Contract 2023-018AINSTRUMENT#: 2023016888 OR BK 6092 PG 1501 PAGES: 10 2/14/2023 11:54:44 AM
GARY J. COONEY, CLERK OF THE CIRCUIT COURT & COMPTROLLER, LAKE COUNTY, FLORIDA
REC FEES: $86.50
2023-018A
ANNEXATION AND UTILITY SERVICE AGREEMENT
FOR WASTEWATER
This document constitutes an agreement between the CITY of Clermont, hereby referred to as
CITY, a municipality of the State of Florida, and Golden Years Living, LLC, and any successors
or assigns, hereby referred to as OWNER.
WITNESSETH
Whereas, OWNER is requesting service for a 67,000 square foot assisted living development
described on Exhibit `A', attached hereto and by this reference made a part hereof; and
Whereas, the Property is located in the unincorporated area of Lake County and the OWNER is
requesting sewer service from the CITY; and
Whereas, as a condition of CITY providing said sewer to the property. 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 subdivision; and
Whereas, as a condition of the provision of sewer 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, once the certificate of completion of the building permit is issued by
Lake County, if CITY chooses to do so; and
Whereas, OWNER and CITY are entering into this Agreement to set forth the terms and
conditions under which sewer 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. SEWER — Each and all of the foregoing premises are incorporated into and constitute
a part of this Agreement.
1.1 CITY shall provide sewer 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 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.
1.4 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.
1.5 The OWNER shall be responsible for the construction of all onsite lines and
appurtenances to serve the project. No building permits shall be issued until sewer is
Page 1 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1502 PAGE 2 of 10
provided to the site or until a bond or letter of credit, acceptable to CITY, is in place to
guarantee completion of improvements. No Certificate of Occupancy shall be issued until
sewer improvements have been completed and accepted by the CITY.
1.6 The OWNER shall be responsible for all costs of onsite 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.
1.7 The existing utilities must 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.
1.8 The OWNER shall be responsible for all costs including design, permitting, materials and
construction of the sewer lines and appurtenances, both on site and off site, required to
serve the Property.
1.9 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.
1.10 The development being served is shown in Exhibit "C". Major changes as determined by
the Clermont Site Review Committee may require an amendment to this Agreement.
1.11 This Agreement shall be voided after five (5) years if building permits have not been issued
and building construction has not started.
1.12 The Agreement shall be for 11,700 gpd for sewer based on an annual average.
1.13 It will be the OWNER's responsibility to provide adequate hydraulic modeling to identify
that the project can connect to the City's existing utility system or identify any upgrades
the developer will need to make to the system to serve the project. The OWNER shall
reimburse the City for all expenses the City incurs from its contracted engineering firm
for review of the developer's submittals.
Section 2. DEVELOPMENT STANDARDS
(a) The project shall be developed in accordance with the Hampton Manor Assisted Living
Facility Ordinance 2022-34 that was approved by Lake County on August 2, 2022.
(b) The CITY agrees to accept the site plan approved by Lake County and the certificate
of completion of the building permit.
(c) The project shall be developed according to City standards, unless otherwise
stipulated in this Agreement or subsequent amendments to this Agreement.
Section 3. IMPACT FEES
In further consideration of and as a condition precedent to, the City's agreement to the annexation
restriction, Owner shall pay to City within ninety (90) days of the effective date of this Agreement
applicable City Impact Fees based on the approved Lake County plans for Owner's project. The
Page 2 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1503 PAGE 3 of 10
payment of impact fees hereunder to the City shall be in addition to any and all impact fees that
Lake County may assess related to the development of the property.
Section 4. ANNEXATION
(a) OWNER agrees that CITY may annex the Property into the City of Clermont upon
issuance of certificate of completion by Lake County, if CITY, in 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". The
Notice of Encumbrance shall be executed by all owners of 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.
(b) As a condition precedent to the City's obligations hereunder, OWNER shall pay to City
within ninety (90) days of the effective date of this Agreement the sum of $3,500 to
defer the cost to the City to process the annexation petition contemplated herein.
Section 5. 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 6. 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
Section7. AMENDMENTS
OWNER
Golden Years Living LLC
7560 River Road
Flushing, MI 48433
Any amendment to this agreement is not effective unless the amendment is in writing and signed
by all parties.
Page 3 —Golden Years Living LLC — Hampton Manor ALF Annexation 8 Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1504 PAGE 4 of 10
Section 8. EFFECTIVE DATE
The effective date of this agreement shall be the day of execution of the agreement required
hereunder. This Agreement shall be valid for no longer than five (5) years.
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement on the
date listed below.. CITY through its City Manager, authorized to execute same by City Council
action, and OWNER through
DATED this I& day of AQknLASa.. 2023.
CITY OF CLERMONT
Tim Murry, Mayor
ATTEST:
j l�l
l
-{ X Tracy Ackroyd Howe, MMC, City Clerk
Approved as to form and legality:
i-
an ns, City Attorney
�orl, ' '"r
,CyY�^1,'1
r' ��i�'r�►
Page 4 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1505 PAGE 5 of 10
OWNER: Golden
Title: MaUL(Ai r
S NAb I I:- in
Print Name
STATE OF C41('�i1(j
COUNTY OF f tn:r
The foregoing instrument was acknowledged before me on this day of
2023, by ` zhnh'k(►""m rCtr� ,who is personally known to e
or who has produced ',� (cx� as identification and who did
not take an oath.
NotaryPublic : QAm SEAL: JENNA zvu
i Notary Public • State of Michigan
County of St l f M commission ExpireslJful 8, 20 8
Type/print name _ l� r
Acting in the County :54
Uf
Page 5 -Golden Years Living LLC - Hampton Manor ALF Annexation 8 Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1506 PAGE 6 of 10
Owner:
Golden Years Living LLC
Description:
AK 1412277
EXHIBIT "A"
PROPERTY DESCRIPTION
LEGAL DESCRIPTION
FROM SW COR OF SW 114 OF SEC 9-23-26 RUN N 0-01-0 E ALONG W LINE OF SW 114 A DIST OF
1010.46 FT TO N LINE OF S 1/2 OF SAID TRACT 56 MONTE VISTA PARK FARMS PB 2 PG 27, THENCE
RUN S 89-10-12 E 1570.62 FT FOR POB, RUN S 01-40-07 E 346.70 FT TO A NON -TANGENT CURVE
CONCAVE TO THE SW, THENCE RUN SE'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF
69-31-01 A RADIUS OF 80 FT, AN ARC LENGTH OF 97.06 FT, A CHORD BEARING OF S 41-34-16 E &
A CHORD DIST OF 91.22 FT, THENCE RUN S 06-48-46 E 102.58 FT TO A CURVE CONCAVE TO THE
NE, THENCE RUN SE'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF 80-14-23, A RADIUS
OF 20.04 FT, AN ARC LENGTH OF 28.07 FT, A CHORD BEARING OF S 46-55-22 E & A CHORD DIST
OF 25.83 FT TO A COMPOUND CURVE CONCAVE TO THE N, THENCE RUN ETY ALONG SAID
CURVE HAVING A CENTRAL ANGLE OF 13-36-16, A RADIUS OF 353 FT, AN ARC LENGTH OF 83.82
FT, A CHORD BEARING OF N 86-09-16 E & A CHORD BEARING OF N 86-09-16 E & A CHORD DIST
OF 83.62 FT, THENCE RUN N 79-21-08 E 85.82 FT TO A CURVE CONCAVE TO THE NORTH, THENCE
RUN E'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF 06-23-50, A RADIUS OF 515.80 FT,
AN ARC LENGTH OF 57.59 FT, A CHORD BEARING OF N 75-49-25 E & A CHORD DIST OF 57.56 FT,
THENCE RUN N 72-37-30 E 97.93 FT, THENCE RUN N 17-12-43 W 15 FT, THENCE RUN N 72-37-30 E
99.29 FT TO THE W RNV LINE OF SR 25, BEING A NON -TANGENT CURVE CONCAVE TO THE W,
THENCE RUN N'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF 0-45-01, A RADIUS OF
11380.14 FT, AN ARC LENGTH OF 149.04 FT, A CHORD BEARING OF N 18-0-41 W & A CHORD DIST
OF 149.04 FT, THENCE RUN N 18-23-12 W 293.39 FT, N 89-10-12 W 370.44 FT TO POB ORB 2481 PG
913
Page 6 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1507 PAGE 7 of 10
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 10th day of January 2023, between GOLDEN YEARS
LIVING LLC, property owners 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"
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.
Page 7 —Golden Years Living LLC — Hampton Manor ALF Annexation 8 Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888
OR BOOK 6092/PAGE 1508 PAGE 8 of 10
PROPERTY OWNER(S):
Golden Years Livin LLC
By:
ignatu
Sli�h � �c1 r7,�n
Type or print name
By:
Signature
Type or print name
STATE OF RlChi�Dn
COUNTY OF
WITNESSES (Two required):
Witnesses
1.
Signature
Type or print name
2.
Signature
"VI G efC'
Type or print name
The foregoing instrument was acknowledged before me on this -(d day of
2023, by — -Ah;cl, �itl who is
personally known to me or who has produced
as identification and who did not take an oath.
JENNA ZYLA
Notary Public SEAL: Nccnn' Public State of Michigan
County of St Clair
My Commission Expires Jul 8, 2028
Acting In the County of
Type/print name
Pursuant to Section 695.29(3)(0: this instrument exempt from Chapter 695, F.S.,; Prepared by a Public Officer, City Attomey, City of
Clermont, Florida 34712
Page 8 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1509 PAGE 9 of 10
EXHIBIT "C"
DIMENSION PLAN
Hampton Manor Assisted Living Facility (ALF) - Master Site Plan:
•,-,
V+' i`
... __.,._.� S ; im/ A ♦ aav� curssti Ma'�rh noier�,�l C y (�
� IMd 71K p
• ARV —� y - {"
tolta All
6.
Vil
116.
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f FR .•��' •P',R ?
.Ii` 1� r,• .. �rf .��•c777S.ii
! ��.' ..�! � 'may• ] ,. � � `
Page 9 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
INSTRUMENT# 2023016888 OR BOOK 6092/PAGE 1510 PAGE 10 of 10
EXHIBIT "D»
LOCATION MAP
Page 10 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
ANNEXATION AND UTILITY SERVICE AGREEMENT
FOR WASTEWATER
This document constitutes an agreement between the CITY of Clermont, hereby referred to as
CITY, a municipality of the State of Florida, and Golden Years Living, LLC, and any successors
or assigns, hereby referred to as OWNER.
WITNESSETH
Whereas, OWNER is requesting service for a 67,000 square foot assisted living development
described on Exhibit `A', attached hereto and by this reference made a part hereof; and
Whereas, the Property is located in the unincorporated area of Lake County and the OWNER is
requesting sewer service from the CITY; and
Whereas, as a condition of CITY providing said sewer to the property. 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 subdivision; and
Whereas, as a condition of the provision of sewer 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, once the certificate of completion of the building permit is issued by
Lake County, if CITY chooses to do so; and
Whereas, OWNER and CITY are entering into this Agreement to set forth the terms and
conditions under which sewer 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. SEWER — Each and all of the foregoing premises are incorporated into and constitute
a part of this Agreement.
1.1 CITY shall provide sewer 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 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.
1.4 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.
1.5 The OWNER shall be responsible for the construction of all onsite lines and
appurtenances to serve the project. No building permits shall be issued until sewer is
Page 1 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
provided to the site or until a bond or letter of credit, acceptable to CITY, is in place to
guarantee completion of improvements. No Certificate of Occupancy shall be issued until
sewer improvements have been completed and accepted by the CITY.
1.6 The OWNER shall be responsible for all costs of onsite 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.
1.7 The existing utilities must 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.
1.8 The OWNER shall be responsible for all costs including design, permitting, materials and
construction of the sewer lines and appurtenances, both on site and off site, required to
serve the Property.
1.9 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.
1.10 The development being served is shown in Exhibit "C". Major changes as determined by
the Clermont Site Review Committee may require an amendment to this Agreement.
1.11 This Agreement shall be voided after five (5) years if building permits have not been issued
and building construction has not started.
1.12 The Agreement shall be for 11,700 gpd for sewer based on an annual average.
1.13 It will be the OWNER's responsibility to provide adequate hydraulic modeling to identify
that the project can connect to the City's existing utility system or identify any upgrades
the developer will need to make to the system to serve the project. The OWNER shall
reimburse the City for all expenses the City incurs from its contracted engineering firm
for review of the developer's submittals.
Section 2. DEVELOPMENT STANDARDS
(a) The project shall be developed in accordance with the Hampton Manor Assisted Living
Facility Ordinance 2022-34 that was approved by Lake County on August 2, 2022.
(b) The CITY agrees to accept the site plan approved by Lake County and the certificate
of completion of the building permit.
(c) The project shall be developed according to City standards, unless otherwise
stipulated in this Agreement or subsequent amendments to this Agreement.
Section 3. IMPACT FEES
In further consideration of and as a condition precedent to, the City's agreement to the annexation
restriction, Owner shall pay to City within ninety (90) days of the effective date of this Agreement
applicable City Impact Fees based on the approved Lake County plans for Owner's project. The
Page 2 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
payment of impact fees hereunder to the City shall be in addition to any and all impact fees that
Lake County may assess related to the development of the property.
Section 4. ANNEXATION
(a) OWNER agrees that CITY may annex the Property into the City of Clermont upon
issuance of certificate of completion by Lake County, if CITY, in 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". The
Notice of Encumbrance shall be executed by all owners of 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.
(b) As a condition precedent to the City's obligations hereunder, OWNER shall pay to City
within ninety (90) days of the effective date of this Agreement the sum of $3,500 to
defer the cost to the City to process the annexation petition contemplated herein.
Section 5. 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 6. 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
Section7. AMENDMENTS
OWNER
Golden Years Living LLC
7560 River Road
Flushing, MI 48433
Any amendment to this agreement is not effective unless the amendment is in writing and signed
by all parties.
Page 3 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
Section 8. EFFECTIVE DATE
The effective date of this agreement shall be the day of execution of the agreement required
hereunder. This Agreement shall be valid for no longer than five (5) years.
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement on the
date listed below. CITY through its City Manager, authorized to execute same by City Council
action, and OWNER through
DATED this On day of W) QSS _ , 2023.
CITY OF CLERMONT
Tim Murry, Mayor
ATTEST:
- cX Tracy Ackroyd Howe, MMC, City Clerk
,.•
Page 4 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
OWNER:
Title: MM
S i\a ,1 e Fvv% l(� V,)
Print Name
STATE OF WiNDU
COUNTY OF 5j((gir
The foregoing instrument was acknowledged before me on this day of �Vuoc
2023, by , who is personally known to e
or who has produced as identification and who did
not take an oath.
Notary Public :Siam —Lu [a SEAL: JENNAZYLA
Notary Public . State of Michigan
County of St Clair
Type/print name My Commission Expires Jul 8, 2028
Acting in the County of
Page 5 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
Owner:
Golden Years Living LLC
Description:
AK 1412277
EXHIBIT "A"
PROPERTY DESCRIPTION
LEGAL DESCRIPTION
FROM SW COR OF SW 1/4 OF SEC 9-23-26 RUN N 0-01-0 E ALONG W LINE OF SW 1/4 A DIST OF
1010.46 FT TO N LINE OF S 1/2 OF SAID TRACT 56 MONTE VISTA PARK FARMS PB 2 PG 27, THENCE
RUN S 89-10-12 E 1570.62 FT FOR POB, RUN S 01-40-07 E 346.70 FT TO A NON -TANGENT CURVE
CONCAVE TO THE SW, THENCE RUN SE'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF
69-31-01 A RADIUS OF 80 FT, AN ARC LENGTH OF 97.06 FT, A CHORD BEARING OF S 41-34-16 E &
A CHORD DIST OF 91.22 FT, THENCE RUN S 06-48-46 E 102.58 FT TO A CURVE CONCAVE TO THE
NE, THENCE RUN SE'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF 80-14-23, A RADIUS
OF 20.04 FT, AN ARC LENGTH OF 28.07 FT, A CHORD BEARING OF S 46-55-22 E & A CHORD DIST
OF 25.83 FT TO A COMPOUND CURVE CONCAVE TO THE N, THENCE RUN E'LY ALONG SAID
CURVE HAVING A CENTRAL ANGLE OF 13-36-16, A RADIUS OF 353 FT, AN ARC LENGTH OF 83.82
FT, A CHORD BEARING OF N 86-09-16 E & A CHORD BEARING OF N 86-09-16 E & A CHORD DIST
OF 83.62 FT, THENCE RUN N 79-21-08 E 85.82 FT TO A CURVE CONCAVE TO THE NORTH, THENCE
RUN E'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF 06-23-50, A RADIUS OF 515.80 FT,
AN ARC LENGTH OF 57.59 FT, A CHORD BEARING OF N 75-49-25 E & A CHORD DIST OF 57.56 FT,
THENCE RUN N 72-37-30 E 97.93 FT, THENCE RUN N 17-12-43 W 15 FT, THENCE RUN N 72-37-30 E
99.29 FT TO THE W R/W LINE OF SR 25, BEING A NON -TANGENT CURVE CONCAVE TO THE W,
THENCE RUN N'LY ALONG SAID CURVE HAVING A CENTRAL ANGLE OF 0-45-01, A RADIUS OF
11380.14 FT, AN ARC LENGTH OF 149.04 FT, A CHORD BEARING OF N 18-0-41 W & A CHORD DIST
OF 149.04 FT, THENCE RUN N 18-23-12 W 293.39 FT, N 89-10-12 W 370.44 FT TO POB ORB 2481 PG
913
Page 6 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
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 10th day of January 2023, between GOLDEN YEARS
LIVING LLC, property owners 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"
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.
Page 7 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
PROPERTY OWNER(S):
Golden Years Living LLC
Type or print name
WITNESSES (Two required):
By: 2.
Signature
Type or print name
STATE OF Kl�k VD
COUNTY OF 5f . ( la, i("
Witnesses
Signature
A�l{-� ��rNGwtGiv�
Type or print name"
Signature 4VI Gee esC1
/VW
Type or print name
The foregoing instrument was acknowledged before me on this (d day of
2023, by n ahi d i
personally known to me or who has produced
as identification and who did not take an oath.
JENNAZYLA
Notary Public SEAL: LActing
blic - State of Michigan
unty of St Clair
sion Expires Jul 8, 20288
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Pursuant to Section 695.29(3)(0: this instrument exempt from Chapter 695, F.S.,; Prepared by a Public Officer, City Attorney, City of
Clermont, Florida 34712
Page 8 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater
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EXHIBIT "D"
LOCATION MAP
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Page 10 —Golden Years Living LLC — Hampton Manor ALF Annexation & Utility Service Agreement
for Wastewater