PLT2005-00024
CITY OF CLEARWATER
DEVELOPMENT & NEIGHBORHOOD SERVICES
REFUND REQUEST FORM
CASE NUMBER:
p
TYPE OF FEE (S):
Lff\
TOTAL AMOUNT OF
REFUND:
REAsON FeR REFUND:
, ,
$
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NAME _OF.CUSTOMER c
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REQbEstJNG -REFqNi>:~ - / ~ ,
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_ _',', _"' _ _ PIJ9NE:'
CITY STAFF MEMBER '
REQUESTINQ :REFUND:
. WE CAN ONLY MAIL T IS REFUN TO HE PERSON WHO WROTE THE
ORIGINAL CHECK PLEASE GIVE THE ADDRESS YOU WOULD LIKE THE
CHECK TO BE MAILED TO BELOW
?6QYI\[)a~
-----
STAFF NOTES:
REFUND APPROVED BY: (lA-v( ~~
Please attach any additional documents as needed.
Authorization For Disbursement
Date 9/29/2005
Time 1 18 PM
Vendor/Payee name Canterbury Oaks of Clearwater
2nd line vendor/payee name 2002 W Cleveland Street
Rem It to Street / PO Box Tampa, FL 33606
Remit to City, State, Zip Code
Purchase orders are required for payments In excess of $2,500
Purchase Orders are reqUired If prior year payments or expected payments have or will exceed $2,500
PO NUMBER (If required) RELEASE # RECEIPT #
Provide a description or reason for this expense
Application for Plat, unable to process refund $60000 on PL T 2005-00024
If you are chargmg more than one account please
provide additional descnptlon for each account CHARGE TO ACCOUNT # AMOUNT TO CHARGE
1 PL T2005-00024 010-341240 600 00
2 000
3 000
4 000
5 000
6 000
7 000
8 000
9 000
10 000
11 000
12 000
13 000
14 000
15 000
16 000
I Grand Total I $600001
J, Full Signature J, of person authorized to Sign Purchase Order Receiver Copy
Print Name and Tille of person Signing -+ l\Je\ I '\\, ~.-,." (j~?~ l\ev" (\&,0 f1rd
Pnnt thiS form and attach the anginal document(s) that validate the amount tau are requesting paymentJfor- Attach
any caples that must be sent With the check Improperly completed forms will delay check request
Please explam below If you are requestmg the Finance Department not to mall check to the vendor
Create11 by W M I edder
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Authorization For Disbursement
Dale 9/29/2005
Tlme119PM
(,
J
Vendor/Payee name Canterbury Oaks of Clearwater
2nd line vendor/payee name 2002 W Cleveland Street
Remit to Street / PO Box Tampa, FL 33606
Remit to City, State, Zip Code
Purchase orders are required for payments m excess of $2,500
Purchase Orders are required If prior year payments or expected payments have or will exceed $2,500
PO NUMBER (If required) RELEASE # RECEIPT #
Provide a descnptlon or reason for this expense
Application for Plat, unable to process refund $600 00 on PL T 2005-00024
If you are chargmg more than one account please
provide additional descnptlon for each account CHARGE TO ACCOUNT # AMOUNT TO CHARGE
1 PL T2005-00024 010-341240 600 00
2 000
3 000
4 000
5 000
6 000
7 000
8 000
9 000
10 000
11 000
12 000
13 000
14 000
15 000
16 000
I Grand Total I $600 001
J, Full Signature J.. of person authorized to sign Purchase 0rder Receiver Copy
Print Name and Title of person slgnmg ~
Print this form and attach the anginal document(s) that validate the amount you are requesting payment for Attach
any copies that must be sent with the check Improperly completed forms will delay check request
Please explam below If you are requesting the Fmance Department not to mall check to the vendor
Created by W M Tedder
ell:.' Clprk OoI:\Jmenl # oiJS21-(l002
Keyed
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ORIGINAL
PL T2005-00024
525 S HERCULES AVE
Date Received: 08/25/2005
CANTERBERRY OAKS
ZONING DISTRICT: 0
LAND USE: RlOG
ATLAS PAGE: 298B
PLANNER OF RECORD: NOT ENTERED
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PROPERTY OWNER S NAME
ADDRESS
PHONE NUMBER
* APPLICANT'S NAME
ADDRESS
PHONE NUMBER
AGENT NAME
ADDRESS
PHONE NUMBER
ORIGINAL
CITY OF CLEARWATER
APPLICATION FOR PLAT APPROVAL
PLANNING DEPARTMENT
MUNICIPAL SERV1CES BUILDING, 100 SOUTH MYRTLE AVENUE znd FLOOR
PHONE (727)-562-4567 FAX (727) 562-4865
cu?(ert:r~ C&..-0 ~ C krw~~" G
c:2_0Qd~~CZC---LE ve.Loa..rL_L__~-:?::;L2':!!.__/- ~_J 6"06'
6'/3 -2:)3 - C?O~ <:/ FAX NUMBER ?/ 3- _2.r 3- -5 Pc> 7'
r1s 0.60 u (?
FAX NUMBER
FAX NUMBER
I, Ihe undersigned, acknowledge that all
representations made In thiS application
are true and accurate to the best of my
knowledge /.
byJ~ Co ,......"'-";-Yvho IS personally
~~
Signature of owner or representative
STATE OF FLORIDA, COUNTY OF PINELLAS
S)forn to a9~ subscribed before me thiS }~ day of
~'..~.i!~.LL____, AD, 't9::.__ to me and/or
.,.)OcJS
C &1- If..;, _ &( - J$;
o
known to
Notary Public
my commission expires
RICHARD DEGAS 0 II
M'f COMMISSION #OD 50052
. 07
Bo nded through Advantage Notary
Fourteen (14) copies of the prehmlnary plat must be submitted
-*
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re,~~s
The preliminary plat shall be prepared by a surveyor, architect, landscape archItect or engmeer drawn to a scale
not smaller than 1 100 and shall not exceed 24" X 36" and Include the follOWing informatIOn
NORTH ARROW, SCALE AND DATE,/
TITLE UNDER WHICH THE PROPOSED PlAT IS TO BE RECORDED, /
NAME, ADDRESS AND TELEPHONE NUMBER OF THE PERSON PREPARING THE PLAT /
IDENTIFICATION CLEARLY STATING THAT THE DRAWING IS A PREliMINARY PLAT
LEGAL DESCRIPTION OF THE PROPERTY WITH U S SURVEY SECTION, TOWNSHIP AND RANGE LINES, /
~ PROPOSED SlREEr NAMES, ,/
n- IHig [E 0 W ~ [If!1
AUG 2 6 2005 I! q
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--I"C.d
...}.., ~
~ EXISTING AND PROPOSED RIGffTS.OF-WA Y AND EASEMENTS
/
PLANl\
ul (L.
- ,
~ NAMES, APPROPRlATEL Y POSITlONED OF ADJOINING PLATS,
~;J.. S- - S- 7 -S- S'
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~rc.-~.s Pagel ~n......e.......
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~
o DIMENSIONS AND ,AA~F THE FOLLOWING
THEbVERAL~ AND EACH LOT'
STREETS- .
RIGKT5-0F-WAY, INCLUDING RADII OF CUL-DE-SACS,
COMMON OPEN SPACE OR OTHER LAND TO BE DEDICATED FOR A PUBLIC PURPOSE IF ANY
OR\G\NAL
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Page 2
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ORIGINAL
REAL ESTATE AOVISORS
,\
Mr Don Malone
City of Clearwater Englneenng Department
100 S Myrtle Avenue, Ste 210
Clearwater, FL 33756
August 23, 2005
Re Canterbury Oaks Office Park, 525 - 575 Hercules Ave, CleOlwafer, FL
Dear Don,
Further to our conversation yesterday, please find enclosed the Application for
Preliminary Plat Approval for the above property together With 14 copies of the
preliminary plat and a check In the sum of $600 payable to the City of Clearwater
The fee Simple Interest In the IndiVidual bUildings (or portion of bUilding as shown on the
plat) Will be sold to IndiVidual owners who Will become members of the condominium
asSOCiation The common areas will eventually be owned by the association
If you have any questions or reqUire any further Information please do not heSitate to
contact me
Thank you very much for your help In thiS matter
Sincerely,
(ig fE 0 \VI i~~ rn
--.-l
Al'6 2 6 2116 ~..1
! PLAN~~Wf1~SV~
Julie E Corrance
Vice President
Cc Scott Rice - City of Clearwater Engineering Department
Bryan J Stanley, P A
2002 W Cleveland St
SUite 100
Tampa FL 33606
Tel 813-253-0020
Fax 813-253-3809
ajcuervo@cuervorealestote com