CITY OF NORTH PORT Neighborhood Development Services Planning Division Relocation of Easement Packet

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CITY OF NORTH PORT Neighborhood Development Services Planning Division Planninginfo@cityofnorthport.com Relocation of Easement Packet The following items are to be included in the submission: Relocation of Easement Application Affidavit(s) Relocation of Easement Checklist Relocation of Easement Fee Sheet *Note* Please be advised that each application is considered a separate petition and will be reviewed as such. Packets will not be processed if incomplete or missing requested information. If there is more than one property owner of the subject property, all owners must complete an affidavit.

CITY OF NORTH PORT Neighborhood Development Services Planning Division 4970 City Hall Boulevard North Port, FL 34286-4100 www.cityofnorthport.com Phone (941) 429-7156 DATE RECEIVED DATE STAMP RELOCATION OF EASEMENT APPLICATION Upon making any application to the City for any reason, the applicant agrees to comply with all the requirements of the Unified Land Development Code and further agrees to allow authorized city staff and personnel to enter and inspect the property during normal business hours Date Application Received: Accepted by: Project No: - - Above to Be Completed by Planning Staff P.P. Project Name: Name of Applicant: Name of Corporation/LLC (If Applicable): Street Address: City: State: Zip Code: Phone: FAX No. E-mail: Name of Property Owner: (if different from the applicant above) Street Address: City: State: Zip Code: Phone: FAX No. E-mail: Property Description: (Please list additional PID s on a separate sheet of paper) (Information can be found at http://www.scpa.com/testsearch/) Parcel I.D. No(s): 1. - - 2. - - Legal: Lot(s): Block: Addition: Tract or Parcel: Subdivision: Section: Township: Range: Acreage: Street Address: Page 1 of 2

Purpose of Application: Please briefly state what the intended use of the property will be or why you are making this application (e.g. general project description). Easement in use? Yes: No: Zoning District: (e.g. RSF, RTF, RMF, AG, ILW, CG, OPI, PCD): Existing land use (e.g., house, commercial structure, vacant): 11. Easements to be Relocated Lot: Lot Number Type: TR = Total Relocate, PR = Partial Relocate Construction: Please identify if the encroachment is the result of new construction (new) or a pre-existing condition (existing). If the encroachment is the result of a pre-existing condition, please provide the actual/estimated date of construction of the improvements. Relocate Type Construction Date Item(s) Encroaching into Easement Area Lot # Side Right Side Left Lot # Side Right Side Left Lot # Side Right Side Left *All of the information provided on this application is true and correct to the best of my knowledge. Signature of Applicant Date Print Applicant Name Page 2 of 2

AFFIDAVIT I (the undersigned), being first duly sworn, depose and say that I am the owner, attorney, attorney-in-fact, agent, lessee or representative of the owner(s) of the property described and which is the subject matter of the proposed hearing; that all answers to the questions in this application, and all sketches, data and other supplementary matter attached to and made a part of the application are honest and true to the best of my (our) knowledge and belief. I understand this application must be complete and accurate before the hearing can be advertised, and that I am authorized to sign the application by the owner or owners. I (we) authorize City staff to visit the site as necessary for proper review of this petition. If there are any special conditions such as locked gates, restricted hours, guard dogs, etc., please provide the name and telephone number of the individual who can allow access. Sworn and subscribed before me this day of, 20, Signature of Applicant or Authorized Agent Print Name and Title STATE OF, COUNTY OF The foregoing instrument was acknowledged by me this day of, 20, by who is personally known to me or has produced as identification, and who did/did not take an oath. Signature - Notary Public (Place Notary Seal Below) AFFIDAVIT AUTHORIZATION FOR AGENT/APPLICANT I (we),, property owner(s), hereby authorize to act as Agent/Applicant on our behalf to apply for this petition on the property described as (legal description) Signature of Owner Date STATE OF, COUNTY OF The foregoing instrument was acknowledged by me this day of, 20, by who is personally known to me or has produced as identification, and who did not take an oath. (Place Notary Seal Below) Signature - Notary Public

Checklist of Required Submittal Items: RELOCATION OF EASEMENT Exhibit A- Title Assurance/Current Deed for proof of ownership Exhibit B- Certification that Taxes and Assessments have been paid Exhibit C- Current Survey (2 copies) (A legal description and boundary survey signed and sealed by a registered land surveyor in the State of Florida.) Exhibit D- Survey of the proposed new location (2 copies) (A sketch and description of the new location of the easement together with an unexecuted grant of easement.)

CITY OF NORTH PORT Relocation of Easement Fee Sheet Property Location (Address): PID(s) #: Relocation of Easement Calculation Fees Total City Fee $100 Surveyor Review Fee (to be assessed after review) TOTAL -All fees should be made payable to the City of North Port. Fees must be paid prior to the processing of the submittal. -Applicant agrees to pay surveyor review fee before the release of documentation from the City for approval. -Applicant is responsible for all recording fees charged by Sarasota County. Please contact Planning Staff if you have any questions, 941.429.7156