APPLICATION FOR ABANDONMENT OF A DEVELOPMENT OF REGIONAL IMPACT. I,, the undersigned owner or authorized. representative of hereby request that the

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FORM RPM-BSP-ABANDON DRI-1 STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS DIVISION OF COMMUNITY PLANNING BUREAU OF LOCAL PLANNING 2555 Shumard Oak Blvd. Tallahassee, Florida 32399 850/488-4925 APPLICATION FOR ABANDONMENT OF A DEVELOPMENT OF REGIONAL IMPACT I,, the undersigned owner or authorized representative of hereby request that the (local government) issue a notice of abandonment for the Development of Regional Impact (DRI) which was issued on for the development. I agree to record the notice of abandonment, in accordance with Section 28.222, Florida Statutes, with the clerk of the circuit court for each county in which land covered by the terms of the DRI is located. I hereby certify that the plan of development identified in the development order as a DRI will no longer be pursued. Furthermore, I certify and acknowledge that, if this request for abandonment of the DRI is approved, the project will lose vested rights protection under Subsection 163.3167(8), Florida Statutes, for approved DRIs but may be entitled to other vested rights protection under that statute or otherwise under law.

I hereby certify that all information submitted with and pursuant to this application of abandonment of the DRI is true and correct to the best of my knowledge and belief and that on this date a copy of this application has been submitted to the appropriate local government, appropriate regional planning agency and the Division of Community Planning in the Department of Community Affairs. Date Signature Street or P.O. Address City State Zip Phone Number

A. Describe the actual amount of development completed, the size and scope of the resulting plan of development (after abandonment). Further, describe the extent to which existing permits or approvals authorize development which would exceed that allowed under the resulting plan of development (after abandonment) and: 1. Provide the amount of existing development as defined under Section 380.04, Florida Statutes (F.S.), that has occurred on site including the amount of existing vertical development by land use in gross square feet, dwelling units, or other applicable units of measure; the amount of infrastructure completed at the site; etc. Attach a copy of the approved site plan for this development as EXHIBIT A. 2. Identify the amount of development that is planned (after abandonment) including the amount of vertical development by land use in gross square feet, dwelling units, or other applicable units of measure; the percentage of any applicable guidelines and standards identified in s.380.0651 F.S., or Rule 28-24, Florida Administrative Code (F.A.C.); the amount of infrastructure to be completed at the site; etc. Attach a site plan for the project as proposed after abandonment as EXHIBIT B. 3. Identify all state and federal permits applied for or obtained to date. Specify the agency, type of permit and function of each permit. Attach copies for each permit or permit application (if no permit has been issued) as EXHIBIT C. 4. Identify all undeveloped tracts of land (other than individual single family lots) sold to separate entities or developers. Specify the size and buyer of each tract or parcel. Attach a map identifying the undeveloped tracts as EXHIBIT D. B. Provide the following as attachments: 1. A certification of concurrence with abandonment from all DRI property owners who were owners at the time of the development order (D.O.) approval, or their successors. Use Attached Signatory Certification and attach as EXHIBIT E. 2. An explanation of the reason for seeking an abandonment of the DRI. Attach as EXHIBIT F. 3. Statement from local government of jurisdiction indicating whether all development to date is in compliance with all applicable local regulations. If evidence is presented that a request was made to the local government for such a statement but no statement is provided within 30 days of the request, the developer should provide evidence in support of such a claim of compliance. Attach as EXHIBIT G. 4. A discussion of any material adverse impacts for the development on any existing

resources or existing or planned facilities and the mitigation of these impacts. Attach as EXHIBIT H. 5. A list of each of the conditions in the DRI development order included to protect or mitigate the project s impact to resources or facilities. Include an explanation and documentation that each condition was adhered to by the developer. Attach as EXHIBIT I. 6. A copy of the binding letter (Form RPM-BSP-BLID-1) identifying the DRI status for the proposed project which has been issued by the Division of Community Planning for disposition, in all cases where there is a proposal to abandon a project which has not commenced development under Section 380.04, F.S., and is proposed to consist of development which is between 80-120 percent of any applicable threshold after abandonment.

EXHIBIT E SIGNATORY CERTIFICATION I,, am an owner (with the exception of individuals who own a single residential dwelling unit) of all or part of the property identified as the approved development of regional impact located in _, and whose development order was issued by, on. I hereby concur with the request to abandon the above referenced DRI. Date Signature Street or P.O. Address City, State, Zip