APPLICATION TO CONSTRUCT A DOCK
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1 APPLICATION TO CONSTRUCT A DOCK (In Accordance with Orange County Code Chapter 15, Article IX, Orange County Code) Mail or Orange County Environmental Protection Division Deliver To: 800 Mercy Drive, Suite 4 Orlando, Florida (407) , Fax (407) **Filing fee of $ payable to The Board of County Commissioners** **Process fee for Appeals and Variances: $409.00** SECTION 1 OWNER(S) OF THE LAND Name: Title and Company: Address: City: State: Zip: Telephone and Fax: ENTITY TO RECEIVE PERMIT (IF OTHER THAN OWNER) Name: Title and Company: Address: City: State: Zip: Telephone and Fax: AGENT/CONSULTANT AUTHORIZED TO SECURE PERMIT Name: Title and Company: Address: City: State: Zip: Telephone and Fax: CONTRACTOR (IF DIFFERENT FROM AGENT) Name: Title and Company: Address: City: State: Zip: Telephone and Fax: Revised Page 1 of 5
2 SECTION 2 - GENERAL INFORMATION Street Address: Tax Parcel ID Legal Description: Name of water body: Normal High Water Elevation (NHWE): msl Is the proposed dock? Please check one: Private Semi-Private Public What is the width of the shoreline (in linear feet), as measured at the NHWE? feet. What is the size of proposed terminal platform? square feet. [See Chapter 15; Article IX; Section (b)] Are you requesting a variance? Yes No Are you requesting a waiver? Yes No If yes, provide section Number: 15- (example: ) and describe the nature of the variance and/or waiver request: Note applications for a waiver and/or variance from the boat dock ordinance will require the completion of a separate waiver and/or variance application and may require additional fees. If you have questions, please call EPD for assistance. Brief Description of proposed work: Are there docks on the abutting properties? Yes No Are there any access restrictions to the property (locked gate/loose dogs): REQUIRED ATTACHMENT(S) CHECKLIST: Satisfactory evidence of title. (Example: copy of property deed). Documentation showing riparian rights for the parcel. A copy of a survey, to scale, of the real property which accurately depicts current conditions. Four (4) copies of a site plan depicting the exact location of the proposed dock, and shall include the following: An arrow indicating the northerly direction of the scale to which the sketch or drawing was prepared. The name of the water body upon which the proposed dock structure or renovation is to be located. The exact distance between the shoreline and a permanent object or construction. The exact setback distance from adjacent property lines and projected property lines to all portions of the dock. The floor and roof elevations of the proposed or existing dock. The current water depth at the end of the proposed or existing dock, and at all proposed mooring locations. The length of the proposed or existing dock, as measured from the NHWE to the point most waterward of the NHWE. Revised Page 2 of 5
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5 SECTION 3 Name and Address of adjacent property owners: Name: Address: City: State Zip Name: Address: City: State Zip NOTICE TO APPLICANTS: The proposed dock structure may require a permit from either the Florida Department of Environmental Protection or the applicable Water Management District. In addition to public regulations which Orange County enforces, be advised that there may be other private restrictions or approval requirements that will affect your ability to erect this structure. Please review your deed restrictions and/or consult with your Homeowner s Association or Architectural Review Board. Revised Page 4 of 5
6 APPLICATION TO CONSTRUCT A BOAT DOCK APPLICATION FOR WAIVER (Pursuant to Orange County Code, Chapter 15, Article IX, Section (a)(2)) Mail or Orange County Environmental Protection Division Deliver To: 800 Mercy Drive, Suite 4 Orlando, Florida (407) , Fax (407) I on behalf of (if applicable) pursuant to Orange County Code Chapter 15, Article IX, Section (a)(2) am requesting a waiver to section (choose and circle from the following: (b), (b), (a) and (a)) of the Orange County Dock Construction Ordinance. 1. Describe how this waiver would not negatively impact the environment: 2. Describe the effect of the proposed waiver on abutting shoreline owners: The environmental protection officer and the board may require of the applicant information necessary to carry out the purposes of this article. By signing and submitting this application form, I am applying for a waiver to the Section indicated of the Orange County Dock Construction Ordinance identified above, according to the supporting data and other incidental information filed with this application. I am familiar with the information contained in this application, and represent that such information is true, complete, and accurate. I understand this is an application and not a permit, and that work conducted prior to approval is a violation. I understand that this application and any permit issued pursuant thereto, does not relieve me of any obligation for obtaining any other required federal, state, or local permits prior to commencement of construction. I understand that knowingly making any false statements or representation in this application is a violation of Sections & , Orange County Code. Name of Applicant: Signature of Applicant/Agent Date: Corporate Title (if applicable): Application for Boat Dock Waiver Rev
7 AfterRecording Returnto: MarkBennett DOC# 20 First Service Title offlorida, LLC / : LeeRoad Șuite405 Deed Do 8.5g Page WinterPark,FL ThisInstrument Prepared by: Pl speag MarkBennett p05an0 First Service Title offlorida, LLC 6 Countyni To: ComPtroller #IRST SER 2699LeeRoad Șuite405 1 VICE TITLE OF FL WinterPark,FL32789 I asa necessary incident tothefulfillment ofconditions contained ina title insurance commitment issuedbyit. PropertyAppraisersParcelI.D.(Folio)Number(s): FileNo.: WARRANTY DEED This Warranty Deed, Made the 15thday ofapril,2014, by Edward Tyler Simpson and Marcia Lynn Swenson, individuallyand CO-Trustees of the Ed Simpson and Lynn Swenson Revocable Trust, Dated July 9,2010, as husband and wife,whose postofficeaddress is:506 LillianDrive,Orlando, FL 32806, hereinafter calledthe"grantor"țocharles J. Blakleyand Jessica L. Blakley,as husband and wife,whose post officeaddress is: 506 LillianDrive,Orlando, FL 32806, hereinaftercalledthe "Grantee". WITNESSETH: Thousand That saidgrantor,forand inconsideration ofthesum offour Hundred Eighty Dollarsand No Cents ($480,000.00)and othervaluableconsiderations, receiptwhereof is herebyacknowledged,herebygrants,bargainsșells,aliens,remises,releases,conveys and confirms untothegrantee,allthatcertainlandsituateinorange County,Floridațowit: SEE EXHIBIT "A"ATTACHED HERETO The propertyisthehomestead ofthegrantor(s). TOGETHER withallthe tenements,hereditamentsand appurtenancestheretobelongingor in anywise appertaining. To Have and to Hold,thesame infeesimpleforever. And thegrantorherebycovenantswithsaidgranteethatthegrantoris lawfully seizedofsaidlandinfee simple;thatthegrantorhas good right and lawfulauthoritytoselland convey saidland;thatthegrantor hereby fullywarrantsthe titleto said land and willdefend the same againstthe lawfulclaimsof all personswhomsoever; and thatsaidlandisfreeofallencumbrances, excepttaxesaccruingsubsequent to2013, reservations, restrictions and easements ofrecord,ifany. (Theterms"Grantor" and"grantee" hereinshall beconstrued toinclude allgendersandsingular orplural asthecontext indicates.) IN WITNESS WHEREOF, Grantorhas hereuntoset Grantor'shand and sealthe day and year first above written. SiGNEDINTHE PRESENCE OF THE FOLLOWING WITNESSES TWO SEPARATE DISINTER ITNESSES REQUIRED Witness Signature: EDWARD TYLER SIMPSON RCIA LYNN PrintedName: SWENSON, INDIVIDUAL AND C -TRUSTEES OF THE IMPSON D LY SWENSON REV E T AT JULY 9,2010 %#ard Tyl son / indivduall n -Truste Marcia Lynn Swenson individually and CO-Trustee WitnessSignature PrintedName: StateofFlorida County oforange The foregoinginstrumentwas acknowledged beforeme this15thday ofapril,2014 by Edward Tyler Simpson and MarciaLynn Swenson, individually and CO-TrusteesoftheEd Simpson and Lynn Swenson RevocableTrust,Dated July9,2010, as husband and wife,who is/are personally known tome orhas/ have pr ce license(s) as identification. My Commission Expires: NotaryPublicSign ure ( PrintedName arkbennett
8 EXHIBIT "A" LEGAL DESCRIPTION Lot46,The Lillian Barnum Sub-division, accordingtotheplatthereof,recordedinplatbook "M",Page 99 ofthe PublicRecords oforange County,Florida,and beginatthesouthwestcornerofsaidlot46,the Lillian Barnum Sub-division, as recordedinplatbook "M",Page 99,ofthe PublicRecords oforange County,Florida;runSouth 5 Chains from saidpointofbeginningintolake JennieJewel,runthenceEast inwatersoflake JennieJewel 75 feet;thencerun North5 Chains tothesoutheastcornerofsaidlot46, The Lillian Barnum Sub-division; thencewest alongthesouth lineofsaidlot46,a distanceof75 feetto thepointofbeginning;beingpartoflot16,allotmentofthe Randolph Lands FortGatlin,as recordedin PlatBook "C",Page 58,ofthe PublicRecords oforange County,Florida.
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11 2.0'± 0.6'± 1.8'± 15.0' 0.8'± 5.3' 18.2' 2.7'± 12.4' 44.4' 15.1' 4' 4.0' 90.2' 90.0' 0.3'± NOTES: 1. THIS SURVEY WAS PREPARED FROM TITLE INFORMATION FURNISHED TO THIS SURVEYOR. THERE MAY BE OTHER RESTRICTIONS OR UNRECORDED EASEMENTS THAT AFFECT THIS PROPERTY. PROPERTIES ARE SUBJECT TO COVENANTS, RESTRICTIONS, EASEMENTS AND SETBACKS OF RECORD. 2. NO UNDERGROUND IMPROVEMENTS HAVE BEEN LOCATED UNLESS OTHERWISE SHOWN. SEPTIC IF SHOWN IS +/-. 3. THIS SURVEY IS PREPARED FOR THE SOLE BENEFIT OF THOSE CERTIFIED TO AND SHOULD NOT BE RELIED UPON OR USED BY ANY OTHER ENTITY. 4. DIMENSIONS SHOWN FOR THE LOCATION OF IMPROVEMENTS HEREON SHOULD NOT BE USED TO RECONSTRUCT BOUNDARY LINES. BOUNDARY BEARINGS AND DISTANCES ARE SHOWN AS PLATTED UNLESS DENOTED AS MEASURED. 5. BEARINGS ARE BASED ON ASSUMED DATUM AND ON THE LINE SHOWN AS BASE BEARING (BB). 6. PROPERTY HEREON LOCATED IN ZONE " X & AE " PER F.I.R.M. MAP PANEL NO C 0430 F DATED RESIDENCE HEREON LOCATED IN ZONE " X " PER F.I.R.M. MAP PANEL NO C 0430 F DATED BUILDING LINES SHOWN, REPRESENT BUILDING WALLS. EAVES, IF ANY, NOT LOCATED OR SHOWN. Boundary And Mapping Associates, Inc. 109 WEST ORANGE STREET ALTAMONTE SPRINGS, FL PH. (407) LAND SURVEYORS LB 4565 DESCRIPTION: Lot 46, The Lillian Barnum Sub-division, according to the plat thereof, recorded in Plat Book "M", Page 99 of the Public Records of Orange County, Florida, and begin at the Southwest corner of said Lot 46, The Lillian Barnum Subdivision, as recorded in Plat Book "M", Page 99, of the Public Records of Orange County, Florida; run South 5 Chains from said point of beginning into Lake Jennie Jewel, run thence East in waters of Lake Jennie Jewel 75 feet; thence run North 5 Chains to the Southeast corner of said Lot 46, The Lillian Barnum Sub-division; thence west along the South line of said Lot 46, a distance of 75 feet to the point of beginning; being part of Lot 16, allotment of the Randolph Lands Fort Gatlin, as recorded in Plat Book "C", Page 58, of the Public Records of Orange County, Florida R E G I S T E R E D CERTI R O D N E Y 25' This is a digitally signed and sealed drawing of a boundary survey performed under the direction of the undersigned. Six copies are authorized on or about the date of the survey shown hereon and certified only to those persons and/or entities listed hereon The boundary survey meets the minimum techinal standards as set forth by the Florida Board of Professional Surveyors and Mappers in Chapter 5J-17 F.A.C. pursuant to section Florida statutes. RODNEY W. JACKSON, PSM 6281 Not valid without the signature and the original raised seal of a Florida licensed surveyor and mapper. JOB NO.: DATE: FIELD: SIGNED: DRAWN BY: RWJ P.C.: RP F L O S W FI U R CHECKED BY: RWJ I V J CATE No STATE OF R DA A C K S & E Y O R O N A P M E R P STREET R/W 75.00'(P) LOT 45 Column 1.4' Off 90 20'50''(M) 90 25'00"(P) S 0 20'50''W '(M) '(P) REC 2" I.P. NO # SW CORNER OF LOT '(D) EDGE OF PAVEMENT REC 1 1/4" I.P. NO # X X X X X X X X X X X X 0.7'± X X X X X X X X X X X X X X 20.4' 6.5' 6.2' 97'± (M) TO WATER N 90 00'00''W 75.16'(M) 75'(P) 20.6' 2.4' X CARPORT 2.4' 4.5' 1.7' 20.6' 2.3' 1.6' 20.4' 24.0' C/L LILLIAN DRIVE 14.4' 30.4' X 22.4' RESIDENCE # 506 SCREENED PATIO 23.0' 11.9' NORMAL HIGH WATER ELEVATION WOOD DECK STEPS COVERED PROPOSED DOCK BLOCK WALL W/COLUMNS LOT 46 AC AC METAL SHED NO CONCRETE 75.09'(M) 75'(D) APPROXIMATE EDGE OF WATER ' 7.6' 5.5' 10.5' 80''± (M) TO WATER X X X X X X X X X X X X X X X X X X X X X X X X X X X 89 38'10''(M) 89 35'00"(P) 22.1' 21.6' LAKE JENNIE JEWEL Part of Lot 16, Allotment of the Randolph Lands Fort Gatlin, 75'(D) S. LINE LOT ' P.P. REC 1 1/4" I.P. NO # N 0 21'50''E '(M) '(P) 25' REC 2" I.P. NO # SE CORNER OF LOT '(D) LOT 47 Property Address: 506 LILLIAN DRIVE SCALE 1" = 40' CERTIFIED TO: CHARLES J. BLAKLEY AND JESSICA L. BLAKLEY TRUSTCO BANK FIRST SERVICE TITLE OF FLORIDA, LLC STEWART TITLE GUARANTY COMPANY LEGEND Add distance from Dock To Line: ORDERED BY: First Service Title of Florida 1755 W Broadway St Oviedo, FL Phone: (407) CONCRETE PAVERS / REC. - RECOVERED BRICK I.P. - IRON PIPE PRC- POINT OF REVERSE CURVE I.C. - ILLEGIBLE CAP # R.P. - RADIUS POINT C.M. - CONCRETE MONUMENT R - RADIUS RB - REBAR L - LENGTH OF ARC RAD. - RADIAL S.E. - SIDEWALK EASEMENT N.R. - NOT RADIAL U.E.- UTILITY EASEMENT N&D - NAIL & DISC D.E.- DRAINAGE EASEMENT (P) - PER PLAT L.E.- LANDSCAPE EASEMENT (M) - AS MEASURED P.E.- POOL EQUIPMENT (D) - PER DESCRIPTION P.P.- POWER POLE O.L. - ON LINE X - CHAIN LINK / WIRE FENCE P.C. - POINT OF CURVATURE WOODEN FENCE P.T. - POINT OF TANGENCY - VINYL FENCE R/W - RIGHT-OF-WAY A - ALUMINUM FENCE
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