HomeMy Public PortalAboutAPP 012-17 (Large Plan in File)TOWN OF GULF STREAM
ARCHITECTURAL REVIEW AND PLANNING REPORT
Application #: 012 -17 Owner: James & Beverly Kolea
Address: 900 Orchid Lane Agent: Peter Carney
Proposed Improvement: Construct a rear portico and a new front entrance.
Approvals Requested:
Level II Architectural /Site Plan: To construct a rear portico and a new front entrance to
the existing one - story, single family Bermuda /British
Colonial style dwelling, net additions of 403 SF
Gross Lot size: 39,984 SF (Unity of Title) Effective Lot Area: 39,984 SF
Proposed Total Floor Area: 6,634 SF
Zoning District: RS -P
Architectural Style: G/S Bermuda
Issues Considered During Review:
Section 70 -70 Floor area calculations
Section 70 -74 Setbacks
Allowable: 8,230 SF
Height: 17.0' (roof height < 20' Preferred)
Neighborhood: Mixed
Section 70 -99 Roof design, slope and materials
Section 70 -100 Roof and eave heights
Section 70 -239 Windows
Recommendation:
Motion to approve Level II Architectural/ Site Plan based on a finding that the proposed rear
portico and a new front entrance to the existing one-
story, single family Bermuda /British Colonial style
dwelling, net additions of 403 SF meet the minimum
intent of the Design Manual and applicable review
standards with the following conditions:
1. If the proposed site plan is altered because of the requirements of the Health
Department a revised site plan will require ARPB approval.
Action:
ARPB
Level II Architectural/ Site Plan: Approved as requested W/ condition as recommended above.
(4 -0)
Town of Gulf Stream
TOWN OF GULF STREAM
APPLICATION FOR DEVELOPMENT APPROVAL
NOV 15 2917
This form is to be used for all development review applications to be heard by the Town of Gulf Stream
Architectural Review and Planning Board, Board of Adjustment, and /or Town Commission. To complete the
form properly, please review the accompanying Town of Gulf Stream Instruction Manual for Application for
Development Review Form. Failure to complete this form properly will delay its consideration.
ARPB File #_L2__ 17
PART II. GENERAL INFORMATION
To be completed by all applicants.
A. Project Information
I.A.1. Project/OwnerName: 0,*V%4r.3 d- 3Q ✓2v f.1 <o I-e a
I.A.2. Project Address: 760 0 re_ (^' d I- . r.e
I.A.3. Project �Property Legal Description: L V T # � s , T I a c¢ 40 S o )l J
ToX - j &,"r 1 41� ya -43- I r, — e `r -].z -000 -0 *3a
I.AA. Project Description (describe in detail, including # of stories, etc.) £Y l S 'f l �y ( S �vv
w , l p J �-
I.A.5. Square Footage of New Structure or Addition: nXt-0 er r C e: r' f /er yovJya
Architectural Style: Derr.✓, 0. J0-) j 0 e- IJEI.s I- (.2 10 {
I
1.A.6. Check all that apply: WYArchitectural /Site Plan Review ❑ Land Clearing ❑ North Ocean Boulevard
Overlay (complete section B) ❑ Demolition of Structures ❑ Non- residential uses ❑ Variance
(complete section G) ❑ Special Exception (complete section F)
1.A.7. (a) Proposed F.F.E.: Type of Foundation: aV I J i r
B. Owner Information r1
I.B.1. Owner Address: PO ' / oX (S2- watrV -X PR 1e}o*C-7
I.B.2. Owner Phone Number: Fi ro 17- ° 3SS'L Fax: (oI v
1.B.3. Owner Signature:_ �1
C. Agent Information v /
I.C.I. Agent Name and Firm Name: LeR�.- ryv,K g-y
I.C.2. Agent Address: 136 6,9' S ¢` d,e"g. ST toy �e %r t1t 3 yg3
I.C.3. Agent Phone Numbe . (o) S /- 7 /f- 3 .S- cell Fax
1.C.4. Agent Signature:
Official L1 Only
Pre -App Date: ARPB Date:
App Date: Recommendation:
Com Date: TC Date:
Decision:
DD
Application for Development Approval Form ADA.2000
revised 6/13/00 Page 2
Town of Gulf Stream
PART III. PROJECT DESCRIPTION AND JUSTIFICATION
To be completed by all applicants after pre- application conference with Town Staff. Please be concise but
brief. Attach additional sheets only when necessary and be sure to include the appropriate and complete
question number for each response.
A. Project Description and Justification
III.A.1. In what zoning district is the project site located? g () — P
III.A.2. Is the project compatible with the intent of the zoning district ? O No
Explain:
III.A.3. Is the project consistent with the Future Land Use Map and goals, objectives and policies of the
Comprehensive Plan? No
Explain:
III.A.4. How are ingress and egress to the property to be provided? 2X 1,5 +1 ra d rive t . o!
,j
III.A.5.
a.
b.
C.
d.
e.
f.
9•
h.
How are the following utilities being provided to the property?
Stormwater Drainage -9-A t l 4-, .-r
Sanitary Sewer 0" 51 { �
Potable water - !R „ !21 c
l ,
Irrigation Water P.0 �I� , C
Electricity t�`� Y i
Telephone
Gas q
Cable Television
III.A.6. If the project involves the erection of one or more structures, please describe how the structures are
consistent with the criteria in Section 66 -144 of the Town of Gulf Stream Code. (Attach additional
sheet if necessary.)
PART IV. ADDITIONAL INFORMATION
Section A is to be completed by all applicants after pre- application conference with Town staff. Answering
"Yes" to any question in Section A requires the completion of additional Sections as indicated.
A. Additional Approvals /Requirements
IV.A.1. Does the project involve land area within fifty feet (50') of the Al (North Ocean Boulevard)
right -of -way? Yes (° (If "Yes ", Section B of this part must be completed.)
IV.A.2. Does the project involve the demolition of one or more structures? Yes No
(If "Yes ", Section C of this part must be completed.)
IV.A.3. Does the project involve the clearing or the filling of any portion of an existing vacant lot or more than
fifty percent (50 %) of the landscape area of a developed lot? Yes
(If "Yes ", Section D of this part must be completed.)
IV.A.4. Does the project require approval of a Special Exception? Yes
(If "Yes ", Section E of this part must be completed.)
IV.A.5. Is the pro' t at variance with any regulations contained in the Zoning Code?
N
Yes (If "Yes ", Section G of this part must be completed.)
Application for Development Approval, Form ADA.32000 Page
February 2002
PART 1. APPLICATION REQUIREMENTS
To be completed by Town Staff during pre - application conference.
A. Review and Approval Processes
❑ 1. N. Ocean Overlay Permit
❑ 2. Land Clearing Permit
❑ 3. Annexation Review
❑ 4. Comprehensive Plan Text Amendment Review
5. Demolition Permit
❑ 6. Future Land Use Mao Chanae Review
❑ 7. Appeal
❑ 8. Zoning code Text Amendment Review
B. Application Materials
❑ 9.
;<10.
❑ 11.
❑ 12.
❑ 13.
❑ 14.
❑ 15. Rezoning Review
❑ 16. (Other)
aRi`:AC 2 :1YC -Z'-D&
NOV 15 2012
Sign Review To,,;n of Gulf a:r sm, TL
Site Plan Review, Level II
Site Plan Revision
Special Exception Review
Subdivision Review
Variance Review
NUMBER OFf,I'v,
COPIES APPLICATION MATERIAL dY
REQUIRED 4
1 1. Completed Development Application
I 2. Fee of fX'o + IS +
12 3. Generation Location Ma on site Plan)
12 4. Site Plan 2 full size, 10 reduced to 11x17'
12 5. Building Elevations 2 full size, 10 reduced*)
12 6. Floor Plans (2 full size, 10 reduced" ) V,
12 7. Roof Plans 2 full size, 10 reduced*)
8. Perspective and /or Color rendering
1 Recommended for meeting)
1 9. Drainage Plan if altered
12 10. Landscape Plan 2 full size, 10 reduced'
11. Septic Tank Permit
12. DOT Driveway Permit (if on Al A, for any
alterations to drive
13. DOT Landscape Permit (Al A)
12 14. Survey 11" x 17" > /yy'
15. Subdivision Plat
16. Concurrency Documents
1 17. Proof of Ownership warrant deed ✓
JL,pd
entAffidavit jacent Pro ert Own perty owners withi 25' 00' (stamped addressed
veIo es, no return ess ) ert Owners Affidavit otos of Existin Home if a licable nstruction Traffic Mana ement Plan a " .ar
'NOTE• Wh
ere multiple copses of a drawln a required, two copies shall be an original full
size (24" x 36 ") drawing which is signed and sealed. All other copies shall be reduced to 11" x
17 ". Tse refer to the instruction for more detailed information.
t�VA cQts,U Vp,\k �1(,0 ( +, "lam
Application for Development Approval, Form ADA.32000 Page 1
November 2001
ere multiple copses of a drawln a required, two copies shall be an original full
size (24" x 36 ") drawing which is signed and sealed. All other copies shall be reduced to 11" x
17 ". Tse refer to the instruction for more detailed information.
t�VA cQts,U Vp,\k �1(,0 ( +, "lam
Application for Development Approval, Form ADA.32000 Page 1
November 2001
NOTICE OF APPLICATION FOR DEVELOPMENT APPROVAL OI I
NOTICE IS HEREBY GIVEN that the Architectural Review and
Planning Board of the Town of Gulf Stream will hold a Public
Hearing on Thursday, December 27, 2012 at 8:30 A.M., in the
Commission Chambers of the Town Hall, 100 Sea Road, Gulf Stream,
Florida, at which the following will be considered:
An application submitted by Peter Carney as agent for James
and Beverly Kolea, owners of property located at 960 Orchid
Lane, Gulf Stream, Florida, legally described as Lot 83,
Place Au Soleil Subdivision, Gulf Stream, Florida, for the
following:
LEVEL 2 ARCHITECTURAL/SITE PLAN REVIEW to construct a rear
portico and a new front entrance to the existing one - story,
single family Bermuda /British Colonial style dwelling,
additions of 403 square feet.
The Architectural Review and Planning Board shall make a
final decision regarding the subject application at the meeting
noticed above. The meeting may be adjourned from time to time and
place to place as may be necessary to hear all parties and
evidence.
The complete application materials are on file in the Office
of the Town Clerk located at 100 Sea Road, Gulf Stream, Florida
33483, and may be reviewed during regular business hours, which
generally include non - holiday weekdays from 9:00 A.M. to 4:00 P.M.
ALL PARTIES INTERESTED IN THESE MATTERS may appear before the
Architectural Review and Planning Board of the Town of Gulf Stream
at the time and place aforesaid and be heard.
SHOULD ANY INTERESTED PARTY SEEK TO APPEAL ANY DECISION MADE BY
THE ARCHITECTURAL REVIEW AND PLANNING BOARD WITH RESPECT TO ANY
MATTER CONSIDERED AT THIS PUBLIC HEARING, SAID PARTY WILL NEED A
RECORD OF THE PROCEEDINGS, AND FOR SUCH PURPOSE, MAY NEED TO
INSURE THAT A VERBATIM RECORD OF THE PROCEEDINGS IS MADE, WHICH
RECORD INCLUDES THE TESTIMONY AND EVIDENCE UPON WHICH THE APPEAL
IS TO BE BASED. 286.0105, F.S.S.
Dated: November 28, 2012
TOWN OF GULF STREAM, FLORIDA
Rita L. Taylor, Town Clerk
TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
COMMISSIONERS
JOAN K. ORTHWON, Mayor
THOMAS M. STANLEY, Vice Mayor
MURIEL 1. ANDERSON
W. GARRETT GERING
ROBERT W. GANGER
December 27, 2012
Mr. & Mrs. James Kolea
P. 0. Box 152
Wayne, Pa 19087
Dear Mr. & Mrs. Kolea:
This is to confirm that at the
Review and Planning Board on t';
Architectural /Site Plan Review
front entrance to the existing
Colonial style dwelling at 960
feet was considered.
Telephone
(561) 276 -5116
Fax
(561) 737-0188
Town Manager
WILLIAM H. THRASHER
Town Clerk
RITA L. TAYLOR
Public Hearing held by the Architectural
its date, your application for a Level 2
to construct a rear portico and a new
one - story, single family Bermuda /British
Orchid Lane, a total of 403 square
The application was approved as submitted with the condition that if
the proposed site plan is altered because of the requirements of the
Health Department, a revised site plan will require ARPB approval.
This approval shall expire on December 27, 2013 if a Building Permit
Application, including the aforementioned improvements, has not been
applied for.
Very truly yours,
2� /"
Rita L. Taylor
Town Clerk
cc: Peter Carney
100 SEA ROAD, GULF STREAM, FLORIDA 33483
TOWN OF GULF STREAM SITE DATA TABLE
Gross Lot Area
Zg, 1µa4
Effective Lot Area
FAR Calculations
EXISTING
DEMO
NEW
NET
1" Floor Living
4,5Vk
I
-
4, 570
Ceilings over 15' (double)
—
2ntl Floor Living
1" Floor Covered
(porches, overhangs > 2 f)
? Floor Covered
, 3Z
Z-71
Awnings > 3' and screen
enclosure (at 50% )
—
—
—
—
Garage
Gross Floor Area Uy8
Out Buildings
~5,250
Total Floor Area Proposed
A -4
(oilv3�
First 20,ODO X.33
Over 20,000 X .20
, 7
Total Allowable FAR
Per Manual
gi ZZq , 7
Total Nardscape Area
Required Landscape Area
of sae z 40%
Z5q
Actual % Landscape Open
Space Area
_
DeputyJConstitems/SitedaWi 1/01
b1,3`I
NOU -9 -2012 09:53 FROM:FRED R ZEITTEf 1 410 287 3131 TO:16106475L P.111
-6
10i�S��
On Gros,
TOWN OF GULF STREAM SITE DATA TABLE
Gross Lot Area
Z "If.
Effective Lot Area
FARCalculatiouz
M- STING
DEMO
NEW
NET
1 Floor Living
!figgg S.F.
Ig. fir,
4T7,0
Ccfliap over 15'
double
_
2° Floor living
—
V Floor Covered
(porches) overhanp>
2212
53 p S.�
x32 5F
,
1 Z'� L
�O 1 7
I
— 27 !
Co30i
i floor Covered
Awnings > 3' and
screen encl. t7%
Garage
Coln2 4,.F
----
Gross Floor Area
Out Buildings
Total Floor Area
ro osed
4570
First 20,000 X .33
- 1.21
(o� 6 0-0
7
Over 20,000 X.20
Total Allowable FAR
Per Manual
Total HardscapeArea
6 97 IY
Required Landscape
Area (Jol skex 40%)
I I I z_5-9
Aeiusl % Landscaped
O ea Sgnea Area
3 7 s
I -" Qj/ C�/Y',.
.VhP.Kle,v add
L� �etS TR7.n
f /6V � d d
Co I„n. /'7/'5 /0, E 7/
PAx
U NOV 15 2017
Toren of Gulf S.rcam, Yl
TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
COMMISSIONERS
WILLIAM F. KDCH, JR. Mayor
JOAN K. ORTHWEIN, Vice Mayor
FRED B. DEVITT III
CHRIS D. WHEELER
MORIEL J. ANDERSON
STATE OF FLORIDA
COUNTY OF PALM BEACH
TOWN OF GULF STREAM
AFFIDAVIT
BEFORE ME THIS DAY PERSONALLY APPEARED
C,
®RECE1Vk1nLL>
NOV 1 'CI?
Telephone
(561) 276.5116
Fax
(551) 737 -0186
Town Manager
WILLIAM H. THRASHER
Town Clerk
RITA LTAYLOR
PJI - W CA2ar , WHO BEING DULY SWORN, DEPOSES AND SAYS
THAT THE ACCOMPANYING LIST OF PROPERTY OWNERS, MAILING
ADDRESSES AND LEGAL DESCRIPTIONS OF ALL PROPERTY (circle one):
(1) within 25 feet, *(for N. Ocean Overlay, Demolition, Land Clearing; Signs and Site
Plan Review
(2) within 300 feet, *(for Variances or Appeals)
(3) adjacent to *(for Special Exceptions)
THE BELOW DESCRIBED PARCEL OF LAND IS, TO THE BEST OF HIS
KNOWLEDGE, COMPLETE AND ACCURATE AS RECORDED IN THE LATEST
OFFICIAL TAX ROLLS IN THE PALM BEACH COUNTY COURTHOUSE.
*street and waterways are excluded from this distance
THE SUBJECT OPERT IS LEGALLY DESCRIBED AS FOLLOWS:
"oI[t &- 4G 1' 1 . I, b i— '1 '
FURTHER AFFIANT SAYETH NOT:
SWORN AND SUBSCRIBED BEFORE ME THIS
MY COMMISSION EXPIRES:
Deputy /forms /const/ 10/ 15/08
(SIGNATURE)
t
y DAY OF 20 1d—
(NOTARY Pul IC)
SHIRLEY COHN
= Notary Public - Slate of Florida
My Comm. Expires Jun 1, 2016
Commission A EE 200669
Banded Through National Notary Aasn.
Lo ISCi
P * ap red by and return to:
John M. Cappeller, Jr.
Florida Title & Closing Co.
358 Camino Gardens Blvd. Suite 303
Boca Raton, FL 33432
561 -392 -3636
File Number: FT12 -098
Will Call No.: 159
�� IIIIUIIlllillll( GdliGllillfllNlilit11111iRlll�l
CFN 20120206004
04
CIR BX 25222 FG 0970
RECORDED 05/2412012 10:58:15
Palm Beach County, Florida
AMT 1. 025, 000. 00
Doc Stamp 7,175.00
Sharon R. Back,CLERE d COMPTROLLER
Pqs 0970 - 973; (4pgs)
Parcel Identification No. 204346-04-22-HO-0830
ISpace Atwrve This Line For Recording Data]
Warranty Deed
(STATUTORY rORM - SECTION 699,02, F.S.)
This Indenture made this / 6 day of May, 2012 between Sharon Osmolovsky, a single woman whose post office
address is 4003 Halsey Street, Kensington, MD 20895 of the County of Montgomery, State of Maryland, grantor ", and
.lames Kolea and Beverly Kulcu, husband and wife whose post office address is P.O. Box 152, Wayne, PA 19087 of the
COUnq of Chester, State of Pennsylvania, grantee *,
Witnesseth Thar said grantor, for and in consideration of the sum of TEN AND NO 1100 DOLLARS (SI0.00) and other
good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land.
Situate. lying and being in Palm Beach County, Florida, to -wit:
Lot 83, PLACE AU SOLEIL, according to the Plat thereof as recorded in Plat Book 27, Page 69,
Public Records of Palm Beach County, Florida.
Subject to restrictions, reservations and casements of record and taxes for the xvcar 2012 and
thercarter
and said grantor does hereby fully warrant the title to said land, and will defend the same aeainst lawful claims of all persons
whomsoever.
" "Omnuw" and "Omntee" are used liw singular or plural, m context rcipoms.
N0y i 51221?
DoubleT1me.
C C
In Witness Whereof. grantor has hereunto set grantor's hand and seal the day and year first above written.
Signed, sealed and delivered in our presence:
r
J JYJ �f Vfil �/�{!'
14 o .
Mame :.l /n• / lAf&'D
State of Florida
County of Palm Eicach
The foregoing instrument was acknowledged before me this / 8 day of May, 2012 by Sharon Osmolovsky, who U is
personally known or [X] has produced a driver's license as identificati
- h=
[Notary Sea[] Nota Public
JOEL M. COMERFORD Printed Name: 'vQ� /1l • COIAJ . icm n
•w$: Notary Public - State of Florida
• •; My Comm. Expires Sep 19, 2015 My Commission Expires:
'y i7,= Commission I EE 100497
••.at�4'` BondtdTbroUll aOanalHaaryAstn.
NNoV 1 5 2019
fm
llYrrunlr feed (Slalulvn• Faun) - Page'_ DoubleTim"
PREPARED BYAND RETURN TO:
PLACE AU SOLEIL ASSOCIATION, INC
P.O. Boa 113
Boynton Beach, FL 33425
C
�RECEIV
NO�r 15 2012
CONSENT TO CONVEYANCE
WHEREAS, -5/4 e-1 A.-I Df, "12 L ,1 V-5 /< rf is (are) the record
title holder(s) of the following described property situate in Palm Beach County, Florida, to wit:
LOT, PLACE AU SOLEIL, according to the Plat thereof recorded in Plat Book 27,
Page 69, of the Public Records of Palm Beach County, Florida.
SUBJECT, however, to covenants and conditions as contained in the Declaration originally recorded
in Official Records Book 729, at Page 117, subsequently amended and restated in Official Records Book 3714,
Page 226 and Official Records Book 14572, Page 181, all of the Public Records of Palm Beach County,
Florida, wherein an option to purchase or right of first refusal was reserved; and
WHEREAS, PLACE AU SOLEIL, INC., and PLACE AU SOLEIL DEVELOPMENT CORPORATION,
both Florida corporations, did, on April 15, 1973, assign all privileges, rights, powers, duties and authority
reserved to them by said Declaration to ROBERT C. REED, by that instrument recorded in Official Records
Book 2161, at Page 1099, of the Public Records of Palm Beach County, Florida; and
WHEREAS, ROBERT C. REED did, on February 15, 1977, assign all privileges, rights, powers, duties
and authority reserved to him by reason of said Declaration and the aforesaid assignment, to PLACE AU
SOLEIL HOMEOWNERS' ASSOCIATION, INC., a Florida corporation, by that certain instrument recorded
May 10, 1977, in Official Records Book 2676, at Page 1807, of the Public Records of Palm Beach County,
Florida; and
WHEREAS, PLACE AU SOLEIL HOMEOWNERS' ASSOCIATION, INC. did, on March 20, 1980,
assign all privileges, rights, powers, duties and authority reserved to it by reason of said Declaration and
aforesaid assignment, to PLACE AU SOLEIL ASSOCIATION, INC., a Florida corporation not for profit, by that
certain instrument recorded March 31, 1980, in Official Records Book 3259, at Page 1512, of the Public
Records of Palm Beach County, Florida; and
WHEREAS, the aforesaid present owner(s) of the aforedescribed property desire to sell and convey
said premises to
TA" P"; v-- AEF I/0(2- L%)./ ant A
hereinafter referred to as the "proposed Grantee."
NOW, THEREFORE, the undersigned, acting for and on behalf of PLACE AU SOLEIL
ASSOCIATION, INC., for the sum of TEN and 00 /100 DOLLARS ($10.00) and for other good and valuable
consideration, do hereby expressly waive any and all interest it may possess with regard to the aforesaid
premises including any option to purchase and /or right of first refusal and do hereby consent to the foregoing
J
G C
• • ,.
Hpa1
152012
z•i�'!�', i'f>,�,R caa���:'j.,T^ ai.,Lx..L' ....I:.r...- ra,- �.!t,..• ' . -ri. =. ..--- �r.s•Z —_ - .iy......._...
e
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proposed conveyance to the aforedescribed 'proposed Grantee', PROVIDED, HOWEVER, that this consent
shall apply only as to the conveyance hereinabove referred to, and the reservation set forth in the aforesaid
Declaration, all other provisions of same to remain in full force and effect.
IN WITNESS WHEREOF, the undersigned have set their hands and seals the day and year as swom
to below.
PLACE AU SOLEIL ASSOCIATION, INC.
I
-President
y/�
Attest:
,Secret. a1 g n r J
(COlpordie.Seal�, 4,.'; ,.�
STATE OF FLORIDA
COUNTY OF PALM BEACH
BEFORE ME, personally appeared 4171, 6Z171?e X A As Presidentlf PACE
AU SOLEIL ASSOCIATION, INC., to me well known to be the person described in and who executed the togegoing;_,
Consent To Conveyance and who acknowledged before me that the execution thereof was made freely as such ofAt err3s
the authorized act of the corporation. K
SWniM2�� ribed b fo e y day of 20_
ubllc slate or Florida
S Anderson m6sion EEO1e 00� 01/09!2015 � print Name
Notary Public
(SEAL] Commission No. EEU38334-1
My commission expires: I 1 9 / Zo 1S
STATE OF FLORIDA
COUNTY OF PALM BEACH
BEFORE ME, personally appeared � A- nJ-;�,e/t G7 A iv -, Olietary of PLACE
AU SOLEIL ASSOCIATION, INC., to me well known to be the person described in and who executed the foregoing
Consent To Conveyance and who acknowedged before me that the execution thereof was made freely as such officer as
the authorized act of the corporation. ,•
SWORN TO and subscribed before me this day of 20LI
rww'"o OEENA L JONES
Notary Publlc - State Of Florida
y My Comm. Expires Aug 9. 2015
°lt CO"19p N EE 120507
LIIL
.—(Print Name)
Notary Public
Commission No.'
My commission expires
®RECC��r�.�,,
NOV t l ?n 2
TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
COMMISSIONERS
WILLIAM F. KOCH, JR. Mayor
JOAN K. ORTHWEIN, Vice Mayor
FRED B. DEVITT III
CHRIS 0. WHEELER
MORIEL J. ANDERSON
STATE OF FLORIDA )
COUNTY OF PALM BEACH )
TOWN OF GULF STREAM )
F11001ad ".e2. 010
C
(*RECE1V17n -)
012 -17
BEFORE ME THIS DAY PERSONALLY APPEARED (Owner) � ffsyvS LD e,-,
, WHO BEING DULY SWORN, DEPOSES AND SAYS:
Telephone
(561) 276-5116
Fax
(561) 737 -0166
Town Manager
WILLIAM H. THRASHER
Town Clerk
RITA L TAYLOR
THAT THE PERSON(S) OR COMPANY OR FIRM LISTED BELOW
HAVE THE CONSENT OF THE OWNER OF THE PROPERTY LISTED
BELOW TO REPRESENT THE OWNER OF SAID PROPERTY AS
AGENT FOR SITE PLAN REVIEW WITHIN THE TOWN OF GULF STREAM.
THE SUB CT PROPERTY IS LEGALLY DESCRIBED AS FOLLOWS:
I Sze A, Scle, I JAI- ?3
AGENT'S(S) NAME:
COMPANY OR FIRM NAME:
AGENT'SnRESS:
ell IL D-1 A cPq ii . Ec-
AGENT'S PHONE:
FURTHER AFFIANT SAYETH NOT.
(Owner Signature)
SWORN AND SUBSCRIBED BEFORE ME THIS
MY COMMISSION EXPIRES:
L.
~ DAY OF ate^ , 20
ARY P y SHIRLEY COHN
m Notary Public - State of Florida
My Comm. Expires Jun 1, 2016
:' Commission A' EE 200669
Bonded Through National Notary Assn.
100 SEA ROAD, GULF STREAM, FLORIDA 33483
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