List of Required Submittals Only complete applications will be accepted: The following items are optional, but strongly suggested:

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SUBDIVISION DECISION Application No. Included in this packet: Pre-Application Meeting Notes Application Affidavit to Authorize Agent Neighborhood Worksheet Public Participation Report Planning and Economic Development Department Development Review Services List of Required Submittals Only complete applications will be accepted: Completed application and narrative Pre-application Meeting Notes Affidavit to Authorize Agent, if Agent signs application Application fee payment (fee schedule on application) Public Participation Report (Not Required for Vacations) For Lot Refacing applications: documentation showing that the notice of the application and a request for a letter of consent were sent to the abutting property owners. 2 copies of Site Plan or Survey of the subject property: To scale on 8.5 x 11 or 11 x 17 paper North arrow Setbacks of structures to the property lines A Sketch and Legal Description of the subject area prepared by a licensed surveyor PDF of all above drawings (may be emailed to Staff Planner) The following items are optional, but strongly suggested: Neighborhood Worksheet Photographs of the subject property and structure(s) A Pre-Application Meeting is Required Prior to Submittal. To schedule, please call (727) 892-5498. City of St. Petersburg P.O. Box 2842 St. Petersburg, FL 33731-2842 (727) 893-7471 UPDATED: 09-10-15 Completeness review by city staff:

Pre-Application Meeting Notes Meeting Date: Address/Location: Type of Application: Staff Planner: Staff Contact Info: Neighborhood Association(s) Neighborhood Association President Name(s) & Contact Info Issues/Concerns: City of St. Petersburg One 4 th Street North PO Box 2842 St. Petersburg, FL 33731-2842 (727) 893-7471 www.stpete.org/ldr

Page 2 of 6 SUBDIVISION DECISION Application Application No. All applications are to be filled out completely and correctly. The application shall be submitted to the City of St. Petersburg s Development Review Services Division, located on the 1 st floor of the Municipal Services Building, One 4 th Street North. Application Type: Lot Line Adjustment Vacating Street Right-of-Way Per: 16.40.140 & Lot Split Vacating Alley Right-of-Way 16.70.050 Lot Refacing Vacating Walkway Right-of-Way Street Name Change Vacating Easement Street Closing Vacating Air Rights NAME of APPLICANT (Property Owner): City, State, Zip: Telephone No: NAME of AGENT or REPRESENTATIVE: City, State, Zip: Telephone No: PROPERTY INFORMATION: Street Address or General Location: Parcel ID#(s): DESCRIPTION OF REQUEST: GENERAL INFORMATION Email Address: Email Address: PRE-APPLICATION DATE: PLANNER: FEE SCHEDULE Lot Line & Lot Split Adjustment Administrative Review $200.00 Vacating Streets & Alleys $1,000.00 Lot Line & Lot Split Adjustment Commission Review $300.00 Vacating Walkway $400.00 Lot Refacing Administrative Review $300.00 Vacating Easements $500.00 Lot Refacing Commission Review $500.00 Vacating Air Rights $1,000.00 Variance with any of the above $200.00 Street Name Change $1,000.00 Street Closing $1,000.00 Cash, credit, and checks made payable to the City of St. Petersburg AUTHORIZATION City Staff and the designated Commission may visit the subject property during review of the requested variance. Any Code violations on the property that are noted during the inspections will be referred to the City s Codes Compliance Assistance Department. The applicant, by filing this application, agrees he or she will comply with the decision(s) regarding this application and conform to all conditions of approval. The applicant s signature affirms that all information contained within this application has been completed, and that the applicant understands that processing this application may involve substantial time and expense. Filing an application does not guarantee approval, and denial or withdrawal of an application does not result in remittance of the application fee. NOTE: IT IS INCUMBENT UPON THE APPLICANT TO SUBMIT CORRECT INFORMATION. ANY MISLEADING, DECEPTIVE, INCOMPLETE, OR INCORRECT INFORMATION MAY INVALIDATE YOUR APPROVAL. Signature of Owner/Agent: *Affidavit to Authorize Agent required, if signed by Agent. Date: Page 3 of 6

CITY OF ST. PETERSBURG PLANNING & ECONOMIC DEVELOPMENT DEPT. DEVELOPMENT REVIEW SERVICES DIVISION DEVELOPMENT REVIEW COMMISSION AFFIDAVIT TO AUTHORIZE AGENT I am (we are) the owner(s) and record title holder(s) of the property noted herein Property Owner s Name: This property constitutes the property for which the following request is made Property Address: Parcel ID Number: Request: The undersigned has(have) appointed and does(do) appoint the following agent(s) to execute any application(s) or other documentation necessary to effectuate such application(s) Agent s Name(s): This affidavit has been executed to induce the City of St. Petersburg, Florida, to consider and act on the above described property. I (we), the undersigned authority, hereby certify that the foregoing is true and correct. Signature (owner): Printed Name Sworn to and subscribed on this date Identification or personally known: Notary Signature: (Print): Commission Expiration (Stamp or date): Date: City of St. Petersburg One 4 th Street North PO Box 2842 St. Petersburg, FL 33731-2842 (727) 893-7471 www.stpete.org/ldr Page 4 of 6

NEIGHBORHOOD WORKSHEET Applicants are strongly encouraged to obtain signatures in support of the proposal(s) from owners of property adjacent to or otherwise affected by a particular request. NEIGHBORHOOD WORKSHEET Description of Request: Case No.: The undersigned adjacent property owners understand the nature of the applicant s request and do not object (attach additional sheets if necessary): 1. Affected Property Address: 2. Affected Property Address: 3. Affected Property Address: 4. Affected Property Address: 5. Affected Property Address: 6. Affected Property Address: 7. Affected Property Address: 8. Affected Property Address: Page 5 of 6

PUBLIC PARTICIPATION REPORT Application No. In accordance with LDR Section 16.70.040.1.F.2. It is the policy of the City to encourage applicants to meet with residents of the surrounding neighborhoods prior to filing an application for a permit requiring review and public hearing. The applicant, at his option, may elect to include neighborhood mediation as a preparatory step in the development process. Participation in the public participation process prior to required public hearings will be considered by the decision-making official when considering the need, or request, for a continuance of an application. It is not the intent of this section to require neighborhood meetings, but to encourage meetings prior to the submission of applications for approval and documentation of efforts which have been made to address any potential concerns prior to the formal application process. APPLICANT REPORT 1. Details of techniques the applicant used to involve the public (a) Dates and locations of all meetings where citizens were invited to discuss the applicant's proposal (b) Content, dates mailed, and number of mailings, including letters, meeting notices, newsletters, and other publications (c) Where residents, property owners, and interested parties receiving notices, newsletters, or other written materials are located 2. Summary of concerns, issues, and problems expressed during the process 3. Signature or affidavit of compliance - President or vice-president of any neighborhood associations Check one: ( ) Proposal supported ( ) Do not support the Proposal ( ) Unable to comment on the Proposal at this time ( ) Other comment(s): Association Name President or Vice-President Signature If the president or vice-president of the neighborhood association are unavailable or refuse to sign such certification, a statement as to the efforts to contact them and (in the event of unavailability or unwillingness to sign) why they were unable or unwilling to sign the certification. Page 6 of 6 City of St. Petersburg One 4 th Street North St. Petersburg, FL 33731-2842 (727) 893-7471 www.stpete.org/ldr