Contract 2023-003AINSTRUMENT#: 2023005777 OR BK 6080 PG 979 PAGES: 7 1/18/2023 10:18:28 AM
GARY J. COONEY, CLERK OF THE CIRCUIT COURT & COMPTROLLER, LAKE COUNTY, FLORIDA
REC FEES: $61.00
2023 003A
UTILITY SERVICE AGREEMENT - WATER
This document constitutes an agreement between the City of Clermont, hereby referred to as
CITY, a municipality of the State of Florida, and Mardoche Dorsonne, and any successors or
assigns, hereby referred to as OWNER.
WITNESSETH
Whereas, OWNER is requesting service to a new single family residential home which is located
on 0.68+/- acres at XXXXX Hartle Road, (Alt Key — 3817537) on real property (the "Property")
described on Exhibit `A', attached hereto and by this reference made a part hereof; and
Whereas, the Property is located in the incorporated area of Lake County and the OWNER is
requesting water service from the CITY; and
Whereas, as a condition of CITY providing said water service to the Property, OWNER is to
extend water lines to serve the Property and lines and appurtenances must be sized and
constructed in accordance with the minimum requirements of CITY Land Development
Regulations and to meet the flow demands for the site; and
Whereas, the CITY may, at the sole option of the CITY, elect to oversize the water lines and
appurtenances in order to provide additional capacity to other properties; and
Whereas, as a condition of the provision of water service to the Property by the CITY, OWNER
agrees that this Agreement shall constitute an unconditional application to annex the Property
into the City of Clermont, if the CITY chooses to do so; and
Whereas, OWNER and CITY are entering into this Agreement to set forth the terms and
conditions under which water service shall be extended and sized.
NOW THEREFORE, in consideration of the mutual promises and covenants hereinafter
contained, the parties do hereby agree as follows:
Section 1.OFF-SITE WATER — Each and all of the foregoing premises are incorporated into and
constitute a part of this Agreement.
1.1 CITY shall provide water service for the Property.
1.2 OWNER shall connect to the existing City system at connection point or points approved
by CITY.
1.3 The route of any off site lines shall be according to engineering plans produced by
OWNER and approved by the CITY.
1.4 The OWNER shall construct the facilities, lines and appurtenances necessary to serve the
development and provide such documentation necessary for the CITY to ascertain that
the lines shall meet the minimum line size requirements as specified by the CITY Land
Development Regulations.
1 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
INSTRUMENT# 2023005777 OR BOOK 6080/PAGE 980 PAGE 2 of 7
1.5 In the event the CITY chooses to oversize the lines or appurtenances, the CITY shall
provide to the OWNER the specifications regarding sizes to be included in the final
improvement plans.
1.6 The OWNER shall be responsible for the construction of all on site and off site lines and
appurtenances to serve the project. No building permits shall be issued until water is
provided to the site or until a bond or letter of credit, acceptable to CITY, is in place to
guarantee completion of off -site improvements.
1.7 The OWNER shall be responsible for all costs of on -site and off -site improvements,
including but not limited to design, material, permitting and installation of sufficient size
lines, lift stations and other appurtenances necessary to allow the CITY to serve the
Property.
1.8 The existing utilities shall stay in service throughout construction. If the construction
requires that the utilities be relocated or altered, the OWNER shall prepare plans, permit
the project and construct the modifications at the OWNER's expense.
1.9 The project shall provide access easements to the City of Clermont to access the water
meter for the site. The City of Clermont will charge water fees based on the water meter
readings.
1.10 The CITY shall be responsible for the difference in cost of materials to oversize the line if
the CITY chooses to oversize based on plans and cost estimates provided by OWNER to
CITY, and approved in advance by the CITY.
1.11 The OWNER shall provide to the CITY a cost estimate for materials for the minimum size
lines and appurtenances and a cost estimate for materials for an approved oversize. Cost
estimate shall be contractors bid as certified by OWNER'S project engineer. The CITY
shall review and either approve or reject the costs.
1.12 The OWNER shall be responsible for all costs including design, permitting, materials and
construction of the water lines and appurtenances, both on site and off site, required to
serve the Property.
1.13 The OWNER shall be responsible for all applicable fees including but not limited to impact
fees, connection fees and permitting fees. All fees are non-refundable.
Section 2. DEVELOPMENT STANDARDS
2.1 Any other water service development items to the site that have not been addressed must
be completed in accordance with City of Clermont standards unless otherwise stipulated
in this Agreement or subsequent amendments to this Agreement.
2.2 The use shall be limited to a single-family residential structure with typical water use, 250
gallons per day, annual average.
2.3 Existing well shall only be used for irrigation purposes and must not connect to the home
or City Water supply. The owner shall maintain a RPZ backflow device on the potable
water system.
2 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
INSTRUMENT# 2023005777
OR BOOK 6080/PAGE 981 PAGE 3 of 7
Section 3. ANNEXATION
OWNER agrees that CITY may annex the Property into the City of Clermont if CITY, at its sole
discretion, chooses to do so. In conjunction herewith, OWNER shall provide to CITY a Notice of
Encumbrance To Annex Property in a form substantially in compliance with the form set forth in
Exhibit "B", attached hereto and incorporated herein. The CITY shall record this Notice in the
public records of Lake County whereupon it is agreed it shall serve as an enforceable
encumbrance on the real property described in Exhibit "A" and shall be accompanied, at
OWNER's expense, by a current certificate of title or opinion letter acceptable to CITY and issued
by a licensed title company or attorney identifying all owners in interest of the real property. All
land transfers by OWNER shall contain a deed restriction or covenant noting the existence of this
encumbrance to annex, such restriction to be recorded as a covenant to run with the land.
The OWNER, agrees on his/hers/theirs/its own behalf and that of Grantors' heirs and assigns that
once the property is annexed into the City, in the event that the septic tank or septic field fails, the
OWNER shall connect to City's sewer system when a sewer connection is available as
determined by City.
Section 4. SEVERABILITY
In the event that any provision of this agreement shall be held invalid or unenforceable, the
provision shall be deleted from this agreement without affecting in any respect whatsoever the
validity of the remainder of this agreement.
Section 5. NOTICES
All notices, demands, or other writings required to be given or made or sent in this Agreement, or
which may be given or made or sent, by either party to the other, shall be deemed to have been
fully given or made or sent when in writing and addressed as follows:
CITY
City of Clermont
City Manager
P.O. Box 120219
Clermont, FL 34712-0219
Section 6. AMENDMENTS
OWNER
Mardoche Dorsonne
1422 Shoreside Way STE 110-135
Winter Garden, FL 34787
Any amendment to this agreement is not effective unless the amendment is in writing and signed
by all parties.
Section 7. EFFECTIVE DATE AND TERM
This agreement shall take effect as of the latest date either party executes this agreement and
shall expire on the fifth anniversary thereof unless extended by a subsequent agreement of the
parties.
3 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
INSTRUMENT# 2023005777 OR BOOK 6080/PAGE 982 PAGE 4 of 7
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement on the
dates listed below. CITY through its City Manager, authorized to execute it by City Council
action.
DATED this 10"' day of January 2023.
CITY OF CLERMONT
Tim Murry, Mayor
OWNER:
Mardoche Dorsonne
Signature
STATE OF 0i? (� c-.
COUNTY OF (G ^ Clt
ATTEST:
�( Tracy Ackroyd Howe, MMC, City Clerk
Ac
k/+ADN.--LL,Ztom.✓ - ...1 ..��ei�W41►�IrA`Y�
Print Name
I HEREBY CERTIFY that on this day, before me, an o icer ly thrp[ized to administer
oaths and take acknowledgments, personally appeared a r, d wt ;gas
of , who provided identification in
the form of L r who is personally known to be the person described in and
who executed the fore nd th1t he acknowledged kiE
executed the same.
Witness my hand and offic' seat'this day of 2blic SWe of FloridariceMion GG 944219rjWo2a
Notary Public SEA
v.
Type/print name o-
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4 - Mardoche borsonne - AK 3817537, Utility Service Agreement for Water Services
INSTRUMENT# 2023005777 OR BOOK 6080/PAGE 983
PAGE 5 of 7
EXHIBIT "A"
PROPERTY DESCRIPTION
Owner:
Mardoche Dorsonne
1422 Shoreside Way STE 110-135
Winter Garden, FL 34787
Description:
FROM NW COR OF SE 1/4 OF SW 1/4 RUN S 89-19-56 E 130 FT FOR POB, CONT S
89-19-56 E 130 FT, S 00-35-31 W 188 FT, S 89-19-56 E 70 FT, N 41-31-42 E 114.70 FT
TO W RAN LINE OF HARTLE RD, S 17-03-37 W ALONG SAID R/W LINE 80 FT, S 62-
52-45 W 53.63 FT, N 89-19-56 W 205 FT, N 00-35-31 E 203 FT TO POB ORB 6037 PG
274
Containing 0.68 +/- acres more or less.
Lake County Alternate Key Numbers:
3817537
5 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
INSTRUMENT# 2023005777 OR BOOK 6080/PAGE 984 PAGE 6 of 7
EXHIBIT 'B"
Notice of Encumbrance
to Annex to City of Clermont
City of Clermont
685 W. Montrose Street
Clermont, FL 34712
THIS INSTRUMENT, Made this 101h day of January, 2023, between Mardoche Dorsonne,
property owner in the County of Lake, State of Florida Grantor*, and the CITY OF CLERMONT,
FLORIDA, A Municipal Corporation, Grantee*:
WITNESSETH, NOTICE is given that heretofore or contemporaneously herewith Grantor has
petitioned the Grantee for it to permit voluntary annexation of Grantor's property below
described into the corporate limits of the City of Clermont, and
GRANTOR, for and in consideration of the sum of ONE and 00/100 ($1.00) and other good and
valuable consideration to Grantor in hand paid by Grantee, the receipt whereof is hereby
acknowledged, DOES HEREBY ENCUMBER the below — described real property situate, lying
and being in Lake County, Florida with the absolute requirement that the subject real property
may be, at the sole discretion, and upon request of Grantee, annexed into the city limits of the
City of Clermont at such time that the annexation of said real property is in accordance with
applicable law,
GRANTOR, further agrees, on his/hers/theirs/its own behalf and that of Grantors' heirs and
assigns to perform all ministerial functions necessary of the Grantor or Grantor's heirs and/or
assigns (as the case may be) then required by law to enable the described real property to be
incorporated into the city limits of the City of Clermont and where such ministerial functions
consist of a simple written request or the renewal of the petition of which notice is given above,
then this instrument shall be considered such request and/or renewal. The subject property is
described as:
Exhibit "A"
GRANTER, agrees on his/hers/theirs/its own behalf and that of Grantors' heirs and assigns that
once the property is annexed into the City, in the event that the septic tank or septic field fails,
6 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
INSTRUMENT# 2023005777 OR BOOK 6080/PAGE 985 PAGE 7 of 7
the GRANTER shall connect to City's sewer system when a sewer connection is available as
determined by City.
Grantor is used for singular or plural, as the context requires. IN WITNESS THEREOF,
GRANTOR has hereunto set Grantor's hand and seal the day and year first above written.
PROPERTY OWNER(S): WITNESSES (Two required):
Mardoche Dorsonne
Signature
Type or print name
f/
STATE OF / t
Witnesses
Signature
Type or print name
2�
' Signature
Type or print name
COUNTY OF
��., )ewo
The foregoing n m a acknoWedged before me on this day of A,j—,;.__
20 G , by r �'Gry $ i r✓�✓ � ... , who is personally known to me
or who has produced (/�- as identification and who did
not take an oath. F
" Notary Pubk SmW of Florid,
Notary Public ." / ' M Csid ommie—lon GG 944219
Expires Z2012024
Type/print naine ..Sties
Pursuant to SectimY695.29(3)(f): this instrument exempt from Chapter 695, F.S.,; Prepared by a Public Officer, City Attorney,
City of C(�rmont, P,76sida 34712
• Ir
7 - Mardoche Dorsonne - AK 3817537, Utility Service Agreement for Water Services
UTILITY SERVICE AGREEMENT - WATER
This document constitutes an agreement between the City of Clermont, hereby referred to as
CITY, a municipality of the State of Florida, and Mardoche Dorsonne, and any successors or
assigns, hereby referred to as OWNER.
WITNESSETH
Whereas, OWNER is requesting service to a new single family residential home which is located
on 0.68+/- acres at XXXXX Hartle Road, (Alt Key - 3817537) on real property (the "Property")
described on Exhibit `A', attached hereto and by this reference made a part hereof; and
Whereas, the Property is located in the incorporated area of Lake County and the OWNER is
requesting water service from the CITY; and
Whereas, as a condition of CITY providing said water service to the Property, OWNER is to
extend water lines to serve the Property and lines and appurtenances must be sized and
constructed in accordance with the minimum requirements of CITY Land Development
Regulations and to meet the flow demands for the site; and
Whereas, the CITY may, at the sole option of the CITY, elect to oversize the water lines and
appurtenances in order to provide additional capacity to other properties; and
Whereas, as a condition of the provision of water service to the Property by the CITY, OWNER
agrees that this Agreement shall constitute an unconditional application to annex the Property
into the City of Clermont, if the CITY chooses to do so; and
Whereas, OWNER and CITY are entering into this Agreement to set forth the terms and
conditions under which water service shall be extended and sized.
NOW THEREFORE, in consideration of the mutual promises and covenants hereinafter
contained, the parties do hereby agree as follows:
Section 1. OFF -SITE WATER - Each and all of the foregoing premises are incorporated into and
constitute a part of this Agreement.
1.1 CITY shall provide water service for the Property.
1.2 OWNER shall connect to the existing City system at connection point or points approved
by CITY.
1.3 The route of any off site lines shall be according to engineering plans produced by
OWNER and approved by the CITY.
1.4 The OWNER shall construct the facilities, lines and appurtenances necessary to serve the
development and provide such documentation necessary for the CITY to ascertain that
the lines shall meet the minimum line size requirements as specified by the CITY Land
Development Regulations.
1 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
1.5 In the event the CITY chooses to oversize the lines or appurtenances, the CITY shall
provide to the OWNER the specifications regarding sizes to be included in the final
improvement plans.
1.6 The OWNER shall be responsible for the construction of all on site and off site lines and
appurtenances to serve the project. No building permits shall be issued until water is
provided to the site or until a bond or letter of credit, acceptable to CITY, is in place to
guarantee completion of off -site improvements.
1.7 The OWNER shall be responsible for all costs of on -site and off -site improvements,
including but not limited to design, material, permitting and installation of sufficient size
lines, lift stations and other appurtenances necessary to allow the CITY to serve the
Property.
1.8 The existing utilities shall stay in service throughout construction. If the construction
requires that the utilities be relocated or altered, the OWNER shall prepare plans, permit
the project and construct the modifications at the OWNER's expense.
1.9 The project shall provide access easements to the City of Clermont to access the water
meter for the site. The City of Clermont will charge water fees based on the water meter
readings.
1.10 The CITY shall be responsible for the difference in cost of materials to oversize the line if
the CITY chooses to oversize based on plans and cost estimates provided by OWNER to
CITY, and approved in advance by the CITY.
1.11 The OWNER shall provide to the CITY a cost estimate for materials for the minimum size
lines and appurtenances and a cost estimate for materials for an approved oversize. Cost
estimate shall be contractors bid as certified by OWNER'S project engineer. The CITY
shall review and either approve or reject the costs.
1.12 The OWNER shall be responsible for all costs including design, permitting, materials and
construction of the water lines and appurtenances, both on site and off site, required to
serve the Property.
1.13 The OWNER shall be responsible for all applicable fees including but not limited to impact
fees, connection fees and permitting fees. All fees are non-refundable.
Section 2. DEVELOPMENT STANDARDS
2.1 Any other water service development items to the site that have not been addressed must
be completed in accordance with City of Clermont standards unless otherwise stipulated
in this Agreement or subsequent amendments to this Agreement.
2.2 The use shall be limited to a single-family residential structure with typical water use, 250
gallons per day, annual average.
2.3 Existing well shall only be used for irrigation purposes and must not connect to the home
or City Water supply. The owner shall maintain a RPZ backflow device on the potable
water system.
2 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
Section 3. ANNEXATION
OWNER agrees that CITY may annex the Property into the City of Clermont if CITY, at its sole
discretion, chooses to do so. In conjunction herewith, OWNER shall provide to CITY a Notice of
Encumbrance To Annex Property in a form substantially in compliance with the form set forth in
Exhibit "B", attached hereto and incorporated herein. The CITY shall record this Notice in the
public records of Lake County whereupon it is agreed it shall serve as an enforceable
encumbrance on the real property described in Exhibit "A" and shall be accompanied, at
OWNER's expense, by a current certificate of title or opinion letter acceptable to CITY and issued
by a licensed title company or attorney identifying all owners in interest of the real property. All
land transfers by OWNER shall contain a deed restriction or covenant noting the existence of this
encumbrance to annex, such restriction to be recorded as a covenant to run with the land.
The OWNER, agrees on his/hers/theirs/its own behalf and that of Grantors' heirs and assigns that
once the property is annexed into the City, in the event that the septic tank or septic field fails, the
OWNER shall connect to City's sewer system when a sewer connection is available as
determined by City.
Section 4. SEVERABILITY
In the event that any provision of this agreement shall be held invalid or unenforceable, the
provision shall be deleted from this agreement without affecting in any respect whatsoever the
validity of the remainder of this agreement.
Section 5. NOTICES
All notices, demands, or other writings required to be given or made or sent in this Agreement, or
which may be given or made or sent, by either party to the other, shall be deemed to have been
fully given or made or sent when in writing and addressed as follows:
CITY
City of Clermont
City Manager
P.O. Box 120219
Clermont, FL 34712-0219
Section 6. AMENDMENTS
OWNER
Mardoche Dorsonne
1422 Shoreside Way STE 110-135
Winter Garden, FL 34787
Any amendment to this agreement is not effective unless the amendment is in writing and signed
by all parties.
Section 7. EFFECTIVE DATE AND TERM
This agreement shall take effect as of the latest date either party executes this agreement and
shall expire on the fifth anniversary thereof unless extended by a subsequent agreement of the
parties.
3 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement on the
dates listed below. CITY through its City Manager, authorized to execute it by City Council
action.
DATED this 101h day of January 2023.
CITY OF CLERMONT
Tim Murry, Wyor
OWNER:
Mardoche Dorsonne
t'119411/wl— -
Signature
STATE OF
COUNTY OF G n
ATTEST:
( Tracy Ackroyd Howe, MMC, City Clerk
Nrint Name
I HEREBY CERTIFY that on this day, before me, an o dicer ly tl� ized to administer
oaths and take acknowledgments, personally appeared /� d �✓t 11 has
of , who provided identification in
the form of r who is personally known to be the person described in and
who executed the foreh and tt�at he acknowledged before me that he executed the same.
Witness my hand d offic' se this / day of 1
> �410y IN Notary Public State of Florida
Donald Pnce
My Commission GG 944219
Notary Public SEA c►a Expires04/28/2024
l
Type/print na i 'bA/';'
4 — MardocheI'lle
ne — AK 3817537, Utility Service Agreement for Water Services
EXHIBIT "A"
PROPERTY DESCRIPTION
Owner:
Mardoche Dorsonne
1422 Shoreside Way STE 110-135
Winter Garden, FL 34787
Description:
FROM NW COR OF SE 1/4 OF SW 1/4 RUN S 89-19-56 E 130 FT FOR POB, CONT S
89-19-56 E 130 FT, S 00-35-31 W 188 FT, S 89-19-56 E 70 FT, N 41-31-42 E 114.70 FT
TO W R/W LINE OF HARTLE RD, S 17-03-37 W ALONG SAID R/W LINE 80 FT, S 62-
52-45 W 53.63 FT, N 89-19-56 W 205 FT, N 00-35-31 E 203 FT TO POB ORB 6037 PG
274
Containing 0.68 +/- acres more or less.
Lake County Alternate Key Numbers:
3817537
401
M � •
5 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
EXHIBIT 'B"
Notice of Encumbrance
to Annex to City of Clermont
City of Clermont
685 W. Montrose Street
Clermont, FL 34712
THIS INSTRUMENT, Made this 10"' day of January, 2023, between Mardoche Dorsonne,
property owner in the County of Lake, State of Florida Grantor*, and the CITY OF CLERMONT,
FLORIDA, A Municipal Corporation, Grantee*:
WITNESSETH, NOTICE is given that heretofore or contemporaneously herewith Grantor has
petitioned the Grantee for it to permit voluntary annexation of Grantor's property below
described into the corporate limits of the City of Clermont, and
GRANTOR, for and in consideration of the sum of ONE and 00/100 ($1.00) and other good and
valuable consideration to Grantor in hand paid by Grantee, the receipt whereof is hereby
acknowledged, DOES HEREBY ENCUMBER the below — described real property situate, lying
and being in Lake County, Florida with the absolute requirement that the subject real property
may be, at the sole discretion, and upon request of Grantee, annexed into the city limits of the
City of Clermont at such time that the annexation of said real property is in accordance with
applicable law,
GRANTOR, further agrees, on his/hers/theirs/its own behalf and that of Grantors' heirs and
assigns to perform all ministerial functions necessary of the Grantor or Grantor's heirs and/or
assigns (as the case may be) then required by law to enable the described real property to be
incorporated into the city limits of the City of Clermont and where such ministerial functions
consist of a simple written request or the renewal of the petition of which notice is given above,
then this instrument shall be considered such request and/or renewal. The subject property is
described as:
Exhibit "A"
GRANTER, agrees on his/hers/theirs/its own behalf and that of Grantors' heirs and assigns that
once the property is annexed into the City, in the event that the septic tank or septic field fails,
6 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services
the GRANTER shall connect to City's sewer system when a sewer connection is available as
determined by City.
Grantor is used for singular or plural, as the context requires. IN WITNESS THEREOF,
GRANTOR has hereunto set Grantor's hand and seal the day and year first above written.
PROPERTY OWNER(S):
Mardoche Dorsonne
By:
Signature
Type or print name
STATE OF 1
WITNESSES (Two required):
Witnesses
y
Signature
Type or print name
2.
Signature
:1z,n1 ,Sr.0 Fisk�r is
Type or print name
COUNTY OF j, 4 {
TOhe oregoing 'n (�� a� ac edged before me on this day of)�40JOA
3, by A ` dG /✓,✓ , who is personally known to m�
or who has produced as identification and who did
not take an oath.
Notary Public
Type/print na ne _ ( 3
D (e) .,,,''
Pursuant -to $ecti,n<495.29(3)(f):
a of,t)ptnont, B16rida 34712
5IW ON
or i<a
Notary public State of Florida
Donald Price
My Commission GG 944219
Expires 04/28/2024
this instrument exempt from Chapter 695, F.S.,; Prepared by a Public Officer, City Attorney,
7 — Mardoche Dorsonne — AK 3817537, Utility Service Agreement for Water Services