Property Information. Address: City/State/Zip: TWN-RN-SEC: Folio(s): Zoning: Future Land Use: Property Size: Property Owner Information

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VARIANCE APPLICATION IMPORTANT INSTRUCTIONS TO ALL APPLICANTS: Yu must schedule an appintment t submit this applicatin by calling 813-272-5600.

1 VARIANCE APPLICATION IMPORTANT INSTRUCTIONS TO ALL APPLICANTS: Yu must schedule an appintment t submit this applicatin by calling All requirements listed n the submittal checklist must be met. Incmplete applicatins will nt be accepted. Prperty Infrmatin Address: City/State/Zip: TWN-RN-SEC: Fli(s): Zning: Future Land Use: Prperty Size: Prperty Owner Infrmatin Name: Daytime Phne: Address: City/State/Zip: FAX Number: Applicant Infrmatin Name: Daytime Phne: Address: City/State/Zip: FAX Number: Applicant s Representative (if different than abve) Name: Daytime Phne: Address: City / State/Zip: FAX Number: I HEREBY S WEAR OR AFFIRM THAT AL L THE INFORMATION PROVIDED IN THIS APP LICATION PACKET IS TRU E AND ACCURATE, TO THE BEST OF M Y KNOWLEDGE, AND AUTHORIZE THE REPRESENTATIVE LISTED ABOVE TO ACT ON MY BEHALF FOR THIS APPLICATION. _ Signature f Applicant _ Type r Print Name I HEREBY AUTHORIZE THE PROCESSING OF THIS APPLICATION AND RECOGNIZE THAT THE F INAL ACTION ON THIS P ETITION SHALL BE BI NDING TO THE PROPERTY AS WELL AS TO CURRENT AND ANY FUTURE OWNERS. _ Signature f Prperty Owner _ Type r Print Name Office Use Only Intake Staff Signature: Intake Date: Case Number: Public Hearing Date: Receipt Number: Develpment Services Department, 601 E Kennedy Blvd. 20 th Flr

2 Applicatin Number: AFFIDAVIT TO AUTHORIZE AGENT STATE OF FLORIDA COUNTY OF HILLSBOROUGH (NAME OF ALL PROPERTY OWNERS), being first duly swrn, depse(s) and say(s): 1. That (I am/we are) the wner(s) and recrd title hlder(s) f the fllwing described prperty, t wit: ADDRESS OR GENERAL LOCATIONS: Fli N: 2. That this prperty cnstitutes the prperty fr which a request fr a: applied t the Bard f Cunty Cmmissiners, Hillsbrugh Cunty. (NATURE OF REQUEST) is being 3. That the undersigned (has/have) appinted as (his/their) agent(s) t execute any permits r ther dcuments necessary t affect such permit. 4. That this affidavit has been executed t induce Hillsbrugh Cunt y, Flrida, t cnsider and act n the abvedescribed prperty; 5. That (I/we), the undersigned authrity, hereby certify that the freging is true and crrect. Signature (Prperty Owner) Signature (Prperty Owner) STATE OF FLORIDA COUNTY OF HILLSBOROUGH The freging instrument was acknwledged befre me this by Date Prperty Owner Wh: Persnally knwn t me Flrida Drivers License Other Type f Identificatin And Wh: did did nt take an ath. Signature f Ntary taking acknwledgement Type/Print Name f Ntary Cmmissin Number Expiratin Date STATE OF FLORIDA COUNTY OF HILLSBOROUGH The freging instrument was acknwledged befre me this by Date Prperty Owner Wh: Persnally knwn t me Flrida Drivers License Other Type f Identificatin And Wh: did did nt take an ath. Signature f Ntary taking acknwledgement Type/Print Name f Ntary Cmmissin Number Expiratin Date 2

3 VARIANCE REQUEST Applicatin Number: 1. Prject Narrative: In the space belw describe the variance including any histry and/r related facts that may be helpful in understanding the request. This explanatin shall als specifically identify what is being requested (e.g. Variance f 10 feet frm the required rear yard setback f 25 feet resulting in a rear yard f 15 feet). If additinal space is needed, please attach extra pages t this applicatin. 2. A Variance is requested frm the fllwing Sectin(s) f the Hillsbrugh Cunty Land Develpment Cde: ADDITIONAL INFORMATION 1. Have yu been cited by Hillsbrugh Cunty Cde Enfrcement? N Yes If yes, yu must submit a cpy f the Citatin with this Applicatin. 2. D yu have any ther applicatins filed with Hillsbrugh Cunty that are related t the subject prperty? N Yes If yes, please indicate the nature f the applicatin and the case numbers assigned t the applicatin(s): 3. Is this a request fr a wetland setback variance? N Yes If yes, yu must cmplete the Wetland Setback Memrandum and all required infrmatin must be included with this Applicatin Packet (Attachment A). 4. Please indicate the existing r prpsed utilities fr the subject prperty: Public Water Public Wastewater Private Well Septic Tank 5. Is the variance t allw a t hird lt n well and/r septic r nn-residential develpment with an intensity f three ERC's? N Yes If yes, yu must submit a final determ inatin f the Water, Wastewater, and/r Reclaimed Water Service Applicatin Cnditinal Apprval Reservatin f Capacity prir t yur public hearing (frm may be btained frm 19 th flr Cunty Center). 3

4 VARIANCE CRITERIA RESPONSE Applicatin Number: Yu must prvide a respnse t each f the fllwing questins. If additinal space is needed, please attach extra pages t this applicatin. 1. Explain hw the alleged hardships r practical difficulties are unique and sing ular t the subject prperty and are nt thse suffered in cmmn with ther prperty similarly lcated? 2. Describe hw the literal requirem ents f the Land Develpment Cde (LDC) wuld deprive yu f rights cmmnly enjyed by ther prperties in the same district and area under the terms f the LDC. 3. Explain hw the variance, if allwed, will nt substa ntially interfere with r injure the rights f thers whse prpert y wuld be affected by allwance f the variance. 4. Explain hw the variance is in harmn y with and serves the general intent and purpse f the LDC and th e Cmprehensive Plan (refer t Sectin and f the LDC fr descriptin f intent/purpse). 5. Explain hw the situatin sught t be relieved by the variance des nt result frm an illegal act r result frm the actins f the applicant, resulting in a self-impsed hardship. 6. Explain hw allwing the variance will result in substantia l justice being dne, cnsider ing bth the public benefit s intended t be secured by the LDC and the individual hardships that will be suffered by a failure t grant a variance. 4

5 Applicatin Number: VARIANCE APPLICATION SUBMITTAL CHECKLIST The checklist belw includes ite ms and infrmatin that must accmpany all variance requests. The applicant m ust fill ut the checklist by placing a check mark in each bx indicating the infrmatin has been prvided and sign belw certifying that the applicatin is cmplete. Failure t submit accurate data may require the applicatin t be cntinued t a later public hearing date. Incmplete applicatins will nt be accepted. Applicatin Fee - Check made payable t Hillsbrugh Cunty Bard f Cunty Cmmissiners. Cmpleted Variance Applicatin with Affidavit t Authrize Agent, if applicable. Cmpleted Variance Request and Additinal Infrmatin Sheet. Adjacent Prperty Owners List. The list m ust be btained frm the Prperty Appraisers Office lcated n the 15 th flr f the Cunty Center Bldg (601 E. Kennedy Bulevard). D nt retype the list. If yur prperty has an Agricultural Future Land Us e Designatin r a Future Land Use Designatin f RES-1 yu must btain a list f all prperty wners within 500 feet f the subject prperty. Fr all ther Future Land Use Categries y u must btain a list f all prperty wners within 300 feet f the subject prperty. Cmpleted Variance Criteria Respnse Frm. Recrded Deed fr the Subject Prperty. This can b e btained frm the Clerk f the Circuit Curt Recrding Library lcated at 419 Pierce Street. Legal Descriptin f Subject Prperty. This infrmatin can be fund n yur deed r n the prperty survey. Prperty Survey. The survey (Occupatinal Survey) must have been dne within the last tw y ears and must be t scale. At least ne cpy must be 8 ½ X 11 inches in size. At a minimum, the survey must include the fllwing infrmatin: 1) Nrth arrw and Fli number, prperty wner s name, and address f subject site; 2) Dimensins f the prperty; 3) All rad frntage, driveways, and easements; 4) All existing and prpsed buildings and struct ures n the prperty, the square ftage f these structures, and the distance frm said structures, fences t all prperty lines; 5) Lcatin f any n-site wetlands; 6) Height f all existing and prpsed structures; 7) Infrmatin relevant t the specific variance requested. Cpy f any citatins issued by Cde Enfrcement fr the subject prperty, if applicable. Wetland Setback Variance Memrandum Attachment A - This mem must be cmplete fr all requests fr a variance t the wetland setback. Applicant Signature: I certify that I have cmpleted the applicatin and have included all material checked abve. 5

6 Applicatin Number: ATTACHMENT A - TO BE COMPLETED FOR ALL WETLAND SETBACK VARIANCE REQUESTS MEMORANDUM T: Frm: Subject: Land Use Applicatin Intake and Review Staff, Planning and Grwth Management Natural Resurces Sectin Staff, Transprtatin & Land Develpment Review Divisin Request fr a Variance t a Wetland Setback A preliminary review f the request fr a variance t the wetland setback fr fli number has been cnducted by Planning & Grwth Management (PGM)-Natural Resurces Sectin staff. As a result f this review it has been determined that a variance applicatin must be filed t achieve cmpliance with Article 4.0 f the Land Develpment Cde. The decisin cncerning this applicatin will be determined by the Land Use Hearing Officer (LUHO) fifteen (15) business days fllwing the public hearing. In rder fr this applicatin t be prcessed, all applicable fees must be paid at the time f filing. Additinal Submittal Requirements: Any crrespndence frm ther jurisdictinal agencies pertinent t the request. Scaled tree survey identifying trees 5 inches DBH (trunk diameter at 4 ½ feet abve grade) lcated within that prtin f the setback fr prpsed encrachment and within 30 feet frm the bundaries f the prpsed encrachment. Site Plan Requirements (must be t scale): Official EPC accepted wetland survey. A signed EPC accepted survey f the wetland line must be prvided unless the prperty is a platted subdivisin lt with an fficial date f recrding 5 years r less frm the date f this applicatin. Pertinent wetland setback line (i.e. 30 feet r 50 feet) clearly identified. A crss-sectin f the wetland setback area identifying prpsed impervius and pervius imprvements, existing grade elevatins, prpsed finished grade elevatins & any special design (i.e. stemwalls r retaining walls) t minimize encrachments int the setback. Label each area f wetland setback impervius encrachment, prviding the depth and widths f the encrachment and frm these dimensins calculate the actual encrachment square ftage area. Submit a Wetland Setback Encrachment Cmpensatin Planting Plan meeting the criteria f the PGM s and EPC s Wetland Setback Encrachment Vegetatin Cmpensatin Guidelines if the impervius and/r pervius encrachment square ftage area is 500 square feet r mre. Hwever, fr residential lts a Cmpensatin Planting Plan must be submitted if the impervius/pervius encrachment square ftage area is mre than 500 square feet r 10% r greater than the ttal square ftage area f the prperty s wetland setback whichever is less. Prvide a narrative fr justificatin f the encrachment. Shw the cmpensatin area and label the square ftage f the cmpensatin area. Identify vegetative cver type within the wetland setback. Preliminary Review and Site Plan Sufficiency Check Cnducted By: Specific Variance Requested: Revised 07/02/2014 6

7 Applicatin Number: CROSS SECTION EXAMPLE 7

AIRPORT HAZARD EVALUATION (Effective Octber 13, 2015) Prperties lcated within the map areas depicted belw may be subject t a separate Airprt Height Zning Permit apprval prcess f the Hillsbrugh

Additinally, pursuant t an Interlcal Agreement between the HCAA and Hillsbrugh Cunty, any Land Develpment Prpsal within prximity t Tampa Internatinal Airprt and Tampa Executive Airprt and

8 AIRPORT HAZARD EVALUATION (Effective Octber 13, 2015) Prperties lcated within the map areas depicted belw may be subject t a separate Airprt Height Zning Permit apprval prcess f the Hillsbrugh Cunty Aviatin Authrity (HCAA), pursuant t the HCAA s Airprt Zning Regulatins. Additinally, pursuant t an Interlcal Agreement between the HCAA and Hillsbrugh Cunty, any Land Develpment Prpsal within prximity t Tampa Internatinal Airprt and Tampa Executive Airprt and Educatinal facilities and landfills lcated with certain mapped areas will be transmitted t HCAA fr review. Fr additinal infrmatin and questins: Tampa Internatinal Airprt Infrmatin Link: height zning Cntact: Tny Mantegna / Tampa Internatinal Airprt Phne: (813) tmantegna@tampaairprt.cm

Petition to Rezone Packet

Petition to Rezone Packet Petitin t Rezne Packet Cntents Prcedure and Required Materials Petitin Applicatin Affidavit Permissin t Reprduce Cnfirmatin f Ownership by Owner; and Authrizatin fr Agent r Petitiner, when a different