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SPECIAL EXCEPTION SITE PLAN REVIEW Application No. Included in this packet: Pre-Application Meeting Notes Application Affidavit to Authorize Agent Data Sheet Traffic Input Report Neighborhood Worksheet Public Participation Report Planning and Economic Development Department Development Review Services Division City of St. Petersburg P.O. Box 2842 St. Petersburg, FL 33731 727 / 893.7471 UPDATED: 05-17-17 Page 1 of 8 List of Required Submittals Only complete applications will be accepted: Completed SE & SPR application form Pre-Application Meeting Notes Application fee payment (Additional Fees required if variances are requested) Affidavit to Authorize Agent, if Agent signs application Data Sheet Traffic Impact Report (Methodology to be approved by Transportation and parking Management) Public Participation Report Site plan and survey of the subject property: Two (2) copies (please fold to 8 ½ x 11 ) & one reduced site plan 8 ½ x 11 to scale: black and white & color Drawn to scale (engineers scale no smaller than 1 = 50 ); North arrow Phasing schedule, if applicable Dimensions and exact locations of: property lines, structures, internal walkways, pedestrian connections vehicle use areas (driveways, parking spaces, curbing, wheel stops, ingress/egress, etc.) utilities (overhead power lines, exterior lighting, easements, etc.) buffer walls, fences with elevation and height and material indicated solid waste disposal method and location storm water retention, preservation areas any other architectural or engineering features Landscape plans: Two (2) copies (please fold to 8 ½ x 11 ) One reduced site plan 8 ½ x 11 to scale (black and white) & (color) Legend identifying plants by scientific and common name, size, spacing & quantity Location, type and size in diameter at breast height (d.b.h.) of all specimen trees indicated to be preserved or removed Elevation drawings: 8 ½ x 11 to scale (color), Depicts all sides of existing & proposed structure(s) PDF of application documents (may be emailed to Staff Planner) Variance Narrative, if requesting, addressing application criteria Projects within the DC zoning district(s): Digital 3D building models of the proposed building(s): CD-ROM or DVD; file format: 3DS, MAX (.max,.3ds) or AutoCAD (.dwg,.dxf). The file shall be organized so that the objects of the same material are on the same layer with each layer named appropriately (i.e. such objects as walls, framing, and structure should be grouped in separate layers). The building model to be placed in the correct orientation/direction within the file, with overhead view on screen as follows: North = Up, South = Down, East = Right, and West = Left. A Pre-Application Meeting is Required Prior to Submittal. To schedule, please call (727) 892-5498. 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 Page 2 of 8

SPECIAL EXCEPTION SITE PLAN REVIEW Application No. All applications are to be filled out completely and correctly. The application shall be submitted to the Development Review Services Division, located on the 1 st floor of the Municipal Services Building, One Fourth Street North NAME of APPLICANT (Property Owner): Street Address: City, State, Zip: Telephone No: Email: NAME of AGENT OR REPRESENTATIVE: Street Address: City, State, Zip: Telephone No: Email: NAME of ARCHITECT or ENGINEER: Company Name: Telephone No: Website: PROPERTY INFORMATION: Address/Location: Email: Parcel ID#(s): DESCRIPTION OF REQUEST: GENERAL INFORMATION Contact Name: Email: PRE-APP MEETING DATE: STAFF PLANNER: FEE SCHEDULE SPECIAL EXCEPTION (SE) SITE PLAN REVIEW (SPR) Special Exception (SE), General Application: $1,000.00 Site Plan Review (SPR), General, By Commission $1,000.00 Special Exception (SE), Modification: $ 500.00 Site Plan Review (SPR), General, By POD $ 500.00 Concurrency $ 25.00 Site Plan Review (SPR), General, Related to SE $ 0.00 VARIANCES Site Plan Review (SPR), Modification, By Commission $ 500.00 Each Variance Requested for SE/SPR $ 200.00 Site Plan Review (SPR), Modification, By POD $ 250.00 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 [Type text] Page 3 of 8 Updated 05-17-17

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#: 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): Sworn to and subscribed on this date Printed Name Identification or personally known: Notary Signature: 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 Page 4 of 8

SPECIAL EXCEPTION SITE PLAN REVIEW DATA SHEET ONLY COMPLETE APPLICATIONS WILL BE ACCEPTED. FAILURE TO COMPLETE THIS FORM WILL RESULT IN DEFERRAL OF YOUR APPLICATION. 1. Zoning Classification: 2. Existing Land Use Type(s): 3. Proposed Land Use Type(s): 4. Area of Subject Property: 5. Variance(s) Requested: DATA TABLE 6. Gross Floor Area (total square feet of building(s)) Existing: Proposed: Permitted: 7. Floor Area Ratio (total square feet of building(s) divided by the total square feet of entire site) Existing: Proposed: Permitted: 8. Building Coverage (first floor square footage of building) Existing: % of site Proposed: % of site Permitted: % of site 9. Open Green Space (include all green space on site; do not include any paved areas) Existing: % of site Proposed: % of site 10. Interior Green Space of Vehicle Use Area (include all green space within the parking lot and drive lanes) Existing: % of vehicular area Proposed: % of vehicular area 11. Paving Coverage (including sidewalks within boundary of the subject property; do not include building footprint(s)) Existing: % of site Proposed: % of site Page 5 of 8

SPECIAL EXCEPTION SITE PLAN REVIEW DATA SHEET DATA TABLE (continued page 2) 12. Impervious Surface Coverage (total square feet of all paving, building footprint and other hard surfaced areas) Existing: % of site Proposed: % of site Permitted: % of site 13. Density (units per x ) Sq. Ft. or Acre(s) No. of Employees No. of Clients (C.R. / Home) Existing: Existing: Existing: Proposed: Proposed: Proposed: Permitted: 14 a. Parking (Vehicle) Spaces Existing: includes disabled parking spaces Proposed: includes disabled parking spaces Permitted: includes disabled parking spaces 14 b. Parking (Bicycle) Spaces Existing: Spaces % of vehicular parking Proposed: Spaces % of vehicular parking Permitted: Spaces % of vehicular parking 15. Building Height Existing: Feet Stories Proposed: Feet Stories Permitted: Feet Stories 16. Construction Value What is the estimate of the total value of the project upon completion? $ Note: See Drainage Ordinance for a definition of alteration. If yes, please be aware that this triggers Drainage Ordinance compliance. Please submit drainage calculations to the Engineering Department for review at your earliest convenience. The DRC must approve all Drainage Ordinance variances. Page 6 of 8 City of St. Petersburg One 4 th Street North PO Box 2842 St. Petersburg, FL 33731-2842 (727) 893-7471

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 Street Address: 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: City of St. Petersburg One 4 th Street North PO Box 2842 St. Petersburg, FL 33731-2842 (727) 893-7471

PUBLIC PARTICIPATION REPORT Application No. In accordance with LDR Section 16.70.040.1.F, 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 Street Address: 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 8 of 8 City of St. Petersburg One 4 th Street North PO Box 2842 St. Petersburg, FL 33731 (727) 892-7471