFFICE ADDRESS IS 1216
CLAIRE DRIVE, INTO THE CORPORATE LIMITS OF THE CITY, UPON ANNEXATION INTO THE CITY OF
CLEARWATER, AS RESIDENTIAL LOW, PROVIDING AN EFFECTIVE DATE
ORDINANCE NO 7745-07
AN ORDINANCE OF THE CITY OF CLEARWATER, FLORIDA, AMENDING THE ZONING ATLAS OF THE CITY BY
ZONING CERTAIN REAL PROPERTY LOCATED APPROXIMATELY 160 FEET EAST OF STEVENSON'S DRIVE AND
185 FEET WEST OF STOCKTON DRIVE, CONSISTING OF LOT 7, BLOCK A, STEVENSON'S HEIGHTS, WHOSE
POST OFFICE ADDRESS IS 1216 CLAIRE DRIVE, INTO THE CORPORATE LIMITS OF THE CITY, UPON
ANNEXATION INTO THE CITY OF CLEARWATER, AS LOW MEDIUM DENSITY RESIDENTIAL (LMDR), PROVIDING AN
EFFECTIVE DATE
The proposed ordinances Will affect the land area shown on the map In thiS advertisement
(INSERT MAP HERE)
Schedule of PublIC HeannClS
Tuesday, November 21,2006 before the Community Development Board, at1 00 p m
Thursday, December 14, 2006 before the City Council (15 Reading), at 600 P m
Thursday, January 18, 2007 before the City Council (2nd Reading), at 6 00 P m
All public hearings on the ordinances Will be held In CounCil Chambers, 3rd floor of City Hall, 112 South Osceola Ave,
Clearwater, FlOrida The ordinance and complete legal deSCription of the property proposed for annexallon, by metes and
bounds, may be Inspected or obtained at OffiCial Records & Legislative Services, located at City Hall (James L Waters)
ANX2006-08030
Interested parties may appear and be heard at the hearing or file written notice of approval or objection With the Planning
Director or City Clerk prior to the heanng Any person who deCides to appeal any deCISion made by the Board or Council,
With respect to any matter conSidered at such heanngs, Will need to request a record of the proceedings and, for such
purpose, may need to ensure that a verbatim record of the proceedings IS made, which record Includes the testimony and
eVidence upon which the appeal IS to be based per FlOrida Statute 2860105
Community Development Code Sec 4-206 states that party status shall be granted by the Board In quaSI-JudiCial cases If the
person requesting such status demonstrates that s/he IS substantially affected Party status entities parties to personally
testify, present eVidence, argument and witnesses, cross-examine witnesses, appeal the decISion and speak on
:'reconslderatlon requests, and needs to be requested and obtained dunng the case diScUSSion before the COB
\:., An oath will be admmlstered swearmg m all persons giVing testimony In quasI-Judicial public heanng cases Persons
Without party status speaking before the COB shall be limited to three minutes unless an individual IS representing a group
In which case the Chairperson may authOrize a reasonable amount of time up to 10 minutes The Community
Development Board will review the case and make a recommendation to the City CounCil for final diSposition
Five days prior to the CDS meeting, staff reports and recommendations on the above requests will be available for review
by mterested parties between the hours of 830 a m and 430 pm, weekdays, at the City of Clearwater, Planning
Department, 100 S Myrtle Ave, Clearwater, FL 33756 Please contact the Planning Department 562-4567 to diSCUSS any
questions or concerns about the project and/or to better understand the proposal
Michael Delk
Planning Director
Cynthia E Goudeau, MMC
City Clerk
City of Clearwater
POBox 4748, Clearwater, FL 33758-4748
A COPY OF THIS AD IN LARGE PRINT IS AVAILABLE IN OFFICIAL RECORDS & LEGISLATIVE SERVICES ANY
PERSON WITH A DISABILITY REQUIRING REASONABLE ACCOMMODATION IN ORDER TO PARTICIPATE IN
THIS MEETING SHOULD CALL (727) 562-4093 WITH THEIR REQUEST
To learn more about presenting to Clearwater boards and City Council, go to
http Ilclearwater qranlcus comNlewPubllsher php?vlew Id=11 and click on "ReSident Engagement
Video II You can also check the Informational video out from any Clearwater public library
Ad 11110106 & 1/09/07
u
COB Meeting Date
Case Number
Owner! Appheant
LoeatIOn
Agenda Item
November 21,2006
ANX2006-08030
James L Waters
1216 Clmre Dnve
F6
CITY OF CLEARWATER
PLANNING DEPARTMENT
STAFF REPORT
BACKGROUND INFORMATION
REQUEST:
(a) AnnexatlOn of 0 I 58-aeres of property to the City of
Clearwater,
(b) Future Land Use Plan amendment from Resldentml
Low (RL) Category (County) to ReSldentldl Low (RL)
Category (CIty of Clearwater), and
(e) Rezomng from R-3, Smgle-FamIly ResIdentIal DIstnet
(County) to Low Medium Density Residential (LMDR)
DIstnet (CIty of Clearwater)
SITE INFORMATION
PROPERTY SIZE:
6,825 square feet or 0 158 acres
(65 feet wIde by 105 feet deep)
PROPERTY USE:
Current Use
Proposed Use
Smgle-family dwellmg
Single-famIly dwelhng
PLAN CATEGORY:
Current Category
Proposed Category
Residential Low (RL) (County)
Residential Low (RL) (City)
ZONING DISTRICT:
Current Dlstnct
Proposed DIstnct
R-3, Single-Family Residential (County)
Low MedIUm DensIty ResIdential (LMDR) (City)
Staff Report - Conunumty Development Board -N ovember 21 , 2006 - Ca<;e ANX2 006-0803 0 Page I
SURROUNDING USES:
North
South
East
West
FIre StatIon
Smgle-famIly residence
Smgle-fdmlly re~ldence
Smgle-fmmly residence
ANALYSIS
ThIS annexatIon mvolves a 0 1 58-acre property conslstmg of one parcel, located on the north side
ofClalfe Dnvc, approximately 160 fcet east of Stevenson's Dnve and 185 feet west of Stockton
Dnve The property IS contI!,TUous wIth thc eXIsting City boundanes to the north and we~t,
therefore, the proposed annexatIOn IS consistent with Pmellas County Ordinance #00-63 with
rcgard to voluntary annexatIOn The applIcant IS request10g thiS annexation 10 order to rCCClve
sohd waste servIcc from the City 1t IS proposed that the property be assigned a Future Land Use
Plan dcsIgnatIOn of ResIdentIal Low (RL) and a zomng category of Low MedIUm Dcnslty
Residential (LMDR)
I. IMPACT ON CITY SERVICES:
Recommended Findings of Fact
Water and Sewer
The apphcant rCCClVCS water servIce from the CIty of Clearwater The property IS currently on
City of Clearwater samtary sewer
Sohd Waste
Collection of sohd waste Will be provided by the City of Clearwater The CIty has an 1Oterlocal
agreement WIth Pmellas County to provide for the disposal of sohd waste at the County's
Resource Recovery Plant and capacIty IS available to serve the property
Pohce
The property IS located wlth10 Pohce Dlstnct II and service WIll be admInistered through the
dlstnct headquarters located at 645 Pierce Street There are currently 65 patrol officers and nme
patrol sergeants assigned to thIS dIstnct CommUnity polIcmg servIce wlIl be provIded through
the CIty'S zone system and officers 10 the field The Pohce Department has stated that It WIll bc
able to serve thiS property and the proposed annexatIOn will not adversely affect polIce service
and response time
Fire and Emergency MedIcal ServIecs
FIre and emergency medIcal services will be provided to thiS property by StatIOn #51 located at
1 720 Overbroo k A ven ue The Fire Departm en t WI J I be ab I e to serve th I S property The proposed
annexation WIll not adversely affect fire and EMS service and response tIme
Staff Report - COllunulllty Development Board - November 21 2006 - Case ANX2006-08030
Page 2
Recommended ConclusIOns Of Law
The CIty has adequate capduty to serve this property w1th ~ohd waste, polIce, fire and EMS
service The proposed annexatIOn will not have an adverse effect on publIc facIlitIes and their
levels of service
II. CONSISTENCY WITH CITY'S COMPREHENSIVE PLAN: (Section 4-604.F.2]
Recommended Findings of Fact
The Pmellas County ComprehensIve Plan and the CountYWide Future Land Use Plan map
desIgnate the site as ResidentIal Low (RL) It IS the purpose of the RL category to dep1ct those
areas of the County that are now developed, or appropnate to be developed, m a low densIty
resIdentIal manner, and to recogmze such areas as pnrnanly well-sUlted for residentIal uses that
are cons1stent wIth the Jaw densIty, non-mtenslve quahtIes and natural re&ource eharaeten~tIes of
such areas ResIdentIal 1& the pnmary u&e 10 thIS plan category up to a maXImum of five (5)
dwell10g umts per aexe Secondary uses mclude ResIdentIal EqUIvalent, In&tItutIOnal,
TransportatIOn/UtIlIty, Pubhe EducatIOnal FacIlIty, Anclllary Non-Residential and
RecreatIOn/Open Space
The proposed annexatJOn IS consIstent With and promote& the followmg objectIve of the City of
Clearwater ComprehensIve Plan
24 ObjectIve ~ Compact urban development withIn the urban servIce area shall be promoted
through applteatJOn ofthe Cleanvater CommunIty Development Code
Recommended Conclusions of Law
The property proposed for annexatIon IS contIguous to eXIstIng C1ty boundanes and withIn the
CIty'S urban service area and will be located In the RL category The proposed annexatJOn IS
conS1stent the C1ty'S Comprehensive Plan
III. CONSISTENCY OF DEVELOPMENT WITH COMMUNITY DEVELOPMENT
CODE AND CITY REGULATIONS: [Section 2-202]
Recommended Findings of Fact
The SIte IS currently zoned R-3, S10gle FamIly ResIdentml DIStnCt In Pmellas County The
apphcant proposes to rezone the property to the Low MedIUm DenSity ResidentIal (LMDR)
Dlstnct Under the current LMDR zon1Og dIstnct provISIons, a m10llllum lot width of 50 feet
and a m1mmum lot area of 5,000 square feet are reqUIred The subject Slte IS 65 feet w1de and
6,825 square feet m lot area
Staff Report - COl1llllUmty Development Board - November 21, 2006 - Ca~e ANX2006~08030
Page 3
Recommended Conclusions of Law
The subject property exceeds the CIty'S mInImUm LMDR dimensIOnal reqUlrements and IS
therefore conSIstent With the CommunIty Dcvelopment Code
IV. CONSISTENCY WITH THE COUNTYWIDE PLAN:
Recommended Findings of Fact
Therc IS no change requested m thc CountYWide Future Land Use Plan desIgnation for the site,
whIch will remam ResidentIal Low (RL) WIth a maXImum density of 5 dwelhng UnIts per acre
Recommended Conclusions of Law
No change IS proposed for the Future Land Usc Plan designatIOn of the property proposed for
annexatIOn and the use and densIty of the property IS consIstent WIth the current designatIOn
V. CONSISTENCY WITH PINELLAS COUNTY:
Recommended Findings of Fact
Pursuant to Pmellas County Ordlllance No 00-63, the Pmellas Plannmg Council staff has
reViewed thIS annexatIOn and detenmned It complIcs WIth all dPphcable ordmance cntcna
Pmellas County Ordmance No 00-63(1)(a) reqUires that a proposed annexation be both
contiguous to the eXIstlllg mUllIupal boundanes and compact Thl5. SIte IS contiguous WIth thc
eXlstmg City boundanes to the north and west and represent5. a logical and appropnate extenSIOn
of the eXIstmg boundanes The compactness standard reqUIres that the annexatIOn not create an
enelave or a serpcntllle pattern of mumclpal boundanes
Recommended Conclusions of Law
The annexatIOn of thIS property IS conSIstent WIth thiS standard and no new enclave Will be
created In summary, the annexatIOn of thIS propcrty I') consistent With Flonda law
VI. CODE ENFORCEMENT ANALYSIS:
There are no current code enforcement VIOlatIOns or any code enforcement hIstOl)l on thIS site
StafTReport - Commu111ty Development Board - November 21, 2006 ~ Ca~e ANX2006-08030
Pdgt 4
SUMMARY AND RECOMMENDATIONS
The proposed annexatIon can be served by CIty of Clearwater services, mcludmg solid waste,
polIce, fire and emergency medIcal services wIthout any adverse effect on thc servIce level The
proposed annexatIon IS consIstent wlth both the CIty'S ComprehensIve Plan and IS wnSlstent
with Pmellas County Ordmance No 00-63 regardmg voluntary annexatIOn
Based on the above analysIs, the Planmng Department recommends the followmg actIOns on the
request
(a) Recommend APPRO V At ofthe annexatIOn of 0 158-acres to the CIty of Clearwater,
(b) Recommend APPRO V At of the ResIdentml Low (RL) Future Land U~e Plan
dasslficatlOn, and
(c) Recommend APPROVAL of the Low MedIUm DenSIty ReSIdentIal (LMDR) zomng
c1d~slficatlOn pursuant to the City's Commumty Development Code
Prepared by Plannmg Department Staff
dvt -P;AP'1
Cky Ready, Planner II
A ttachmen ts:
ApphcatlOn
LocatIOn Map
Aenal Photograph
Proposed AnnexatIon
Future Land Use Map
Zomng Map
Surroundmg Uses Map
Site Photographs
S \Planmng Deparlmenl\C D BlAnnexatlOns IANX - 2006\ANX2006-08030 - 1216 ClUlre Dllve - Wale} s1ANX2006-
08030 StafJ_ Reporl doc
Staff Report - CommuOlty Development Board - November 21 , 2006 - Case ANX2006-08 03 0
Page 5
Resume
Franklin Cky Ready
100 South Myrtle Avenue
Clearwater, FL 33756
727-562-4553
ckv. readv(a:)mvclearwater .com
PROFESSIONAL EXPERIENCE
. Planner II
City of Clearwater
. Assistant Planner
Dekalb County, IlhnOls
. GIS Technician
Center for TransportatIOn Educahon & Research
Ames, Iowa
August 2005 to present
December 2004 to August 2005
May 2002 to December 2004
Developed Industnal Park layout for City of Perry, Iowa, Comprehensive Land Use Plan for
Boone County, Iowa, Growth, Development, and Mamstreet RevltahzatIOn Plan for Lake Park,
Iowa, Hlstoncal PreservatIon, Mamstreet ReVItahzatIOn, Growth and Land Use Plan for Seargent
Bluff, Iowa
EDUCATION
Master of Commumty & RegIOnal Planmng, Iowa State Umverslty, 2004
B S m CommunIty & RegIOnal Planmng, Iowa State UmversIty, 2002
B S III Envlfonmental Studies, Iowa State UmversIty, 2002
LICENSES & CERTIFICATES
Amencan Plannmg ASSOCiatIOn
Board Member Ames Zomng Board of Adjustment
SIerra Club/Iowa Chapter
Iowater Voluntary Water Momtonng Program
ISU Commumty & RegIOnal Planmng Club
~
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Location Map
Owner James Waters Case AN X2006-0B030
Site 1216 Claire Drive 0158
Land Use Zoning
PIN 1 0- 29- 15-85446-00 1-0070
From RL (County) R-3 (County}
To RL (City) LMDR (City) Atlas Page 269B
Aerial Photograph
Owner James Waters Case A NX2006-D8030
Site 121 6 Claire Dnve 0158
Land Use Zoning
PIN , 0-29- 15-85446-00 1-00 70
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Owner James Waters Case AN X2006-08030
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Size (Acres
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Case
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Property
Size (Acres)
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PIN 10-29-15-85446-001-0070
from
RL (County)
R-3 (County)
To
RL (City)
Atlas Page
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AN X2006-08030
0158
269B
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ANX2006-08030
1216 Claire Drive
James L. Waters
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ANX2006-08030
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CI1'Y OF CLEARWATEH.
PlANNING DI...PAR'fIvIFNT
PU"I 011[0 13m, 4748, CII.AI~\\'\I!I{, FIUI([I)/\ 3375B-47IJ8
Mtr\l( II'AI SII(JI( L\ 31 ,II D[ v,, J 00 SOl, III M', k II I J\VI \1,1 CI] AI{\VA 111\, n IJlnnA ~-)Tjh
JIIII'IIO'H (727) ')62-4567 I \X (727) SG2-4Kr)')
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])1 VII OI'W '\J HI VII \V
September 12, 2006
James Waters
2451 Bond Avenue
Clearwater, Flonda 33759
RE ApplIcatIon for AnnexatIOn (ANX2006-08030) approval to pennlt a sIte, located at 1216
ClaIre Dnve and consIstmg of 1 parcel totalmg 0 156 acres, mto the CIty of Clearwater
Mr Waters
The Planmng Department has revIewed your apphcatlOn for the Annexation (ANX2006-08030)
for the SIte at 1216 Claire Dnve After a prehmmary reView, staff determll1ed that the
applIcatIon IS complete The applIcation has been entered mto the Department's filIng system
and assigned the case number ANX2006-08030
The followmg schedule has been tentatIvely established for the review of your application by
vanous CIty boards These meetmgs are necessary 111 order to process your request appropn-
ately The attendance by you or your chent may be reqUlred at the Development RevIew Com-
mIttee and Commumty Development Board meetll1gs Should any of the followmg meetmg
hmes and/or locatlOns change or If you WIll be reqUired to attend any ofthese meetmgs you Will
be contacted ImmedIately
10/512006 Development Review CommIttee, tIme to be detennmed (please call Sherry Wat-
kins at 727 5624582 no earlIer than one week pnor to the meetmg date for the
approxlmate tIme that your case WIll be revIewed), III the Plannmg Department
conference room - Room 216 - on the second floor of the mumcIpal servIce
bmldmg, 100 South Myrtle Avenue 111 Clearwater The case WIll be forwarded to
the Commumty Development Board when It IS deemed sufficIent
11/21/2006 Commumty Development Board, meetmg starts at 1 00 pm 111 the Clty Council
Chambers on the 3 rd Floor of CI ty Hall at 112 S Osceo I a A ven u e
12/14/2006 CIty CouncIl (first readmg), meetmg starts at 6 00 pm m the CIty CouncIl
Chambers on the 3rd Floor of City Hall at 112 S Osceola Avenue
II \ ,I, 1111'11 \1,1' \ I \'.1 II,
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September 12, 2006
Waters ResIdence
Page 2
1/1812007
CIty Council (second readmg), meetmg starts at 600 pm m the City CouncIl
Chambers on the 3rt! Floor of CIty Hall at 112 S Osceola Avenue
If you have any questIOns, please do not heSItate to contact me at 727-562-4553
Smcerely,
c:"< ~y0
Cky Ready
Planner II
S IPfrlllntflg Depmlmenl\C D BlAnnexatlOflslANX - 2006lANX2006-08030 - 1216 Claire Dnve - WalerslANX2006-0S030 complete III doc
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CII'Y OF CLEAR\XlA1'ER
PlANNING DEPA1U MENT
P<l\1 011 J( I Bo\ 4748, ell '1I1WI\11 I!, FIOI,II'^ :)) 758 4748
M iJ'W IP,II "1 I!VI( I" HI!II ill \C, I no SOl, ill MYI, III J\VI \1 I (I I IRii"! II{, fl Ol!lf)^ ~ -) 7Si)
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Lo ,c, RAj',(,1 PIA":- IV,
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September 8, 2006
Mr Dav1d Healey, AICP
ExecutIve Duector
Pmellas Plarmmg Council, SUIte 850
600 Cleveland Street
Clearwater, FL 33755
Mr Bnan K Sm1th
DIrector
Pmellas County Planmng Department
600 Cleveland Street, SUIte 750
Clearwater, FL 33755
LIeutenant Terry Sterlmg
StrategIc Plarmmg
Pmellas County Shenffs Office
PO Drawer 2500
Largo, FL 33778
Re' Notice of Voluntary Annexation (ITEM NO.: ANX2006-09034, ANX2006-08030,
ANX2006-09031, ANX2006-09033 and ANX2006-09032)
Dear Mr Healey, Mr SmIth & Lt Sterling
Pursuant to Sectwn 6(2) of the County Ordmance No 00-63, the City of Clearwater IS hereby
notIfymg thc PmelJas Planmng CouncIl of 1tS rece1pt of five (5) new appltcatlOos for voluntary
annexatwn of properties located at 1824 DIane Dnve (ANX2006-09034), 1216 Claire Dnve
(ANX2006-08030), 222 N Belcher Road (ANX2006-09031), 1232 Clane Dnve (ANX2006-
09033) and 1240 Carol Dnve (ANX2006-09032) mto 1ts Junsd1ctlOn The subject propertIes are
located wIthm the C1ty of Cleanvater Plannmg Area and upon annexatlOn will be served by C1ty
of Clearwater sewer and solId waste serv1ce (where avatlable) The proposed annexatlOn IS
conSIstent w1th FlorIda law regardmg mumcIpal annexatIons through theIr adjacency wIth
eX1stmg Clty boundanes and theIr compact m concentratIOn
I I \,~ 1111,1>\1,11 ,\1 \\1 ,"
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September 8,2006
Healey, SmIth & Sterlmg - Page Two
A copy of the petItIOns for annexatIon, the warranty deeds, mcludmg the legal descnptlOns, plats
of record and maps assocIated WIth thiS propertIes are enclosed
The followmg schedule has been tentatIvely establIshed for the reVIew of these applIcatIons by
vanous CIty boards Should any of the followmg meetmg tImes and/or locatIOns change you will
be contacted ImmedIately
11-21-2006 Commumty Development Board, meetmg starts at 1 00 pm III the CIty
CommISSIon Chambers on the 3 rd Floor of City Hall at 112 S Osceola Avenue
12-14-2006 CIty CommISSIOn (first readmg), meetmg starts at 600 p ill III the City
CommIsSIOn Chambers on the 3rd Floor of CIty Hall at 112 S Osceola Avenue
1-18-2007 CIty ComrrnssIOn (second readmg), meetmg starts at 600 pm m the CIty
ComnnSSlOn Chambers on the 3rd Floor of CIty Hall at 112 S Osceola Avenue
Your early response wlIl be greatly apprecIated Please do not heSItate to contact me at (727)
562-4553, should you reqUlre addItIonal mformatlOn
Smcer~
do{ Wi>1
Cky Ready
Planner II
cc Gma Clayton, ASSIstant Plannmg DIrector
Leshe Dougall-SIdes, ASSIstant CIty Attorney
Michael QUIllen, City Engmeenng DIrector
Art Kader, ASSistant Park and RecreatIOn DIrector
S IPlallnmg Deparlmenr\C D BlAnnexlllwnslANX - 20061ANX2006-080JO - 1216 Clmre DrIve - Warers1ANX2006-08030 Leller 10 PPC doc
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Owner James Waters Case ANX2006-08030
Site 1216 Claire Dnve Property 0158
Size (Acres)
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Site 1216 Claire Drive Property 0158
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Owner James Waters Case A NX2006-08030
Site 1216 Claire Drive Property 0158
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Site 121 6 Claire Dnve Property 0158
Size [Acres)
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Aerial Photograph
Owner James Waters Case A NX2006-08030
Site 1216 Claire Dnve 0158
Land Use ZonIng
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Legal Description in Title Affidavit
LOT 7 IN BLOCK A OF STEVENSON'S HEIGHTS, ACCORDING TO THE
PLAT THEREOF, AS RECORDED IN PLAT BOOK 34, ON PAGE 13, OF THE
PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA
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MORtGAGE DUO - ORIGINAL
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Fidelity National Title Insurance Company
Of Pennsylvania
TITLE AFFIDAVIT
STATE OF FLORIDA
[ To be exeouted by Seller (or Mortgagor If no sale Involved) ]
FilE NO. 9551393-I1W
COUNTY OF PINELLAS
Before me, the undersigned authority, personally appeared WILLIE M. BREWTON AND ROSE 11. BREWTON,
HIS WIFE
who, bemg duly sworn accordmg to law, deposes and says as follows (as used m thIS Affidavit, the term "AffIant" shall mclude
all parties executing this AffidaVit)
1
That Affiant Is the owner of, and
a Has agreed to sell to JAMES LEE WATERS
b Will execute a mortgage to Avrn r<'TNANrT Ar. .c:1UJVTrR.c:
the followmg deSCribed property 10 the County of PTNRT,T,llS , State of fi'T,
LOT 7 IN BLOCK A OF STEVENSON'S HEIGHTS, ACCORDING TO THE PLAT THEREOF, AS
RECORDED IN PLAT BOOK 34, ON PAGE 13, OF THE PUBLIC RECORDS OF PINELLAS COUNTY,
~JA!HMnt has been in full, continuous, open, exclusive, peaceable and undisputed possession 01 said property slOce
the time of vesting of title to said property In Affiant, that there are no parties who have any Interest or rig ht to claim an
Interest In said property other than Affiant, and that there are no facts known to Affiant which could give rise to a claim
being asserted against said property, except
or
encumbering,
2
3
NONE
That, other than as shown In Item 1, Affiant has not entered into any agreement, contract, commitment or option for the
sale, lease or mortgage of the property, or any agreement, contract, commitment or option whIch otherwIse affects
said property, except
4
NONE
That there are no taxes, liens or assessments which are due or about to become due or which have attached or could
attach to said property, except.
Taxes accru~ng subsequent to the current year.
5 That Affiant Is a cItizen 01 the United States, of I egal age, under no legal disabilities and has never been known by any name
other than as shown above
6 Mantal status (check appropriate box)
II1X a That AffIant IS mamed, has been contmously marrred dunng the entire term of the ownership of said property,
has never been divorced and has not entered many separatlon agreement or property settlement agreement
o b That Affiant is not married and has never been married dunng the time of ownership of saId property
7 That, If tltl e to said property rs being held by a corporation, partnership or trust, such corporation, partnership or trust IS in
good standing under applicable laws and the contemplated sale or mortgage of saId property by said entity IS pursuant to
proper authOrity
8 That there are no actions or proceedings now pending In any State or Federal Court to which the Affiant IS a party mcludrng,
but not limited to, proceedings In bankruptcy, receIvership or Insolvency, except
NONE
9 That there are no judgments, mortgages, encumbrances or liens of any nature affectrng said property, except
NONE
10 That there have been no improvements, repai rs, add llions or alterations performed upon said property Within the past
90 days That Affiant has not entered IOta any agreement or contract with any party for the
furnishings of any labor, services or material In connection With any Improvements, repairs, additions or alterations
within the referenced time penod, and that there are no parties who have any claIm or right to a lien for servrces, labor
or matenal 10 connectIon with any Improvements, repairs, addlllons or alterations to said property
11 That, to the knowledge of Affiant, the commitment of Fidelity National Title Insurance Company under N09551393
correctly and accurately reflects the status of the title to sard property
AffIant recogmzes that Fidelity NatIOnal TItle Insurance Company Will rely on the statements In ti1l5 AffidaVit and
AffIant makes this AffidaVit for the purpose of Inducing Fidelity NatIOnal TItle Insurance Company to Issue ItS policy or
polICies of trtle Insurance In the above referenced transactIOn
SWORN TO AND SUBSCRIBED before me
this
15
day
tJdL'fl- 7~l~ qf]~~
o
/ -'
My commiSSion expires
I~--:- -: _ _ -:-- _ -- ROSE M.
\ (, "I' --------
.... 'l I 1 ~II , -~~
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} _ ~ I I.... C!lll I I l x J II j. J~ j,.';J r I
-----_ ~~ 1 ~ L 1 j t:.J~~1
- ---- - -_.J
WILLIE 11. BREWTON
BREWTO~ ~?,~""'/~
NOTE IF THIS AFFIDAVIT DOES NOT PROVIDE SUFFICIENT SPACE TO COMPLETE ANY OF THE ABOVE ITEMS, SAID
ITEMS SHOULD BE SET FORTH IN THEIR ENTIRETY ON A SCHEDULE WHICH IS ATIACHED TO THIS AFFIDAVIT
AND WHICH IS INITIALED AND DATED BY THE AFFIANT
~\
-
. '
Fidelity National Title Insurance Co.
Proceeds from Real Estate TransactIons as required by the Internal Revenue Service
Agent name and address
FIDELITY NATIONAL TITLE INS
2515 COUNTRYSIDE BLVD., SUITE C
CLEARWATER, FLORIDA
BRANCH #:08-19352
Substitute Form 1099-8
Tax IdentificatIOn number
23-1290668
This IS Important tax informatIOn and IS being rurnl~hed to the Internal Revenue
Service, as requIred by section 1521 of the lax Reform Act of 1986 If you clf~
required to liIe a return, a negligence penalty or other sanction WJllbe unposcd If
thiS mcome IS laxable and the IRS determmes that IS has nol been reported
TYPE OR MACHINE PRINT ONt y
Escrow Number 9551393
(If none, use dMe of dOSing & sellers 1a.~t name - Example 010393smlth)
2 Date of closing November 15, 1995
Month/Day /Y car
PROPERTY ADDRESS - SEe SIDE 2 FOR EXAMPLES
3
1216 CLAIRE DR. N.
Street Address (ror vacant hUld see Side 2)
102915854460010070
Accessors Parcel Number (ArN)
CLEARWATER
City (If none, Itst county)
Stale
34615
Zip
FL
Acressors Parcel Numbcr (APN)
PROCEEDS FOR THIS SALE WENT TO: (MULTIPLE SELLERS-Use one form for each scUer Treat husband and Wife
as one seller (ftlingJomt tax returns) unless requested otherwise, than separate forms must be used)
See side 2 before completing J-
4a WILLIE M. BREWTON 7.. J~Q~ )12, ;;j/tCc~--6-vL
Sellers Name (first, MI, Last)
I ).foL/-J~-q7;)!1..
Federal Tax ID for thIS seller
b KoSI: (YJ, geetJ)ruN
Spouse or Per.>onal RepresentatIVe (FOR INrORM^ nON PURPOSES ONLY)
I ')(;:<-- Slf- '-If 5 S
Spouse Federal Tax ID (ophonal)
TOTAL CONSIDERATION
(SEE SIDE 2 TO CALCULATE)
5 Tax Credit to Seller $
8 $
18,430.00
Total ConSideration
60
70
Exdld n ge (I r checked)
9
$
Gross Allocated Proceeds
Check here If the maximum detenmnable
proceeds cannot be determined wdb certall1ty
MAILING ADD~ .
10 / / / !J d/2/2bO
Stre~
LA d/7L.d/f'k,/
Gty I
~~
i~
~herc If the address
IS outside of lhe USA
3V&/0
Zip
I hereby certify, under penalty of perjury, that I have read the above information and It IS true and correct
T~nature
. ~
Spouse
~4</h
~~~/.5)11Tlll15195
Date
/kY~
I S"'/
,
/~?S
CE-ll ~ (J .nu.'Y ]?9~ )
Date
Side 1
. .
TAX PRORATION AGREEMENT
ATIC#- 9551393-MW
CLOSING DATE:
November 15, 1995
PROPERTY: 1216 CLAIRE DR.
CLEARWATER, FL
LENDER: AVCO FINANCIAL SERVICES
N.
34615
~e, the unders~gned buyers and sellers of the above descr~bed property hereby
acknowledge that a prorac~on of the real estate taxes has been made and appears on
the clos~ng statement.
We further acknowledge that such prorat~ons have been based on the best ava~lable
~nformat~on without benefit of the tax b~ll or property assessment for the current
year.
If further adjustments or prorat~ons are requ~red after the ~ssuance of the current
year's tax b~ll, same w~ll be made by us. We hereby agree to hold F~del~ty Nat~onal
T~tle Insurance Company harmless for any change ~n the taxes, the prorat~ons, or the
payoff thereof.
Bas~s for Prorations $0.00.
FURTHER ASSURANCE AGREEl1ENT
For and ~n considerat~on of the Lender th~s date fund~ng the clos~ng of ~ts loan
and/or Clos~ng Agent d~sbursing proceeds of th~s sale and/or loan, the unders~gned do
mutually agree to cooperate, adjust, ~n~t~al, reexecute and redel~ver any clos~ng
documents deemed necessary or des~rable ~n the reasonable d~scret~on of Lender and/or
Clos~ng Agent. It ~s the ~ntent~on of the unders~gned that all documentat~on for
th~s transact~on and all payments or d~sbursements made shall be an accurate
reflect~an of the part~es' agreement; that each party should pay all costs and
expenses contemplated by the~r agreement and/or d~ctates by custom and usage in th~s
area; and that Clos~ng Agent shall be rel~eved of the burdens of sect~on 697.10 F.S.
by this assurance.
The unders~gned do hereby so agree and consent to assure that th~s transact~on and
~ts documentat~on w~ll conform to the part~es agreement and/or the Lender's
requ~rements and ~t ~s understood that Lender and C1os~ng Agent w~ll rely upon th~s
agreement and the covenants here~n ~n clos~ng this transact~on.
Sellers:
)~^'i~~h1.0~A~
WILLIE M. BREWTON
/e:/~ 717. \A1t'4'1:/~/
ROSE 11. BREWTON
The forego~ng ~nstrument was acknowledged
November ,1995 by the above sellers.
My Comm~ss~on Exp~res:
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day of
s~gned, sealed and del~vered
~n the presence of:
Buvers:
(Lll'h
'fixES L
jJ~~
The forego~ng ~nstrument was acknowledged before me th~s
November ,1995 by the above Buyers.
15
day of
Ny Comm~ssion Expires:
fr0 NOTARY
PUBLIC
APPLICANT, PROPERTY OWNERS, AND AGENT INFORMATION
JArrtQ-'s L, W~<\e.Q5
3.L\5 \ &oYd Cwt ~ I t:"L ;)~l5<1
Id'l - 5 - 3>5"5 FAXNUMBER 1d-l- leu -OfoS1_
:3~e5\ Li ~\~
(li st a II owners)
AGENT NAME ouJlIVl- ~ ~ t Cy;J
MAILING ADDRESS d L\ 5 \ ~ 6../\.~
~\-,~-2;5~
, ,
~-
APPLICANT NAME
MAILING ADDRESS
PHONE NUMBER
PROPERTY OWNERS
PHONE NUMBER
CITY OF CLEARWATER
PETITION FOR ANNEXATION
PLANNING DEPARTMENT
MUNICIPAL SERVICES BUILDING, 100 SOUTH MYRTLE A VENUE, 2nd FLOOR
PHONE (727)-562-4567 FAX (727) 562-4576
dW ~/~
CJ2wt n 3m
FAXNUMBER I~l -lq \ -olo51\
PROPOSED DEVELOPMENT INFORMATION
LOCATION \ ~ \ \0 L \ Ctljf~ 1)r\ ~ tV (!JluJ I P\ 33755
I
STREET ADDRESS
LEGAL DESCRIPTION
PARCEL NUMBER
EXISTING CATEGORIES
st~'\~ \-\-~~\,\--~ B~U{}z. A in, 7
jD-U-/..)- r~~\::O(}l 00-:10
f2-rvx ~1uJ LAND USE fL~ c&rcb a.f
fLu \ J &tb r-t. LAND USE lle-1l dJ!l1 fu~
ZONING
PROPOSED CATEGORIES ZONING
EXISTING USE AND SIZE
PROPOSED USE AND SIZE
SIZE OF SITE
(number of dwellmg umts, hotel rooms or square footage of nonresldenllal use)
(number of dwelling umts hotel rooms aT square footage of nonresldenllal use)
~S- j.. I () .5
I (we), the underSigned, acknowledge that all
representations made In thiS application
are true and accurate to the best of my
knowledge
STATE OF FLORIDA, COUNTY OF PINELLAS
Sworn to and subscnbed before me thiS \ I day of
~ ' AD, t;e,-UNo to me dlo,
b ..:::J1lrN..e c... L...--e 1..() 6..-.+e. iZ$::. ,who I ersonal1y)
k own has produced
I lfi atl
fttJ
Signature of property owner or representative
my commiSSion expire
MICHELE: T W1WAMs
MY CO
EXPIRES Ju~ 31, 2010
BOIlII'ed ThJ\i ~!ary Public lJnderwritllrs
Annexation (ANX) Petltlon and Disclosure Statement docPage 3 of 4
,
,
~
CITY OF CLEARW A TER
PETITION FOR ANNEXATION
DISCLOSURE STATEMENT
PLANNING DEPARTMENT
MUNICIPAL SERVICES BUILDING, 100 SOUTH MYRTLE A VENUE, 2nd FLOOR
PHONE (727)-562-4567 FAX (727) 562-4576
PROPERTY OWNER NAME ~
ADDRESS r d. \ l.o c... \ u \ Q..L
PHONE NUMBER
PHONE NUMBER tJ-l- ~ .-35YJ FAX NUMBER 1;,2 '7 - 7'f I ,-6(0
ANY OTHER PERSONS HAVING A Y OWNERSHIP INTEREST IN THE SUBJECT PROPERTY
NAME
INTEREST IS
SPECIFIC INTEREST HELD
DOES A CONTRACT EXIST FOR THE SALE OF THE SUBJECT PROPERTY? YES
CONTRACT IS
ALL PARTIES TO CONTRACT
NAME
NAME
ARE THERE ANY OPTIONS TO PURCHASE SUBJECT PROPERTY? YES
LIST ALL PARTIES TO OPTION
NAME
NAME
REPRESENTATIVE(S) NAME
ADDRESS
01, sS-
LIEN HOLDER(S) NAME
NO
(i.411W' ~
A I J '96f<.. I :.....'"'-'
I (we), the undersIgned, acknowledge that alt
representations made rn thiS application
are true and accurate to the best of my
knowledge
STATE OF FLORIDA, COUNTY OF PINELLAS
Swom to and s scribed before me thiS ( I day of
~I ,AD,1~ril'O~
by ~ Xxte ' who personally
known as produced
Identification
/) ?v1:!{A$-v
Signature of property owner or representative
~j~
,'~r,.\"""', MICHELE T W1WAMS
t:~' A ~ MY COMMISSION' DO 552269
~ ~..:f,~ EXPIRES July 31, 2010
"J.;r, . W~ Bonded T11nI NotaIy P\Jbnc lII1d.rwrtte~
Annexation (ANX) Petition and Disclosure Statement docPa
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Fidelity National Title Insurance Company
Of Pennsylvama
TITLE AFFIDAVIT
STATE OF FLORIDA
( To be executed by Seller (or Mortgagor II no sale Involved) ]
FilE NO 9551393-/1W
COUNTY OF PINELLAS
Before me, the undersigned authority, personally appeared WILLIE /1. BREWTON AND ROSE 11. BREWTON,
HIS WIFE
who, being duly sworn accordmg to law, deposes and says as follows (as used m this Affidavit, the term "Affiant" shalllllclude
all parties executing this Affidavit)
2
That AffIant Is the owner of, and
a Has agreed to sell to JA11ES LEE WATERS
b Will execute a mortgage to A vr.n fi"TIV AlVrT lJ. T. .<:;F.TW TrF....
the following descrIbed property m the County of PTIVF:T,T.lJ." , State of "'T.
LOT 7 IN BLOCK A OF STEVENSON'S HEIGHTS, ACCORDING TO THE PLAT THEREOF, AS
RECORDED IN PLAT BOOK 34, ON PAGE 13, OF THE PUBLIC RECORDS OF PINELLAS COUNTY,
1l1i61FAlI?8'nt has been In full, continuous, open, exclusive, peaceable and undisputed possessIon of sard property since
the time of vestmg of title to said property in Affiant, that there are no parties who have any Interest or ng ht to claim an
Interest In said property other than Affiant, and that there are no facts known to Affiant which could give rise to a claim
being asserted against said property, except
or
encumbenng,
3
NONE
That, other than as shown In Item 1, Affiant has not entered mlo any agreement, contract, commitment or option for the
sale, lease or mortgage of the property, or any agreement, contract, commitment or option whIch otherwise affects
said property, except
NONE
That there are no taxes, liens or assessments which are due or about to become due or which have attached or could
attach to said property, except
Taxes accru~ng subsequent to the current year.
4
5 That Affiant IS a cltrzen of the United States, of legal age, under no legal disabilities and has never been lmown by any name
other than as shown above
6 Mantal status (check appropriate box)
Wx a That Affiant IS mamed, has been contlnously married dUring the enUre term of the ownership of said property,
has never been divorced and has not entered In any separation agreement or property seUlement agreement
o b That Affiant is not married and has never been married during the time of ownership of said property
7 That, If tItle to said property IS bemg held by a corporatIon, partnership or trust, such corporatlon, partnership or trust is In
good standing under applicable laws and the contemplated sale or mortgage of said property by said entity IS pursuant to
proper authority
8 That there are no actions or proceedings now pending in any State or Federal Court to which the Affiant IS a party including,
but not limited to, proceedings in bankruptcy, receivership or insolvency, except
NONE
9 That there are no Judgments, mortgages, encumbrances or liens of any nature affectlng said property, except
NONE
10 That there have been no Improvements, repairs, additions or alterations pelformed upon said property wlthm the past
90 days That Affiant has not entered Into any agreement or contract wllh any party for the
furnishings of any labor, services or matenalln connection With any Improvements, repairs, addltfons or alterations
within the referenced time period, and that there are no parties who have any claim or right to a lien for services, labor
or matenal In connection with any Improvements, repairs, addItions or alterations to saId property
11 That, to the knowledge of Afflant, the commitment of Fidelity National Tille Insurance Company under N0.9551393
correctly and accurately reflects the status of the title to said property
Affiant recognizes that Fidelity National TItle Insurance Company Will rely on the statements In this AffidaVit and
AffIant makes thiS Affidavit for the purpose of Inducing Fidelity National Title Insurance Company to issue Its polley or
policies of title Insurance In the above referenced transaction
SWORN TO AND SUBSCRIBED before me
this
15
day
t)~ >>?#q/lj~t
o
WILLIE M. BREWTON
r--~-- h_ - ROSE /1. BREWTON/Z L-.r.:r'1, r d~~" I.C
,\"'(1 , ,,-, ;~--1--;--------' ~gb /f/I ~k~L/~
~ ,; . " " " I.' , I
F~ II" ',I)", ,L 1',;" t 'I "',","l
____ -. ~------.:\ ) j t ~j I J lU
- --- ~_J
NOTE IF THIS AFFIDAVIT DOES NOT PROVIDE SUFFICIENT SPACE TO COMPLETE ANY OF THE ABOVE ITEMS, SAID
ITEMS SHOULD BE SET FORTH IN THEIR ENTIRETY ON A SCHEDULE WHICH IS ATTACHED TO THIS AFFIDAVIT
AND WHICH IS INITIALED AND DATED BY THE AFFIANT
,
/
~
My commISSion expires
TAX PRORATION AGREEMENT
ATIC#- 9551393-MW
CLOSING DATE:
November 15, 1995
PROPERTY: 1216 CLAIRE DR.
CLEARWATER, FL
LENDER: AVCO FINANCIAL SERVICES
N.
34615
We, the unders~gned buyers and sellers of the above descr~bed property hereby
acknowledge that a pror~~on of the real estate taxes has been made and appears on
the c1os~ng statement.
We furcher acknowledge that such prorat~ons have been based on the besc ava~lable
~nformat~on w~thout benef~t of the tax b~ll or property assessment for the current
year.
If further adjustments or prorat~ons are requ~red after the ~ssuance of the current
year's tax bill, same will be made by us. We hereby agree to hold F~del~ty Nat~onal
T~tle Insurance Company harmless for any change ~n the taxes, the prorat~ons, or the
payoff thereof.
Basis for Prorat~ons $0.00.
FURTHER ASSURANCE AGREEMENT
For and ~n cons~derat~on of the Lender th~s date funding the clos~ng of ~ts loan
and/or C1os~ng Agent d~sburs~ng proceeds of th~s sale and/or loan, the unders~gned do
mutually agree to cooperate, adjust, ~n~tial, reexecute and rede1~ver any clos~ng
documents deemed necessary or des~rab1e ~n the reasonable d~scret~on of Lender and/or
C1os~ng Agent. It ~s the ~ncent~on of che undersigned chat all documentat~on for
th~s transact~on and all payments or d~sbursements made shall be an accurate
reflect~on of the part~es' agreement; that each party should pay all coscs and
expenses contemplated by che~r agreemenc and/or d~ctates by custom and usage ~n this
area; and that Clos~ng Agent shall be rel~eved of che burdens of section 697.10 F.B.
by th~s assurance.
The unders~gned do hereby so agree and consent to assure that th~s transact~on and
~ts documentat~on w~ll conform to the part~es agreemenc and/or the Lender's
requ~rements and ~t ~s understood chat Lender and Clos~ng Agent w~ll rely upon th~s
agreement and the covenants here~n ~n clos~ng this transact~on.
Sellers:
)~ -<' ~ flu. );,2 Jd /L(!.{Jd~
WILLIE M. BREWTON
;r;; / ~ 777, v5?/"'";;t;, .I
ROSE N. BREWTON
The forego~ng ~nstrument was acknowledged
November ,1995 by the above sellers.
My Comm~ssion Exp~res:
[~~ r -- -~~ -;~,- l ~ ; \, - , ,,_
, f"t'" t ~ .-
1: / ..,: t I r .... L ....L
j ~ ' :' ',' ~" I, "'<1LI
_~_.l__ _~_ ~~..:_~l_ ___J
s~gned, sealed and de1~vered
~n the presence of:
Buvers:
(ld1l'h
FES L
w,wi~~
ATERS
The forego~g ~nstrument was acknowledged
November ,1995 by the above Buyers.
before me th~s 15
~ NOTARY
day of
My Comm~ssion Exp~res:
PUBLIC
Fidelity National Title Insurance Co.
Proceeds from Real Estate Transactions as required by the Internal Revenue Service
Agent name and address
FIDELITY NATIONAL TITLE INS
2515 COUNTRYSIDE BLVD., SUITE C
CLEARWATER, FLORIDA
BRANCH #:08-19352
Substitute Form 1 099-8
lax IdenllficatlOn number
23-1290668
T]I1S IS Important tax mformatlOn and IS bemg rUrlllshed to the Intemnl Revenue
SeIVIce, as required by sectlOn 1521 of the I ax Reform Act of 1986 If you arL
reqlllred to file a return, a negligence penalty or olher sanction ,,~H be unposed If
tJus Income IS wable and the IRS detennmes lhat IS has not been reported
TYPE OR MACHINE PRINT ONLY
1 Escrow Number 9551393
<If none, use date of c10smg & sellers last name - Example Ol0393smlth)
2 Date of clos1l1g November 15, 1995
Month/Day/Year
PROPERTY ADDRESS - SEE SIDE 2 FOR EXAMPLES
3
1216 CLAIRE DR. N.
Street Address (For vacant land see Side 2)
102915854460010070
Accessors Parcel Number (APN)
Slate
34615
ZIp
AC<;t:ssors Parcel Number (AI'N)
CLEARWATER
Clly (If none, hst county)
FL
PROCEEDS FOR THIS SALE WENT TO: (MULTIPLE SELLERS-Use one form (or each seller Treat husband and Wife
as one seller (fl.hngjoint tax returns) unless requested otherwise, lhan separate forms must be used)
See side 2 before completing _
4a WILLIE M. BREWTON /A /~QL )1"2, )ij,~f1L~>/L I ). & L/ - :3 ~ -q 7:):J..
Sl:llers Name (first, MI, Last) rederal Tax ID for thIS seller
b ICDSe (YJ, gee~J7U0
Spouse or Personal RepresentatIVe (FOR INFORMATION PURPOSES ONLY)
I ~&:<- Slf~ '-11 5 S
Spouse Federal Tax 10 (opllonal)
TOTAL CONSIDERATION
(SEE SIDE 2 TO CALCULATE)
5 Tax Credit to Seller $
8 $
18,430.00
Total Conslderallon
6D
7[]
Exchange (I f checked)
9
$
Gross Allocated Proceeds
Check here If the ml>>amum determmable
proceeds cannot be detcrmmed WIth certamly
MAIUNG ADD~ .
10 Iliff ~O
Sire/! L
C-A d/?1,,--"'/lb'f
Q~ I
o<:2t-€-
qf
State
~hcre If the address
IS outsIde of the U SA
31(&1&
ZIp
I hereby certify, under penalty of perjury, that I have read the above information and It IS true and correct
~~k
1%~/.5)1BllI15195
Date
T'"'/!1tnatJJre
, ~
Spouse
7kY~~
/ ~--I
,
/-Y 9 S
Date
CE-1l5 (JonlU'') 1993)
Side 1