Department of Community Development

|Public Works Department Case # SP To be filled out by CSR |

|Site Plan Application |

| |Application Fee includes first acre ($2,422.00) | $ |

| | |!Unexpected End of|

| | |Formula[pic] |

| |Acres @ $50.00 per acre (after one) any fraction of an acre counts as an additional acre (round up) | $ 0.00 |

| | |!Unexpected End of|

| | |Formula[pic] |

|2.7 acres would be calculated as two additional acres for a total of $2,522.00 | |

|(example: 1.1 acres would be calculated as one additional acre for a total of $2,472.00) | |

| |Amendment ($625) | $ |

| |Minor Change ($100) | $ |

| |Limited Review ($300) | $ |

| |Check # |Total Fee Submit $ |

| | | |

Submittal Materials Required (all spaces on the forms must be filled in):

| | |

| Letter of Intent (see example) | Owner Acknowledgement |

| | |

| Boundary Survey Checklist | Sufficiency Checklist |

| | |

| Site Plan Covenant | Owl/Gopher Affidavit |

| | |

| Landscape Responsibility Agreement | Fire Hydrant Responsibility Agreement |

| |(if applicable) |

| | |

| Water Quality & Attenuation Calculations | Environmental Site Survey |

| signed, sealed & dated (see | |

|sufficiency checklist for requirements) | |

| | |

| Traffic Generation Statement (required) | 15 signed, sealed & dated (see reference guide for requirements) |

| | |

| Traffic Impact Study (if applicable refer to | |

| Section K of the EDS) | |

|Public Works Department Case # SP |

| |10 sets of 24 X 36 (one sealed) site plans, folded (11 copies if on septic) | |

| |4 copies of the Building elevation (front, sides, rear) | |

| |Required documents (if applicable) prior to issuance of site plan permit | |

|Required documents (if applicable) prior to issuance of site plan permit |

| |Environmental Survey | |

| |Pollution Prevention Plan | |

| |South Florida Water Management District permit | |

| |Approved Driveway plans from Lee County DOT or Florida DOT | |

| |Demonstrate Pine Island Road District architectural features | |

| |Conveyance, Acceptance by City Council and Recording of additional easements | |

| |Draft of Property Owner Association Documents (required for multi-entity owner projects or projects proposing an underground surface water system), include |

| |all SFWMD criteria in basis of Review Section 9 relating to maintenance of the surface water management system |

|Required documents (if applicable) after the issuance of the site plan permit but, prior to a structure obtaining a Certificate of Occupancy. |

| |Hold Harmless Agreement (if private structures are in or near an easement that is currently or may be used for City utilities or storm water) |

| |Utilities Agreement (for On-site or Off-site, if conveyed to the City) | |

| |Joint Use Driveway Agreement / Easement (if applicable) | |

| |Certificate of Contributory Assets | |

| |Parcel straps combined | |

| |Is there a Lift Station on site? | |

PROJECT INFORMATION

|Legal Description: (if not platted) Case # SP |

|Project Name | |

|Applicant/Owner Name | |

|Address | |

|Phone | - - |Fax | - - |E-mail | |

|Legal Description |

|Strap Number of Parcel(s): | |

|Property Address (current): | |

|Unit | |Block | |Lot | |

|Plat Book: | |Page:k: | |Subdivision: | |

|Legal Description: (if not platted) | |

|Property Information |

|Acres | |Sq. Ft. | |Avg. Width | |Avg. Depth | |

|Building Frontage | |Protected Species on Property? | |

|Existing Land Use | |Existing Zoning | |

| |Proposed Use: | |

| | | |

|Current Use: | |Proposed Use: | |

|Development Information |

|Non-Residential: (Building Type) | |Sq. Ft. | |

|Number of Units: | |Number of Buildings: | |Number of Stories | |

|Residential Multi-family: Proposed Bldg Sq Ft | |

|Is Phasing Proposed | |Number of Phases Proposed: | |

|Estimated completion schedule: |Phase I | |Phase II | |Phase III | |

| |

|Please Check Additional Permits That May Be Required From Other Agencies: |

| HRS Permit | DEP Permit | SFWMD Permit | COE Permit |

| FDOT Permit | Lee Co. DOT Permit | NPDES Permit | Other |

PROFESSIONAL/OWNER INFORMATION

|Name of Authorized Representative: | |

|Address | |

|Phone - - |Fax - - |E-Mail |

|Name of Owner: | |

|Address | |

|Phone - - |Fax - - |E-Mail |

|Name of Engineer: | |

|Address | |

|Phone - - |Fax - - |E-Mail |

|Name of Surveyor: | |

|Address | |

|Phone - - |Fax - - |E-Mail |

|Name of Contractor: | |

|Address | |

|Phone - - |Fax - - |E-Mail |

|Name of Landscape Architect: | |

|Address | |

|Phone - - |Fax - - |E-Mail |

City of Cape Coral

Public Works Department Case #

Sample of Letter of Intent

(On Company Letterhead)

Site Plan Coordinator

Public Works Department

City of Cape Coral

1015 Cultural Park Boulevard

Cape Coral, Florida 33990

PROJECT: NAME

UNIT___, BLOCK____, LOT(S)_____, STRAP # _____

SUBJECT: SITE PLAN PERMIT LETTER OF INTENT

Dear____:

It is the intent of the property owner, _____, to request a Site Plan Permit for the above referenced project. This site comprises ____ ( acres and is located on ____ within the Pine Island Road District. The project will include the construction of two (2) office/flex-space buildings totaling 12,136 ( square feet, along with the associated utilities, drainage, parking and landscaping.

Ten (10) sets of plans (one signed and sealed) detailing the proposed construction are included in this submittal. Please call if you have any questions.

Sincerely,

attachments

|Public Works Department |SP # | |

Sufficiency Checklist For Boundary Survey

| |Boundary Survey Submittal Requirements |

| |Must meet Florida Administrative Code Chapter 61G17 Florida State Statutes Chapter 472 for a boundary survey |

| |Must be signed, sealed and dated |

| |Must be performed by a Florida Professional Surveyor (within 12 months prior to application submittal) |

| |Must contain the legal description |

| |Must indicate boundary lines of the project tract with bearings and distances shown |

| |Must show lines of original lot boundaries |

| |A North arrow, bar scale and feature legend should be shown |

| |All existing roads, alleys and easements should be shown with their widths and platted use |

| |Show sufficient spot elevations to define the surface drainage on the project site and within 50 feet outside the boundary (Elevations should |

| |be per the 1929 N.G.V.D.) |

| |Show control Benchmark(s) used |

| |Locate and show all visible evidence of utilities and storm water drainage features on or within 50 feet of the project boundary to include: |

| |Water lines, valves, backflow devices, meters and fire hydrants |

| |Sanitary sewer, manholes with invert & top elevation, pipe sizes through manholes with direction of flow indicated |

| |Irrigation lines |

| |Catch basins, storm sewer pipes, junction boxes with inverts, type of inlet, pipe sizes, pipe types and direction of flow |

| |Swales, curbs, gutters with spot elevations and direction of flow |

| |Sidewalk and driveway width |

| |Power poles, guy wires, overhead power lines |

| |Trees, tree grouping and shrubs |

| |Existing building structures on site and within 50 feet of property line |

| |Edge of existing paved areas showing type of pavement |

| |Fences or wall on site or within 50 feet of property line |

| |Show existing contours on 0.50 feet intervals if existing site elevations vary by ( 1.5 feet |

| |Existing natural features such as high points, water courses, depressions, ponds, marshes, swamps, wooded areas and flood elevations (if |

| |available) |

| |Street parking and loading area with parking spaces shown |

| |Location of any protected species habitat or environmentally sensitive lands or vegetation, as well as any known historical or archaeological |

| |resources |

SITE PLAN COVENANT

The undersigned does hereby swear or affirm to be the fee simple title holder and owner of record of the property commonly known as:

|Unit | |Block | |Lot | , |Plat Book | , |Page | |

Or

|Legal Description: | (further described as exhibit A and attached hereto) |

The property described herein is the subject of application for Site Plan Approval. I hereby designate

| |

as the legal representative of the property and as such, this individual is authorized to legally bind all owners of the property in the course of seeking the necessary approvals to develop. This authority includes but is not limited to the hiring and authorization of agents to assist in the preparation of applications, plans, surveys, and studies necessary to obtain the development on the site. This representative will remain the only entity to authorize development activity on the property until such time as a new or amended authorization is delivered to the City of Cape Coral.

The undersigned recognizes the following and will be guided accordingly in the pursuit of development of the project:

The property will be developed and used in conformity with the approved development order including all conditions placed on the development and all commitments agreed to by the applicant in connection with the development order. The legal representative identified herein is responsible for compliance with all terms, conditions, safeguards, and stipulations made at the time of approval of the development order, even if the property is subsequently sold in whole or in part, unless and until a new amended Site Plan Approval Covenant is delivered to the City of Cape Coral. A departure from the provisions of the approved plans or a failure to comply with any requirements, conditions, or safeguards provided for in the development order will constitute a violation of the Land Development Code.

All terms and conditions of the development order will be incorporated into the covenants and restrictions, which run with the land so as to provide notice to subsequent owners that all development must be consistent with those terms and conditions.

So long as this covenant is in force, the City of Cape Coral can, upon the discovery of noncompliance with any of the terms, safeguards, and/or conditions of the development order, seek equitable relief as necessary to compel compliance.

The City of Cape Coral may not issue permits, certificates, or licenses to occupy or use any part of the development and the City of Cape Coral may stop ongoing construction activity until the project is brought into compliance with all terms, conditions and safeguards of the development order.

| | | |

|Signature of owner/officer/partner | |Date |

| | | |

|Typed or printed name | |Title |

| | | |

|STATE OF | |, COUNTY OF | | |

| |

|Sworn to (or affirmed) and subscribed before me this day of , 20 , by |

| |who is personally known or produced | |

|as identification. |

|NOTARY STAMP HERE |Exp. Date: | |Commission Number: | |

| |Signature of Notary Public: | |

| |Printed name of Notary Public: | |

LANDSCAPING RESPONSIBILITY AGREEMENT

|THIS AGREEMENT made and entered into this day of 20 |

|by and between (hereinafter referred to as “OWNER”) |

|and the CITY OF CAPE CORAL FLORIDA (hereinafter referred to as “CITY”). |

NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties agree as follows:

OWNER acknowledges that he/she has planted, or may plant, trees and/or bushes in CITY utility easement located at his/her property described as:

| |

and further acknowledges that such planting is subject to provisions of Section 3.14 of the City of Cape Coral Land Use and Development Regulations.

In consideration of CITY allowing the installation, of said plantings, OWNER agrees that he/she will indemnify and hold CITY, its officers, employees and agents, harmless from any and all claims for injuries and damages to persons and property, both real and personal resulting from said plantings.

OWNER further agrees that CITY may remove the plantings by any method required at any time and for any reason, including, but not limited to, utility repairs and utility expansion.

OWNER agrees to be responsible for all costs involved in relocating or replacing any plantings removed by CITY from the easement. OWNER agrees that CITY shall be under no obligation of any damage to any plantings that may occur during CITY removal of said plantings.

Other than in the event of an emergency, as determined by the CITY, CITY agrees to give notice to OWNER of its intention to remove said plantings not less than seven (7) days where practical, prior to the removal, so that OWNER may relocate the plantings if he/she so desires. Any costs associated with relocation or replacement of said plantings shall be the obligation of OWNER and CITY shall have no responsibility or liability for same.

This agreement shall be binding on OWNER and his or her representative, heirs, assigns, and any purchasers of OWNER’S property.

| | | |

|Signature of owner/officer/partner | |Date |

| | | |

|Typed or printed name | |Title |

| | | |

|STATE OF | |, COUNTY OF | | |

| |

|Sworn to (or affirmed) and subscribed before me this day of , 20 , by |

| |who is personally known or produced | |

|as identification. |

|NOTARY STAMP HERE |Exp. Date: | |Commission Number: | |

| |Signature of Notary Public: | |

| |Printed name of Notary Public: | |

City of Cape Coral

Public Works Department

ACKNOWLEDGEMENT

I, _________________________________, as the owner of this property, or as the duly authorized representative, agree to conform to all applicable laws of the City of Cape Coral and to all applicable Federal, State and County laws, and certify that all information supplied is correct to the best of my knowledge.

In addition, I understand that prior to the issuance of the Certificate of Occupancy for this development; the engineer of record must supply the Public Works Department with the record drawings and a letter of Substantial Compliance for the project.

In addition, I authorize the staff of the City of Cape Coral to enter upon the property for the purposes of investigating and evaluating the request made through this application.

______________________________________ __________________

Signature of owner or authorized representative Date

______________________________________

Typed or printed name

STATE OF ______________

COUNTY OF ____________

The foregoing instrument was certified and subscribed before me _____ day of _________, 20____, by ________________________________, who is personally known to me ___________________________ or who has produced identification __________________________; type of identification produced _____________________; and who did _________ did not __________ take an oath.

______________________________________ __________________

Signature of Notary Public Date

______________________________________

Type or printed name

(SEAL)

|SP # | |

Sufficiency Checklist for Site Construction Plans

|Indicate Page # |Submittal Requirements |

| |The following checklist was developed for the use of a design professional engaged in the preparation of infrastructure plans for commercial and |

| |multi-family developments within the City of Cape Coral. |

| |1. Scale not less than 1” = 50’. |

| | |

| |2. Project Name, North Arrow, and Date (include on all drawings). |

| | |

| |3. Vicinity Map (should be located on the title sheet). |

| | |

| |4. Site Data Information Table must include: |

| |Site Identification (Block & Lot or strap number) |

| |Street Address |

| |Zoning |

| |Land Use |

| |Flood Zone |

| |Development Type |

| |Gross density (if applicable) |

| |Number of dwelling use (if applicable) |

| |Number, type and floor area of each dwelling unit (if applicable) |

| |Building Use |

| |Building Height (feet and stories) |

| |Construction Type |

| |Number of Employees (if applicable) |

| |Number of seats in a place of assembly (if applicable) |

| |5. Development Date Table (please enter the square footage. The calculation will be done for you.) |

(fields in yellow are required)

| |Project site | sq. ft. | 0.00 acreage |100 % of site |

| |Building ground floor area | sq. ft | 0.00 acreage |!Zero Divide % of site |

| |Total Building Area | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Pavement Area | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Concrete (Walks) | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Recreation Area | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Total Impervious | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Total Landscape Area | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Open Space or Green Space | sq. ft | 0.00 acreage |!Zero Divide of site |

| |Total Water Management Area (separate from open space) |

| |Parking spaces required (1 space per Article V, Section 5.1) |

| |Parking spaces provided (include number of handicap spaces) |

| |

|Indicate Page # |Submittal Requirements |

| |6. Site Plan shall Include: |

| |All applicable data and survey information shown on the Boundary and Topographic Survey including property Boundary and easement(s). |

| |Building location and dimensions (structures are not allowed over existing or proposed utilities). |

| | |

| |Building setback distances from the property lines and roadways. |

| | |

| |Location and width of pedestrian walkways including sidewalks. |

| | |

| |Numbered parking spaces. |

| | |

| |Parking space dimensions (See EDS sheet E-1, E-5 & E-6). |

| | |

| |Location of the sight triangle (Is it clear of parking lot, building, etc?) (see EDS G-21 and G-22). |

| | |

| |Location and signing of required handicap spaces (must meet Florida Building Code). |

| | |

| |lndicate all Handicap access route(s) to building. |

| | |

| |Indicate location of accessibility ramp(s) and slope(s) (if applicable). |

| | |

| |Location of parking lot curbing, curb type or landscape hedge. |

| | |

| |Location of all fire lanes, widths, surface type and signage should be indicated (if applicable). |

| | |

| |Provide dumpster location and detail or letter approving curbside pick-up (Is the dumpster outside of easement?). |

| | |

| |Provide a circulation plan for traffic to and from the project as well as internal circulation. |

| | |

| |Location of walls and fences (if applicable). |

| | |

| |Gate detail (including Fire department access) if applicable. |

| | |

| |Location of outdoor lighting, showing direction, height and type (if applicable). |

| | |

| |Location of existing electricity, gas mains, telephone and communication lines. |

| | |

| |Location of any protected species habitat or environmentally sensitive lands or vegetation. |

| | |

| |Location of all proposed signs (if applicable). |

| | |

| |7. Right-of-way infrastructure requirement: |

| |Is this site in the CRA ? |

| | |

| |Is a T.I.S. required (If 300 trips per hour both in and out from all driveways, see Section K of the EDS). |

| | |

| |Does the project propose a new median crossing (If so a T.I.S. would be required). |

| | |

| |Will a turn lane be proposed (see Section K and G-3 turn lanes in the EDS). |

| | |

| |Provide location, dimensions, separation distance, cross sections and type for driveway(s). (See EDS D-3 and D-6 for type D-5 or D-10 for width |

| |and separation) |

| | |

| |Is a joint use drive proposed? (See EDS sheet D-5, D-8, And D-9, Provide Agreement to City Real Estate Division). |

| | |

| |Is driveway apron shown as 6” thick concrete and 3000 psi minimum (see EDS sheets A-1, D-3, & D-6). |

| | |

| |Is the driveway intersection with road between 80 - 90 degrees (less than 80 is unacceptable, see EDS sheet D-2). |

| | |

| |Will the driveway location be inside a right turn lane or future right turn lane (see EDS sheet G-3). |

| | |

| |Provide location, dimensions and cross sections of all proposed access roads, loading area, parking lot areas, sidewalks, medians and median |

| |openings. |

| | |

| |Provide location, dimensions and cross sections of alley (include subgrade and pavement type and thickness, also check during initial design with |

| |City Engineering to determine if City has designed the alley grade, compare the alley grade with the proposed site elevations to insure lot |

| |drainage is contained on site for treatment and detention). |

| | |

| |Ensure ADA slope requirements are provided through the apron (If project is located on the corner of a road and intersecting alley check apron |

| |design from alley to street). |

| | |

| |Provide a construction note: MOT requiring barricades for alley improvements. |

| | |

| |Provide location, dimensions, elevations and cross sections of all curb and curb cuts (should match City design). |

| | |

| |Does the project’s widening or installation of new driveways block existing swale drainage within the right-of-way adjacent to the project (If so, |

| |the use of temporary pipes and structure may be required, see D-7, note 6). |

| | |

| |Label all traffic control devices (signals, stop signs, restricted turn, one-way, no exit, warning and pavement markings). |

| | |

| |Provide detail for corner radius. |

| | |

| |Provide details for street and pavement striping (see EDS sheets D-7, J-1, J-2, & G-4). |

| | |

| |Provide location and dimensions of existing driveways, ADA ramps, intersections within 200 feet. |

| | |

| |Provide specification or notes for restoration of disturbed right-of-way areas (See Sheet D-2). |

| | |

| |Detail to modify or replace existing inlet box, list type (See EDS Sheet C-1, C-2, C-3, C-4, & C-8). |

| | |

| |Detail provided for face plate on type 4 curb inlet. |

| | |

| |Location and detail of junction box (Required where storm sewers change direction, see EDS sheet C-5 & C-6). |

| | |

| |Provide turn lane details, length and cross sections (See Section K, G-2 turn lanes,G-3 left turn lane, G-13 notes, G-14 & G-19). |

| | |

| |Provide concrete curb separator details (the standard curb separator is 3 feet wide and the control access separator is 2 feet wide). |

| | |

| |Provide location of trees shown in the median design (trees must be placed at least 50 feet from the end of the median and 6 feet from the edge of|

| |the curb). |

| | |

| |Provide a 4” diameter sleeve in the end of the median separator for future sign (see EDS sheet G-13, G-19 & J-2). |

| | |

| |Detail for taper lanes (See EDS sheet C-2 turn lanes, D-7 note 4, G-1 3). |

| | |

| |Is a handicap ramp shown on the plans at the corner of the intersections. |

| | |

| |Are right-of-way widths at corners mismatched (see EDS sheet B-4). |

| | |

| |The City Services Division requires that mitered end sections not be used on new driveway culverts on swale section roads. |

| |Provide construction notes: |

| |All concrete placed in the right-of-way shall be 3,000 psi or greater. |

| | |

| |All sidewalk, curb and alley grades are to be set by the Public Works Department. |

| | |

| |Contractor shall protect all City regulatory signs during construction and replace those in the City right-of-way when construction is completed |

| |prior to Engineer Final. |

| |8. Drainage and grading design shall include: |

| |Show existing drainage features, spot elevations, swales, catch basins, manholes, junction boxes, detention area(s), direction of existing on-site |

| |and off-site drainage etc. |

| | |

| |Identify the location(s) and elevation(s) of the proposed surface water management system, parking and pavement area(s), building(s), driveway(s), |

| |perimeter berm(s), control structure(s), new culvert(s) or storm drain(s), detention swale(s) and pond(s). |

| | |

| |Drainage flow patterns for the entire project area. |

| | |

| |Cross section of retention/detention areas, perimeter berms, swales, property lines and control structures with a positive outflow. |

| | |

| |Location, size & length and elevations of all drainage / outfall pipes (Please note: the outfall pipe from the control structure should be designed|

| |to drain to a road or alley surface drainage system. Discharge may be into the canal or to the closest existing City drainage structure such as a |

| |catch basin or junction box on storm sewer). |

| | |

| |Detail of the control structure with bleeder, size and elevation, orifice/weir size and elevation top of grate elevation, outfall pipe. |

| | |

| |Show a baffle on the control structure (if applicable). Baffle to extend below invert of bleeder and weir. |

| | |

| |Demonstrate that all portions of the water management system are interconnected (if applicable). |

| | |

| |Identify how the run-off from the building roof is directed to the surface water management system (i.e. downspouts and roof drain collection |

| |system). |

| | |

| |Provide standard details of underground system which shows filter wraps, construction specifications and a section showing actual NGVD elevation of|

| |components of system and pavement. |

| | |

| |Identify the usage of all adjacent lots and identify direction of run-off. |

| | |

| |Identify method to remove, reduce or eliminate grease/sediments from underground systems. |

| | |

| |Provide maintenance plan for surface water management system. For underground systems a maintenance schedule should also be provided. |

| | |

| |Provide a construction note which indicates all pervious areas will be stabilized with sod or other ground cover. |

| | |

| |Location of erosion control silt fence. |

| | |

| |Erosion control features and measures. |

| | |

| |Location of temporary construction entrance and cross section. |

| | |

| |9. Drainage Calculations |

| |(Provide with construction plans if the project is not part of a master surface water management system) |

| |Identify and provide support for determination of the control elevation (Wet season water table elevation). |

| | |

| |Water quality calculation based on 1” over the project site or 2.5” times the percentage of impervious (Note: the required water quality volume is |

| |the greater of the two volumes). |

| | |

| |Provide compensating water quality treatment for all off-site impervious surface (based on 2.5” over the new impervious area). |

| | |

| |Show stage vs. storage volume chart, identified separately for each area of storage (i.e. detention pond, swale, underground system, site storage, |

| |pavement storage, etc). |

| | |

| |Identify the water quality storage stage (Note: all water quality storage must occur in the detention/retention system, no site or pavement storage|

| |can be used to meet volume). |

| | |

| |Soil storage calculations considering average grade over only pervious surface (if majority of pervious on site is the detention system). |

| | |

| |Determination of the tailwater conditions, considering actual receiving system. |

| | |

| |Recovery calculations for the water quality volume if retention is used (underground systems must recover the volume within one hour and on-site |

| |testing of soils is needed to verify percolation rates). |

| | |

| |The use of off-line systems is encouraged to assist in water quality treatment. |

| | |

| |Supporting documentation for all other parameters used in routing models such as time of concentration, DCIA, percentage of impervious surface. |

| | |

| |Routing models must use the SFWMD rainfall distribution. |

| | |

| |Calculations for the determination of the minimum parking lot, perimeter berm(s) and finished floor elevations and the determination of the peak |

| |discharge rate (The peak stage is from the 5 year 1 day, 25 year 3 day and 100 year 3 day zero discharge storm respectively with the 25 year 3 day |

| |of the off-site peak discharge). |

| | |

| |10. Utilities design shall include: |

| |Use the latest revision of the City of Cape Coral Standard Utility Drawings available from the City Clerk. |

| |Show all existing structure(s) to be demolished on the plans. |

| | |

| |Show location, size and length of all proposed and existing utilities (off-site and on-site) (distinguish existing lines from proposed by dashes |

| |vs. solid lines). |

| | |

| |Show size and location of meters and appropriate backflow prevention (backflow preventer not required on irrigation line). Place meters in the |

| |easement but do not run private utility lines in the public utilities easement. |

| | |

| |Show all existing and proposed easements (if applicable). |

| | |

| |If a pool is proposed, show how it is connected and does it need a separate meter? |

| | |

| |Location of all fire hydrants indicating distance to building(s). |

| | |

| |Location and label of all fire connections. |

| | |

| |Location of irrigation system (Do not locate in the easement and no meter if line is under 1” in diameter). |

| | |

| |Sewer cleanouts (required every 80 feet). |

| | |

| |Location of all on site electricity, gas mains, service lines and other utilities. |

| | |

| |Estimate of the average daily flow demand for potable water, wastewater and irrigation water. |

| | |

| |Identify and label proposed utility mains “public” or “private”. |

| |11. Landscaping Plan showing the following: |

| |Show abutting and adjacent Future Land Use and Zoning Designations. |

| | |

| |Show and provide General Tree (Required and Provided). |

| | |

| |Right-of-way buffering (width of planting shelf, number of shrubs and trees required and provided). |

| | |

| |Parking Area Interior Landscaping (required and provided number of trees and island sq.ft.). |

| | |

| |Show curbing of landscaping area(s). |

| | |

| |Total (required and provided number of trees and shrubs). |

| | |

| |Landscape Legend (include number of, type and size). |

| | |

| |Buffer Yard, width and length (if applicable). |

| | |

| |Irrigation method. |

| | |

| |Specify root barrier to protect physical integrity of sidewalk (if applicable). |

| |12. Additional Requirements: |

| |Deviation Requests – Eng |

| | |

| |Hold Harmless Agreements |

| | |

| |Joint-Use Driveway Agreement |

| | |

| |Cross Access Easement Agreement |

| | |

| |Alley Dedication |

| | |

| |Homeowner’s Association Agreement |

| | |

| |Utility Agreements |

| | |

| |State or County Permits |

| | |

| |Schedule meeting with Public Works Utilities Division and SDR for all proposed Utility Expansion Projects |

| | |

| |Obtain copies of City GIS maps with all existing utilities identified and labeled |

| | |

| |Submit Inter-local Agreement(s) (if Applicable) |

| | |

| |Differentiate and label proposed utility mains “public” or “private” |

| | |

| |Block Design (Y/N) |

| | |

| | If No; are assumptions provided? |

| | |

| |I have prepared the construction plans in accordance with the City of Cape Coral’s Land Use and Development Regulations, the Engineering Design |

| |Standards and this Sufficiency Checklist. |

| | | |

| |Engineer’s Signature |

|Burrowing Owl/Gopher Tortoise Affidavit |

|Contractor or Owner |

|Block |Lot |Unit |Strap # |

|Site Address |

|Within the last 30 days, I have inspected the property described above AND any vacant properties near the jobsite where I or my subcontractors may drive vehicles or |

|place construction material. |

| |

|I have found the following number of Burrowing Owl and/or Gopher Tortoise burrow(s) located on or adjacent to the aforementioned property, including those located in|

|abutting City rights-of-way. |

|None (0) One (1) Two (2) Three (3) Four (4) (Other) ___________ |

| |

|Please select one of the three available options below: |

| | option 1: state and/or federal Permits ARE necessary. I understand that State and/or Federal | |

| |permits are required prior to the commencement of development activity. | |

| |**Please indicate species, in known. Burrowing Owl Gopher Tortoise | |

| | | |

| | OPTION 2: NO STATE PERMITS ARE NECESSARY. No Burrowing Owl and/or Gopher Tortoise burrows exist on | |

| |or adjacent to the aforementioned property, including those located in abutting City rights-of-way. | |

| | OPTION 3: no state permits ARE necessary. Appropriate buffers will be maintained during all phases | |

| |of construction. | |

| |**Please indicate species, in known. Burrowing Owl Gopher Tortoise | |

| |By accepting local building permits, I hereby assume all responsibility to ensure the protection of Burrowing Owls and/or | |

| |Gopher Tortoises and their burrow(s) during all phases of construction activity. I will maintain a protection zone during all | |

| |phases of construction. The protection zone should extend a radius of 10 feet (20-foot diameter) from the Burrowing Owl | |

| |burrow entrance, and/or 25 feet (50-foot diameter) from the Gopher Tortoise burrow entrance. All burrows must be staked | |

| |using the aforementioned dimensions. Permanent installation of a T-perch is recommended for Burrowing Owls. I understand | |

| |that molesting, harassing, or injuring Burrowing Owls or Gopher Tortoises or their burrows is a crime. The City is required to | |

| |notify the law enforcement division of the Florida Fish & Wildlife Conservation Commission if a Wildlife violation is observed. | |

|I fully understand the Federal and State regulations that prohibit the endangerment and/or harassment of Burrowing Owls or |

|Gopher Tortoises and their burrows, and I accept full responsibility for the actions of my employees and subcontractors. |

| |

|I understand that the City is not liable for an applicant’s failure to obtain state and/or federal permits, is not liable for the |

|applicant’s failure to fulfill obligations imposed by a state and/or federal agency, and is not liable for any actions taken by the |

|applicant that result in violations to state and/or federal law. Further, I also understand that the City requires that all applicable |

|state and federal permits be obtained prior to the commencement of development activities. I am fully aware that the failure to |

|secure such permits will result in a Stop Work Order being issued on my site. |

| |

|Under penalty of perjury, I declare that I have read the foregoing document and that all information contained herein is true and |

|correct to the best of my knowledge and that violation of these Laws is punishable by a fine and/or imprisonment. |

| |

|By: |

| |

|Print Name & Title of Contractor or Property Owner Signature of Contractor or Property Owner |

| |

|(Signature Must be Notarized) |

|STATE OF |

| |

|, COUNTY OF |

| |

| |

| |

| |

| |

|Subscribed and sworn to (or affirmed) before me this day of , 20 , by |

| |

| |

|who is personally known or produced |

| |

| |

|Printed name of person signing as identification |

| |

| |

|Exp. Date: |

| |

|Commission Number: |

| |

| |

| |

|Signature of Notary Public: |

| |

| |

| |

|Printed name of Notary Public: |

| |

| |

FIRE HYDRANT RESPONSIBILITY AGREEMENT

|THIS AGREEMENT, made and entered into this | |day of | , |

|20 | , | by and between | , |

(hereinafter referred to as “OWNER”) and the CITY OF CAPE CORAL, FLORIDA (hereinafter referred to as “CITY”).

NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties agree as follows:

OWNER acknowledges that he/she has installed, or intends to install, and owns a fire hydrant(s) outside of CITY right-of-way and/or easement located at his/her property described as:

| |

and further acknowledges that such installation shall be accomplished in accordance with CITY Utility procedures.

OWNER agrees to be fully responsible for the operating condition and to inspect and maintain said fire hydrant(s) on an annual basis.

OWNER further agrees to provide the CITY Fire Department with certification of the required annual inspections in a timely fashion following each inspection.

OWNER agrees to indemnify and hold CITY, its officers, employees and agents, harmless from any and all claims for injuries and damages to persons and property, both real and personal that may be brought against CITY as a result of any operational deficiencies or defects in the fire hydrants(s) located on OWNER’S property.

This agreement shall be binding on OWNER and his or her representative, heirs, assigns, and any purchasers of OWNER’S property.

| | | |

|Date | |Signature of Owner (or contractor with authorization) |

(SIGNATURE MUST BE NOTARIZED)

|STATE OF | |, COUNTY OF | | |

| |

|Sworn to (or affirmed) and subscribed before me this day of , 20 , by |

| |who is personally known or produced | |

|as identification. |

|NOTARY STAMP HERE |Exp. Date: | |Commission Number: | |

| |Signature of Notary Public: | |

| |Printed name of Notary Public: | |

The City of Cape Coral requires an environmental survey for all development projects.

Section 5.4.3 of the Land Development Regulations requires the applicant to make “… adequate provision for fitting development harmoniously into the existing natural environment and will not adversely affect existing uses, scenic character, natural resources or property values in the surrounding areas.”

Properties with areas of natural vegetation and other areas that may have been previously disturbed but have not been routinely mowed (such as agricultural areas) require a survey conducted by an environmental professional. The purpose of the survey is to review the property for plant and wildlife species listed by the Florida Department of Agriculture (FDA), Florida Fish and Wildlife Conservation Commission (FWCC), and U.S. Fish and Wildlife Service (USFWS), as endangered, threatened, or species of special concern. Properties with wetland or potential wetland areas also must be surveyed by an environmental professional.

Surveys for these development projects must adhere to the survey guidelines issued by the Florida Fish and Wildlife Conservation Commission.

Guidelines for Development Projects Located on Previously Disturbed, Routinely Mowed Properties

Previously disturbed parcels that are on a routine mowing program typically offer limited wildlife habitat with some notable exceptions such as burrowing owl and gopher tortoise habitat. Individuals without specific environmental training may be able to recognize burrows of the burrowing owl and gopher tortoise. Therefore, the City will not require a professional wildlife survey for such properties, although it is encouraged. The developer or his/her agent is required to do a systematic walkover of the site and prepare a written report using the guidelines below. Any individuals performing the species surveys are urged to obtain and be familiar with the use of field guides for birds, reptiles, amphibians, mammals, insects, and plants, especially those guides developed for Florida. Additionally, individuals performing the species surveys are urged to consult the six volume series, Rare and Endangered Biota of Florida, published under the general editorship of Peter C.H. Prichard by the University Press of Florida in Gainesville. The individuals performing the species surveys should be equipped with measuring equipment and must be capable of plotting field locations onto a scaled drawing or aerial photograph.

If any protected species of plant or animal life are found on the site, a professionally prepared management plan may be required. City staff will conduct site checks to verify the findings of each survey. Any disturbance of habitat, such as the unpermitted destruction of any animal burrow, will be reported to the state and/or federal authorities and may delay the issuance of the development order until the matter is resolved.

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