APPLICATION FUTURE LAND USE MAP AMENDMENT PLANNING AND ZONING DEPARTMENT CITY OF INDIAN ROCKS BEACH

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APPLICATION FUTURE LAND USE MAP AMENDMENT PLANNING AND ZONING DEPARTMENT CITY OF INDIAN ROCKS BEACH www.indian-rocks-beach.com There is a link to the Indian Rocks Beach Code of Ordinances at the website noted above. (This form was revised February 2014 and replaces and supersedes all previous application forms) 1

FUTURE LAND USE MAP AMENDMENT Be certain that the application is completely filled out and all requirements for filing the application have been met. Incomplete applications cannot be considered. Note the property description section. The type of structure presently on the land must be shown; for example, "single-family residence", "one-story real estate office", etc. If there are no structures at all on the land, then the answer is "none". Proposed use and the effect of granting the application must be shown. One copy of a plot plan of the site, drawn to scale, must be submitted with the application. The plot plan must show the size and dimensions of the lot, the location and dimensions of any existing structures, and the location and size of any proposed structures. The completed application, together with the application fee of $2,500.00. The applicant shall pay the advertising and notification costs of the public hearing. A deposit of $2,000.00 for advertising fee shall be required at the time the application is submitted. If the cost of advertising and notification is less than $2,000.00, the difference will be refunded to the applicant. Advertisement and notification requirements are stipulated by Florida Statute for land use amendments. If the actual costs are greater than $2,000, the difference shall be paid by the applicant within 30 days after final action. When legal counsel and/or a consultant are required by the city, actual cost of legal and consulting fees shall be paid by the applicant within 30 days after final action. A future land use map change requires review and approval by County and State agencies prior to second and final reading. This review can take from 90 to 180 days. The general procedure for future land use map requests is as follows: 1. Hearing and recommendation by Planning & Zoning Board. 2. Hearing and recommendation by Local Planning Agency (L.P.A.) 3. Hearing(s) by the City Commission on ordinance. 2

CITY OF INDIAN ROCKS BEACH APPLICATION FOR FUTURE LAND USE MAP AMENDMENT DATE FILED: NAME: NOTICE TO THE APPLICANT This application with all supplemental data and information, must be completed in accordance with the attached "Information Sheet," and in accordance with the specific instructions set forth in this application and returned to the Planning and Zoning Director, before it can be processed (including advertisement for hearing), as required by law. All applications must be signed by the present owner or trustee of the property. 1.Owner: Name: Address: City: State: Zip Code: Telephone: 2.Agent/ Representative: Address: City: State: Zip Code: Telephone: 2A. Any other person having any ownership, interest in subject property: Specify interest held: Is such interest contingent or absolute? 2B. Is there any existing contract for sale on subject property? Yes No If so, list names of all parties to option: 2C. Are there any options to purchase on subject property? Yes No If so, list names of all parties to option: 3. Hearing requested to consider Re-Zoning to allow the following: 4. Address of Subject Property: 3

5. Legal Description of Subject Property: 6. Lot Size: 7. Present Zoning Classification: Present Land Use Designation: Proposed Zoning Classification: Proposed Land Use Designation: 8. Present Structures and Improvement on the property: 9. Proposed use of property will be: 10. I (We) believe that this application should be granted because: 11. Has any previous application or appeal been filed in connection with this property within the last two years? Yes No. If yes, briefly state the nature of the application or appeal: 12. Has a Certificate of Occupancy been refused? Yes No 13. The following data and exhibits must be submitted with this application and they become a permanent part of the public records: (a) Plot Plan, (at least 8 1/2"x 11") drawn to scale showing all existing structures, use of each, dimension, spacing between, setbacks from all property lines, property dimensions, abutting streets and other public easements, clearly delineated off-street parking spaces and North point. (b) Plat, if it will have particular bearing on the subject application. (c) Certification of Ownership. Submit a certificate from a duly licensed title or abstract company or a licensed attorney-at-law, showing that each applicant is the present title holder of record. (d) Current Survey, (performed within one year) 14. Date property acquired: 4

15. Does Applicant own any property contiguous to the subject property? Yes No If so give complete legal description of contiguous property: CERTIFICATION I hereby certify that I have read and understand the contents of this application and that this application, together with all supplemental data and information is a true representation of the facts concerning this request; that this application is made with my approval, as owner and applicants, as evident by my signature appearing below. It is hereby acknowledged that the filing of this application does not constitute automatic approval of the request; and further that if the request is approved, I will obtain all necessary permits and comply with all applicable orders, codes, conditions and rules and regulations pertaining to the use of the subject property. Signature of Owner, Representative or Trustee The foregoing instrument was acknowledged before me this day of, 20 by, who is personally known to me, or who has produced as identification and who did (did not) take an oath. NOTARY PUBLIC Applications which are filed by corporations must bear the seal of the corporation over the signature of an officer authorized to act on behalf of the corporation. 5