ORAN le APPLICATION TO CONSTRUCT A DOCK C UNTY GOVERNMENT ( FLORID A (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 32808 (407) 836-1400, Fax (407) 836-1499 **Filing fee of $119.00 payable to The Board of County Commissioners** **Process fee for Appeals and Variances: $409.00** OWNER(S) OF THE LAND Connie Emmerson & Steve Emmerson SECTION 1 9419 Winter Garden Vineland Rd. City:. O rland o State: FL Zi p: 32836 Telephone and Fax: (407) 666-0505 Fax (407) 293-2913 Email: ce@royallandscapenursery.com ENTITY TO RECEIVE PERMIT (IF OTHER THAN OWNER) City: State: Zip: Telephone and Fax: Email: AGENT/CONSULTANT AUTHORIZED TO SECURE PERMIT City: State: Zip: Telephone and Fax: CONTRACTOR (IF DIFFERENT FROM AGENT) Email: City: State: Zip: Telephone and Fax: Email: Revised 5-15-14 Page 1 of 5
SECTION 2 - GENERAL INFORMATION Street 9419 winter Garden Vineland Rd., Orlando, FL 32836 Tax Parcel ID 05 _ 24 _ 28 _ 0000 _ 00 _ 020 Legal Description:,s Iltr--3 Name of water body: Lake Sheen Normal High Water Elevation (NHWE): msl Is the proposed dock? Please check one: ZIPrivate OISemi-Private ripuktlic What is the width of the shoreline (in linear feet), as measured at the NHWE? tos feet. What is the size of proposed terminal platform? square feet. [See Chapter 15; Article IX; Section 15-342(b)] Are you requesting a variance? DYes1 'jno Are you requesting a waiver? E]Yes If yes, provide section Number: 15- (example: 15-321) 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): No REQUIRED ATTACHMENT(s) CHECKLIST: II Satisfactory evidence of title. (Example: copy of property deed). Documentation showing riparian rights for the parcel. I A copy of a survey, to scale, of the real property which accurately depicts current conditions. ;V 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 5-15-14 Page 2 of 5
The NHWE as established by the county and field verified by a professional surveyor. The location of any conservation easement areas and wetlands within twenty feet from any portion of the dock. A description of vegetation types identified occurring within twenty feet from any portion of the dock. The location of any lifts, hoists, mooring pilings and mooring areas. A mitigation plan offsetting adverse impacts to the conservation easement areas or wetlands (if applicable). A description of sedimentation and erosion control measures used during construction and/or repair of the dock. Depict and label the projected property lines (if applicable, ie not SSL). AGENT AUTHORIZATION FORM Click here to submit PERSON AUTHORIZING ACCESS TO THE PROPERTY MUST COMPLETE THE FOLLOWING: I either own the property described in this application or I have legal authority to allow access to the property and I consent to any site visit on the property by agents or personnel from Orange County, Florida necessary for the review and inspection of the proposed project specified in this application. I authorize these agents or personnel to enter the property as many times as may be necessary to make such review and inspection. Further, I agree to provide entry to the project site for such agents or personnel to m or permitted work if a permit is granted. Connie Emmerson Typed/Printed Name Signature Date Corporate Title (if appl icable) By signing and submitting this application form, I am applying for the permit 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, water management district or local permit prior to commencement of construction. I understand that Orange County will make no representation as to the proposed dock's impact on navigability or safety. For that reason, I understand that it may be advisable for me to consult with an expert in navigability and safety issues. I agree, or I agree on behalf of my corporation, to operate and maintain the permitted system unless the permitting agency authorizes transfer of the permit to a responsible operation entity; I understand that knowingly making any false statements or representation in this application is a violation of Sections 15-341 & 15-342, Orange County Code. Typed/Printed Name of Applicant Connie Emmerson Signature of Applicant/Agent Corporate Title (if applicable) Revised 5-15-14 Page 3 of 5
SECTION 3 Name and Address of adjacent property owners: City: State Zip 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 5-15-14 Page 4 of 5
Prepared By/Return To: Jeffrey P. Milhausen, Esquire/j4 South Milhauscn, Gateway Center 1000 Legion Place, Suite 1200 Orlando, FL 32801 Phone 407-539-1638 File No 6108-6 cc DOC# 20140476205 B: 10807 P: 0533 09/18/2014 03:05:22 PM Page 1 of 2 Rec Fee: $18.50 Deed Doc Tax: $4 830 00 DOR Admin Fee: $0.00 Intangible Tax: $0.00 Mortgage Stamp: $0.00 Martha 0. Haynie, Comptroller Orange County, FL PU - Rat To: SOUTH MILHAUSEN PA Property Appraiser's Parcel 1.D. #: 05-24-28-0000-00-020 (Space above this line for recording d WARRANTY DEED (STATUTORY FORM - SECTION 689.02, F.S.) KRIS N ANG NAN AND THIS WARRANTY DEED, made this Ir.,;) day of September,, 2014, Mt AFL DANCIANAN, WIF AND HUSBAND, V. hose address is 10( 1 393 r./ (hereinafter referred to as the "Grantor"), to CONNIE EMMER ON, a married woman, whose address is 9419 SR 535, Orlando, Florida 32836 (hereinafter referred to as the "Grantee"): (Whenever used herein the terms "Grantor" and "Grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations.) W1TNESSETH: That the Grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantee, all that certain land situate in Orange County, Florida, to wit: The North 105.7 feet of the South 435.7 feet of the West half (W 1/2) of the Northeast 1/4, LESS the West 30 feet for Road Right of Way in Section 5, Township 24 South, Range 28 East, Orange County, Florida; LESS: Starting at a point 330 feet North of the Southwest corner of the West 1/2 of the Northeast 1/4, LESS 30 feet for Road Right of Way in Section 5. Township 24 South, Range 28 East, run North 80 feet, thence East 500 feet, thence South 80 feet, thence West 500 feet, to the Point of Beginning, as recorded in Public Records of Orange County, Florida, and; LESS that portion deeded to Orange County, Florida June 2, 1995, in Official Records Book 4899, Page 2646, Public Records of Orange County, Florida, more particularly described as follows: Commence at the Railroad Spike at the Southwest corner of the Northeast 1/4 of said Section 5; thence run North 89 58'33" East, along the South line of the Northeast 1/4 of said Section 5, for 30.00 feet to the Easterly Right-of-Way line of Orange County Road 535 (Winter Garden-Vineland Road) as shown on the Right-of-Way Map of Orange County Road Bond Project 38 B and described in Deed Book 392, Pages 127 and 150, of the Public Records of Orange County, Florida; thence run North 00 04'12" East, for 410.00 feet to the Point of Beginning; thence run North 89 58'33" East for 13.15 feet; thence run North 00 03'50" East for 25.70 feet; thence run South 89 58'33" West, for 13.14 feet to the Easterly Right-of-Way line of said Orange County Road 535, thence run South 00 04'12" West, along the Easterly Right-of-Way line of said Orange County Road 535, for 25.70 feet to the Point of Beginning. TOGETHER with all the tenements. hereditaments and appurtenances thereto belonging or in anywise appertaining. AND the Grantor hereby covenants with said Grantee that the Grantor is lawfully seized of said land in fee simple; that the Grantor has good right and lawful authority to sell and convey said land; that the Grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to December 31, 2013, and subject to easements, conditions, covenants, restrictions, reservations, limitations and agreements of record, if any; however, reference herein does not operate to reimpose same. written. IN WITNESS WHEREOF, the Grantor has signed and sealed these presents the day and year first above Signed, Sealed and Delivered In Our Presence: 0
20140476205 Page 2 of 2 STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument DANGANAN and MICJ-IAEL (Jr,44-s 11(1( 4') )r., was acknowledged before me this 0-- day of September, 2014, by KRISTEN DANGANAN, who is/are personally known to me or who produced as identification. (NOTARIAL SEAL) NOTA3 Y PUBLIC My Commission Expires: JULIE K GABALDON MY COMMISSION r EE 136856 EXPIRES: January 6, 2016 60466e. TMr Notary RA* Urdemotera