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OWNERSHIP AFFIDAVIT <br />FOR LIMITED LIABILITY COMPANY <br />STATE OF FLORIDA Public Fearing No. <br />COUNTY OF MIAMI RADE <br />Before me, the undersigned authority, personally appeared CARMIN TILLIT - AMBR <br />hereinafter the Affiant (s), who being first duly sworn by me, on oath, deposes and says: <br />Affiant is the manager, or managing member of the 252 SUNNY ISLES BLVD CU2 LLC <br />Limited Liability Company with the following <br />address: <br />252 SUNNY ISLES BLVD 3 -CU -2, SUNNY ISLES BEACH, FL 33160 <br />2. The Limited Liability Company owns or lease (circle one) the property, which is the <br />subject of the proposed hearing. <br />3. The subject property is legally described as: <br />4. Affiant is legally authorized to file this application for public hearing: <br />s. Affiant understands this affidavit is subject to the penalties of law for perjury and the <br />possibility of voiding of any zoning granted at public hearing. <br />G. Affiant understands that the matters attached to and made part of the application are <br />honest and true to the best of my knowledge and belief. I understand this applicatio must <br />be complete and accurate before the application can be submitted and the ng <br />advertized. f <br />Witnesses: <br />sire <br />Signature <br />Oxana Besedina <br />A�%,/JQPra, Nei euu�„ ,1I <br />Signature <br />Chole Pinkston <br />Print Name <br />Sworn to and su 1 before me on theta clay of <br />Affiant is p all .know me or has produced <br />Identification. <br />Commission Expires: / <br />City of Sunny Isles Beach <br />Public Hearing Application Package <br />Print Name <br />20�, <br />MY COMMISSION # HH 172105 <br />EXPIRES: September 1, 2025 <br />Banded ihru Notary public UndeWteis <br />Page 10 of 30 <br />81 <br />