Annexation Application (2-2011)
CITY OF BOYNTON BEACH 1 PLANNING & ZONING DIVISION 100 East Boynton Beach Boulevard Boynton Beach, FL 33435 Phone: (561) 742-6260 City Applications and Codes Accessed Via Website www.boynton-beach.or
gwww.amlegal.com/boynton-beach_fl.us 07-13-2010 ANNEXATION APPLICATION I. GENERAL INFORMATION: This application must be filled out completely, accurately, and submitted as an original
to the Planning and Zoning Division; an incomplete application will not be processed. Print legibly (in ink) or type all information. In addition to the original, provide a copy of the
completed application as part of the submittal, and pay the applicable fee as adopted by the City Commission. This process is further described in Chapter 2, Article II, Section 2.A
of the Land Development Regulations. A. PRE-APPLICATION CONFERENCE*: Yes: _____ Date(s): ________________________________ * Pursuant to Chapter 2, Article II, Section 1.C.2 of the Land
Development regulations, a pre-application conference shall be required prior to the submittal of this application. B. PROJECT INFORMATION: 1. Name: __________________________________________________
____________________ 2. Site Plan: Is this request for annexation in connection with a new development or construction? Yes*: _____ No: _____ Office Use Only * If yes, the applicant
shall be required to complete a site plan application and submit it concurrently with this request for annexation. Corresponding Site Plan File #: ________________________________ 3.
Existing County Land Use Classification (from Future Land Use Map): ____________________________________________________ 4. Existing County Zoning District (from Official Zoning Map):
_____________________________ 5. Proposed Land Use Classification (from Future Land Use Map)* ________________________ * Pursuant to Chapter 2, Article II, Section 2.A.1.c of the Land
Development Regulations, all privately-initiated applications for voluntary annexation shall be required to complete a Future Land Use Map amendment application, and submit it concurrently
with the request for annexation. 6. Proposed City Zoning District (from Official Zoning Map)* ______________________________ * Pursuant to Chapter 2, Article II, Section 2.A.1.c of the
Land Development Regulations, all privately-initiated applications for voluntary annexation shall be required to complete a Rezoning application, and submit it concurrently with the
request for annexation. 7. Existing Use of Property /Site: __________________________ _________________________ 8. Estimated Present Population: _____________________ ______________________________
9. Existing Utilities Provider: a. Water: ________________________________________________________________ b. Wastewater: ____________________________________________________________
c. Solid Waste (garbage): ___________________________________________________
2 10. Parcel Control Number (PCN)*: ____ -____ -____ -____ -____ -______ -_______ CTY RNG TWP SEC SUB BLK LOT * List all PCN’s on an attached addendum for applications comprised of multiple
lots. 11. Address and Legal Description*: __________________________________________________ ____________________________________________________________________________ _____________________________
_______________________________________________ * Provide on attached addendum if more space is needed. 12. Parcel Size (in square feet /acres): _______________________ /_______________________
C. APPLICANT: 1. Name: ______________________________________________________________________ Company Name: ______________________________________________________________ 2. Address:
____________________________________________________________________ City: _______________________________ State: ________________ Zip Code: __________ Phone: _____________________________
Email: ___________________________________ 3. Interest in Property ((check one)*: Owner ( ), Lessee ( ), Contract Purchaser ( ) * Include a copy of the last recorded Warranty Deed with
all applications. a. Include written consent of all property owners of record if subject property is under joint or multiple ownership; b. If a lessee, include a copy of the Lease Agreement
and written consent of the owner(s); c. If an authorized agent, include a copy of the Agent Agreement or written consent by the seller(s) and owner(s); d. If a corporation or other business
entity, the name of the officer or person responsible for the application and written proof that such representative has the delegated authority to represent the corporation or other
business entity, or in lieu thereof, written proof that he is in fact, an officer of the corporation or other business entity; or e. If a contract purchaser, a copy of the Purchase Contract
and written consent of the seller(s) and owner(s). D. PROPERTY OWNER INFORMATION: 1. Name of Property Owner (Trustee): _______________________________________________ 2. Owner Address:
______________________________________________________________ City: _______________________________ State: ________________ Zip Code: __________
3 E. AGENT INFORMATION*: 1. Name: ______________________________________________________________________ * All correspondence will be mailed to the agent unless there is no agent of
record, in which case, all correspondence will be mailed to the applicant. This party will receive agendas, letters, and other material. Company Name: ________________________________________________
______________ 2. Address: ____________________________________________________________________ City: _______________________________ State: ________________ Zip Code: __________ Phone:
_____________________________ Email: ___________________________________ F. AUTHORIZATION OF AGENT: Signature of authorized agent. Date Signature of Owner(s) or Trustee, of authorized
principal if property is owned by a corporation or other business entity. OR Date Signature of contract purchaser (if applicant). Date G. CERTIFICATION: (I) (We) understand that this
application and all papers and plans submitted herewith become part of the permanent records of the Planning and Zoning Division. (I) (We) hereby certify that the above statements or
showings in any papers or plans submitted herewith are true to the best of (my) (our) knowledge and belief. This application will not be accepted unless signed according to the instructions
below. Signature of Owner(s) or Trustee, of authorized principal if property is owned by a corporation or other business entity. Date OR Signature of contract purchaser (if applicant).
Date
4 II. MANDATORY PLANS AND REPORTS: The applicant shall be required to submit to the Planning and Zoning Division, two (2) sets of the following: A. SURVEY INFORMATION: Not older than
six (6) months, prepared and sealed by a licensed surveyor showing all adjacent rights-of-way, including alleys, and driveways. All surveys shall be drawn at the same scale and each
contained entirely on one (1) sheet, unless the resulting scale causes the drawing to become illegible. In these instances, multiple sheets are allowed, provided that a key sheet is
also used in the submittal. The surveys shall also illustrate the following: 1. Total gross project acreage and square footage; 2. North arrow, scale, and legend; 3. Property boundaries,
legal description, and property control number(s); 4. Existing natural features, including but not limited to lakes, trees and other vegetation, soils, and topography; 5. Existing buildings
and structures, including dimensions, height, and use; 6. Existing utility lines and easements; 7. 7. Existing ground elevations (street and finished floor); and 8. Permanent reference
monuments and permanent control points as required by Chapter 4, Article VIII, Section 4 of the Land Development Regulations. B. REPORTS: When evaluating applications for annexation
approval, the Planning and Development Board and City Commission shall review the following justification: 1. In an attached addendum, the applicant shall be required to provide written
responses that address the review criteria of Chapter 2, Article II, Section 2.A.3 of the Land Development Regulations; and 2. In an attached addendum, the applicant shall be required
to submit a written statement to the Planning and Zoning Division explaining why this annexation will be beneficial to the City. III. CONCURRENCY REQUIREMENTS: Please be advised that
all applications for annexation approval are subject to the City’s Concurrency Management Ordinance and cannot be approved unless public facilities (potable water, sanitary sewer, drainage,
solid waste, recreation, park, and road facilities) would be available to serve the project, consistent with the levels of service adopted in the City’s Comprehensive Plan. Pursuant
to Chapter 2, Article II, Section 2.A.3.c, the City’s ability to provide urban services to the area proposed for annexation shall be assessed. If appropriate, the assessment will include
a plan to extend water and sewer services with timetables for improvements and method for financing such improvements. At the preapplication conference or during the review process,
the Director of Planning and Zoning or designee may request a fiscal impact analysis. Continued on next page
IV. PUBLIC NOTICING REQUIREMENTS: Pursuant to City of Boynton Beach Ordinance 04-007 and 05-004, no quasi-judicial proceeding shall proceed until proof of notice of the proceeding, in
affidavit form, has been filed with the Office of the City Clerk and copied to Planning & Zoning. Proof of notice must include the name and address of each property owner to whom notice
was mailed and a photograph of each sign posted, as hereinafter required. The following notices must be paid for and provided by the applicant: A. MAILING: The applicant shall mail (by
first class mail) a notice of public hearing to the Planning and Zoning Division, and to all individuals and associations owning or having control over land located within 400 feet of
the boundary line of the subject property for which the quasi-judicial hearing is required. All notices shall be mailed and postmarked no less than 10 calendar days before the public
hearing. Palm Beach County Property Appraiser Office Attention: Mapping Division 5 Downtown Service Center South County Office301 North Olive Avenue 501 South Congress AvenueWest Palm
Beach, Florida 33401 Delray Beach, FL 33445Phone: (561) 355-2881 Phone: (561) 276-1250Fax: (561) 355-3881 B. SIGNAGE: One (1) sign for each street frontage of the property shall be posted
no less than 10 calendar days prior to the hearing. The sign shall be legible from a distance of 100 feet and shall contain a description of the approval being sought, the date, time
and location of the hearing, and a statement that the application being considered is available for inspection in the Development Department of the City of Boynton Beach.
6 C. POSTPONEMENT: When a quasi-judicial hearing is tabled or continued at the request of an applicant, re-notice of the hearing shall be provided by the applicant in the same manner
as original notice. D. CITY TECHNICAL SUPPORT AT PUBLIC MEETINGS: 1. Applicants who wish to utilize City electronic media equipment for presentations at City Commission Public Hearings
must notify the Planning and Zoning Department representative at least one (1) week prior to the scheduled meeting; 2. The notification is to include the scope of support to be provided,
including the corresponding agenda item, type of media, materials and equipment needed, along with contact information for the applicant; 3. The department representative will notify
the I.T.S. Department at least two (2) working days prior to the Commission Meeting to schedule technical support; 4. A copy of the items to be presented must be delivered to the I.T.S.
Department no later than 6:00 p.m. on the working day preceding the Commission Meeting. At the conclusion of the meeting, these items will be returned to the department representative
who originated the request; 5. In the event that media or materials are defective, I.T.S Department. will notify department representative by noon of the day of the meeting. 6. At least
thirty minutes prior to the Commission Meeting, non-City individual will meet with I.T.S. Department representative to finalize procedures. Continued on next page
7 E. AFFIDAVIT: AFFIDAVIT RE: Property Address: Project Name: File #: I /We, the undersigned do certify that to the best of my knowledge, the attached ownership list, 400’ radius map
and mailing labels are a complete and accurate representation of the real estate property and property owners within at least 400 feet of the above-referenced subject property. This
reflects the most current records on file in the Palm Beach County Property Appraiser’s Office. The notifications were postmarked a minimum of 10 days in advance of the public hearing.
Site signs were posted on the premises a minimum of 10 days in advance of the public hearing in accordance with City Ordinance 04-007. Attached, are photographs of the signs showing
their placement on the property and proximity to the abutting right-of-way. Sincerely, _____________________________ Applicant /Agent Notary Public, State of Florida Cc: Planning & Zoning
Department S:\Planning\Forms\Applications\New Applications (LDR Rewrite)\Annexation.doc