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Temp. Use Permit - More to LIfe BBQPermit Number: 16 -008 City of Okeechobee 55 SE Third Avenue Okeechobee, FL 34974 (863) 763 -3372 Temporary Use Permit Date(s) of Event: November 11, 2016 5AM -1 PM Permit Expiration: November 11, 2016 11:59PM Purpose of Request: Barbeque Fundraiser -Haiti Mission Trip Property Owner: Royal's OK Lunch Inc. Address: 324 SW 16th Street City: Belle Glade State: Florida Zip Code: 33430 Applicant: More to Life Ministries Applicant's Address: 605 SW Park St. Ste 213 Okeechobee Phone Number: 863 - 532 -1460 Address of Project: 117 SE 8th Avenue Current Zoning: Heavy Commercial (CHV) FLU Designation: Commercial (C) Subdivision: Unplatted Lands of the City of Okeechboee Restrictions /Remarks: All debris must be removed upon final completion date. Owner understands and agrees to the following: X Issuance of a permit may be subject to other conditions and time limitations. X Issuance of a permit is not authorization to violate public or private restrictions. X Failure to comply with applicable regulations may result in withholding future permits. X There may be additional permits required from other governmental entities. REF: .ORD.716, Temporary Structures Date: ON /6 Date: November 8, 2016 CITY OF OIKEECUOBEE General Services Department, Room 101 55 Southeast 3rd Avenue Okeechobee, FL 34974 e•863- 763 -337 ext 2J? Fax:863- 763 -1686 • , , , , , , , „ _ _ DATE RECEIVED: it/ 3/ BATE ISSUED: I I I b- / • 0 DATE(S) OF EVENT: 0\01), l ( 54M _ 1 PH w ''3&a�;�.:.�.�.�,*�. T APPLICATION N0: I % ° CC F `1 • `•% k ., 9 • �,:.��•• FEE:. $i75.00 DATE PAID: ��`- ..0.00 o,f If Non - Profit/Civic Organization t TEMPORARY USE PERMIT APPLICATI Name of Property Owner(s): . C -k'tct - IL �AI -' �1 o (,A t.' 3 C A �� ti l�L C- N ( T. Address: 3,)-6{ 5; Ce/, I(.9 -f-ti �j --(. £321k (a..d. -. , �� ( 3 5q 36 Telephone Numbers: Home: Work: Lt. Moblle /Cell: ' 9 L -5i Pager: Name of Applicant: t - ? a fi r e ? L - _ / -e__ / V r_,�,LLkVI r-e4 y� k4-�`vl�.ir" • Address: &, U 5 5 G) Po v'k `j-� . 6zt,'- e 1 0 eLd'.-e- - f (r( 3 t/ q 7d- Tele•tione Numbers: Home: Work: Mobile /Celt' 14'W Pager: APPLICANT 11 Future Land Use Map Designation: 4 „k, ac l,u F „+r Current Zoning Designation: d /-f V/ Legal Description of Property: nn —"k �t -Wb.� ' f-' � i 7�l tt�i 1i, Address of Property: :01 E. e'77J AV (� e emu.. C Briefly describe use of adjoining pro e erty: 1 . South: o�� e,t_ C�5/-c-t--c, West: ,Ockv” /t'-- Other temporary structures subject to the following regulations: TEMPORARY USE PERMIT APPLICATI Name of Property Owner(s): . C -k'tct - IL �AI -' �1 o (,A t.' 3 C A �� ti l�L C- N ( T. Address: 3,)-6{ 5; Ce/, I(.9 -f-ti �j --(. £321k (a..d. -. , �� ( 3 5q 36 Telephone Numbers: Home: Work: Lt. Moblle /Cell: ' 9 L -5i Pager: Name of Applicant: t - ? a fi r e ? L - _ / -e__ / V r_,�,LLkVI r-e4 y� k4-�`vl�.ir" • Address: &, U 5 5 G) Po v'k `j-� . 6zt,'- e 1 0 eLd'.-e- - f (r( 3 t/ q 7d- Tele•tione Numbers: Home: Work: Mobile /Celt' 14'W Pager: APPLICANT 11 Future Land Use Map Designation: 4 „k, ac l,u F „+r Current Zoning Designation: d /-f V/ Legal Description of Property: nn —"k �t -Wb.� ' f-' � i 7�l tt�i 1i, Address of Property: :01 E. e'77J AV (� e emu.. C Briefly describe use of adjoining pro e erty: 1 . th' llcation is for use by the hereby certify that the information on this application is correct. The Information Included m is app City of Okeechobee in processing my request. False or misleading Information may be punishable by afine of up to $500.00 and im rlsonment of up to thirty days and may result in the summary denial of this application. • A, Si nature City Sta p t Please review the application, attach comments or special conditions): or i‘ d/ State Li Verification: ( Occupational and/or a e cen e l/ Fire Department Approva j,� Police Department Approval: e Public Works Department Ap Building Inspector Appro 1/3/ / Date Date // City Administrator Approval: /as Revisal. /1 /03 blc Date X51/ Date: Date: // -3-4, Date: • Da$e: Lu 0 1 Future Land Use Map Designation: 4 „k, ac l,u F „+r Current Zoning Designation: d /-f V/ Legal Description of Property: nn —"k �t -Wb.� ' f-' � i 7�l tt�i 1i, Address of Property: :01 E. e'77J AV (� e emu.. C Briefly describe use of adjoining pro e erty: 1 . South: o�� e,t_ C�5/-c-t--c, West: ,Ockv” /t'-- Other temporary structures subject to the following regulations: hereby certify that the information on this application is correct. The Information Included m is app City of Okeechobee in processing my request. False or misleading Information may be punishable by afine of up to $500.00 and im rlsonment of up to thirty days and may result in the summary denial of this application. • A, Si nature City Sta p t Please review the application, attach comments or special conditions): or i‘ d/ State Li Verification: ( Occupational and/or a e cen e l/ Fire Department Approva j,� Police Department Approval: e Public Works Department Ap Building Inspector Appro 1/3/ / Date Date // City Administrator Approval: /as Revisal. /1 /03 blc Date X51/ Date: Date: // -3-4, Date: • Da$e: Okeechobee County Property Appraiser raaan„ CFA Parcel: << 2- 22- 37- 35 -0A00- 00013 -A000 Page 1 of 2 2016 Tax Roll Year updated: 10/27/2016 Aerial Viewer Pictometery Googie Maps Owner & Property Info Result: 1 of 1 2015 ` -_ =' 2014 f 2011 ; 2009 02005 .. a ROYALS 0 K LUNCH INC Owner 324 SW 16TH ST BELLE GLADE, FL 334302824 Site 117 SE 8TH AVE, OKEECHOBEE UNPLATTED LANDS OF THE CITY COM AT I NE COR OF GOVT LOT 3 IN SEC 22 RUN S ON E BDRY OF GOVT LOT 3 23.04 FT TO S Description BDRY OF RD 70 THENCE CONT SOUTH 73 FT FOR POB RUN S ON E BDRY OF GOVT 1 LOT 3 456.17 FT TO SE COR OF GOVT LOT 3 RUN S 73 DEG 51 MIN 22 SEC W ON S BD ...more »> Area Use Code 5.481 AC S/T /R 22 -37 -35 COMMUNITY 50 (001600) Tax District The Description above is not to be used as the Legal Description for this parcel in any legal transaction. The Use Code is a Dept. of Revenue (DOR) code. Please contact the Okeechobee County Planning & Development office at 863 - 763 -5548 for specific zoning information. [Property & Assessment Values 2015 Certified Values Mkt Land (3) $549,907 Ag Land (o) $0 Building (5) $1 204,173 $167,967 $1,922,047 XFOB (15) Just Class $0 Appraised Exempt Assessed Total Taxable 2016 Certified Values Mkt Land (3) $731 Ag Land (o) Building (5) $1,224! XFOB (15) $16 Just $2,123 Class $1,922,047 Appraised $0 Exempt $1,922,047 Assessed $2,123 to $2,123; :: county:$1,650,000 i county:$1,815; city:$1,650,000 Total i city:$1,815, other:$1,650,000 Taxable other:$1,8151 „„g; school:$1,922,047 school:$2,123L Sales History Sale Date Sale Price 3/1/1970 3/1/1970 $16,000 $35,000 Book/Page 123/0073 118/0645 Deed V/I Quality (Codes) WD V Q WD V Q RCode Building Characteristics Bldg Sketch Bldg Item Bldg Desc Year Bit Base SF Actual SF Bldg Value Sketch 1 RES F /FOOD (005700) 1971 2376 3136 $141,378 Sketch 2 NBHD CENTR (003800) 1971 26439 30514 $449,942 Sketch 4 STORE RETL (003500) 1971 17695 21693 $283,981 Sketch 5 FOOD MARKT (003900) 1971 9820 11464 $169,276 Sketch 6 NBHD CENTR (003800) 1971 9800 13928 $179,851 http: / /ap2. okeechobeepa. com /gis /recordSearch_3_Details/ 11/3/2016 Detail by Entity Name Page 1 of 2 FLORIDA DEPARTMENT OF STATE .� DIVISION -OF .CORPORATIONS . e:6z Detail by Entity Name Florida Not For Profit Corporation MORE 2 LIFE MINISTRIES, INC Filing Information Document Number N05000002420 FEI /EIN Number 20- 2645914 Date Filed 03/09/2005 Effective Date 03/09/2005 State FL Status ACTIVE Last Event AMENDMENT Event Date Filed 10/27/2006 Event Effective Date NONE Principal Address 605 SW PARK STREET SUITE 214 OKEECHOBEE, FL 34972 Changed: 01/06/2010 Mailing Address 605 SW PARK STREET SUITE 214 OKEECHOBEE, FL 34972 Changed: 01/06/2010 Registered Agent Name & Address MCKEE, CARY L 420 SW 17TH AVE OKEECHOBEE, FL 34974 Name Changed: 03/28/2005 Officer /Director Detail Name & Address Title P MCKEE, CARY L 420 SW 17TH AVE OKEECHOBEE, FL 34974 Title VP GARNER, JAMES 13140 NE 4TH TERR OKEECHOBEE, FL 34972 Title D/T GARNER, JOHN T 1208 SW 3RD AVE. OKEECHOBEE, FL 34974 Annual Reports Report Year Filed Date 2014 01/15/2014 2015 01/07/2015 2016 01/06/2016 httn• / /cearrh cnnhi7 nra /Tnmiiry /('nrnnratinnq Parr h/ QParrhPPenitTlatailiinnnirvtvne= Pntit, 11 /1 /')n1A 0000059 11/15/11 DEPARTMENT OF REVENUE Consumer's Certificate of Exemption Issued Pursuant to Chapter 212, Florida Statutes DR -14 R. 04/11 85- 8013755016C -7 02/29/2012 02/28/2017 501(C)(3) ORGANIZATION Certificate Number This certifies that MORE 2 LIFE MINISTRIES INC 605 SW PARK ST STE 213 OKEECHOBEE FL 34972 -4173 Effective Date Expiration Date Exemption Category is exempt from the payment of Florida sales and use tax on real property rented, transient rental property rented, tangible personal property purchased or rented, or services purchased. DEPARTMENT OF REVENUE Important Information for Exempt Organizations DR -14 R. 04/11 1. You must provide all vendors and suppliers with an exemption certificate before making tax - exempt purchases. See Rule 12A- 1.038, Florida Administrative Code (F.A.C.). 2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property, sleeping accommodations, or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property (Rule 12A- 1.070, F.A.C.). 5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third - degree felony. Any violation will require the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account Management at 800 - 352 -3671. From the available options, select "Registration of Taxes," then "Registration Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480, Tallahassee, FL 32314 -6480. MORE2 -1 OP ID: S2 AC' ORU CERTIFICATE OF LIABILITY INSURANCE `--~� DATE (MMIDDM W) 11102!2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Pritchards & Associates, Inc. 1802 S Parrott Ave Okeechobee, FL 34974 -6179 Lowell H Pritchard CONTACT NAME: Sand/ Hines PHONE FAX NC No, Ext): 863- 763 -7711 ow, No): 863- 763 -5629 ADDRESS: shines pritchardsinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Auto Owners Insurance Co. 18988 INSURED More 2 Life Ministries, Inc. 605 SW Park St Ste 214 Okeechobee, FL 34972 INSURER B : Florida Citrus, Business & Ind 25CC38518120 INSURER C:The Ohio Casualty Insurance Co 24074 INSURER D 1,000,000 INSURER E C, AIMS-MADE INSURER F : OCCUR COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AU UL INSD SUkSR— WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (Y (MMIDD YY) LIMITS C X COMMERCIAL GENERAL LIABILITY X 25CC38518120 11/11/2016 11/11/2017 EACH OCCURRENCE 1,000,000 C, AIMS-MADE OCCUR DAMAGE rO RENTED PREMISE) (Ea occurrenc) $ 1,000,000 MFD EXP (Any one person) $ 10,000 PERSONAL -$ ADV INJURr' $ 1,000,000 GEN'I AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 7 POL ICY I PRO - JECT [DC PRODt 1 T ; - COMP /OP AGG $ 2,000,000 OTHER $ C AUTOMOBILE LIABILITY 5049898900 10/06/2016 10/06/2017 COMBINED SINGLE LIMIT (Ea accident) $ 300,000 X X ANY AUTO BODILY NJURY (Per person i $ ALL OWNED AUTOS HIRED AUTOS BUSINESS X SCHEDULED .AUTOS NON CWNEL AUTOS BODILY INJURY Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUP CLAIMS -MADE EACH OCCURRENCE AGGPEGATF $ DEG RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N I A 106 -44532 04/01/2016 04/01/2017 PEAR IUTE 1 OTH- ANYPROPRIETORIPARTNERrEXECUTIVE YIN OFFICER /MEMBER EXCLUDED'? (Mandatory in NH) 1 F EACH ACCIDENT $ 100,000 E I DISEASE - FA EMP, OYFE $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below F L DISEASE - POLICY LIMIT $ 500,000 C Property Section 25CC38518120 11/11/2016 11/11/2017 DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is listed as Additional Insured in regards to Form CG7635. CANCELLATION ROYA -12 Royals Ok Lunch, Inc. Y 324 SW 16th Street Belle Glade, FL 33430 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE //!�, 1 C571;e4/647 ii/- ACORD 25 (2014101) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD -41ANCAMIMMIDaimmsommaram_ Narlkshory PiAZL 1LS. /4 Okevri.bve, FL H7 5E. Sni Awe:- Legal Description and Aerial — North Shore Plaza UNPLATTED LANDS OF THE CITY COM AT NE COR OF GOVT LOT 3 IN SEC 22 RUNS ON E BDRY OF GOVT LOT 3 23.04 FT TO S BDRY OF RD 70 THENCE CONT SOUTH 73 FT FOR POB RUN S ON E BDRY OF GOVT LOT 3 456.17 FT TO SE COR OF GOVT LOT 3 RUN S 73 DEG 51 MIN 22 SEC W ON S BDRY OF GOVT LOT 3 WHICH IS ALSO HOPKINS M/L 617.09 FT TO E BDRY OF RIVERVIEW DRIVE THENCE RUN NRLY ON E BDRY OF RIVERVIEW DRIVE 678.7 FT MORE OR LESS TO "S .. BDRY OF STATE RD 70 THENCE RUN E ON S BDRY OF STATE RD 70 281.4 FT THENCE RUN S 83 FT THENCE E 100 FT TO POB, SECTION 22, TOWNSHIP 37 SOUTH, RANGE 35 EAST. TOGETHER WITH THE FOLLOWING: UNPLATTED LANDS OF THE CITY BEG AT INTERSECTION OF E BDRY OF GOVT LOT 3 AND S RTY LINE OF RD 0 RTY LINE BEING 60 FT FROM CENTER LINE MEASURED AT RT ANGLES RUN S ALONG E BDRY LINE OF LOT 3 73 FT W P/L TO S RTY LINE OF RD 70 100 FT N P/L TO E BDRY OF GOVT LOT 3 73 FT E ALONG S RTY LINE OF RD 70 100 FT TO POB, SECTION 22, TOWNSHIP 37 SOUTH. RANGE 35 EAST. 5.32 ACRES To whom it may concern: The owners of the North Shore Plaza in Okeechobee hereby give permission to allow More 2 Life Church of Okeechobee to use the premises for a BBQ fundraiser on November 11, 2016. Should you have any questions or concerns, please feel free to contact me. Thank you, Eric Royal — Real Estate Dept. Royal's OK Lunch Inc. 324 SW 16th St., Belle Glade, FL 33430 561 - 996 -6581 x 105 encriDroyolsinc,com