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OWNERSHIP AFFIDAVIT <br />FOR LIMITED LIABILITY COMPANY <br />STATE OF IFICr-140 Public Hearing No. F7z 2- —� 2 - <br />COUNTY OF���rin� <br />Before me, the undersigned authority, personally appeared Barbra Dayton <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 DAYTON FAMILY CO <br />Limited Liability Company with the following <br />address: <br />473 GOLDEN BEACH DRGOLDEN BEACH, FL 33160-222 <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: (aG., l <br />18600 Collins Ave., Sunny Isles Beach FL - 33160-2226 � zZ3H2— I <br />J!.I <br />I <br />4. Affiant is legally authorized to file this application for public hea�`ii)' {,I i' ' r - <br />r:'.,: r FT- F:•.: ; I .. <br />5. Affiant understands this affidavit is subject to the penalties ofLW4�pujup-y aud-tie.- <br />possibility of voiding of any zoning granted at public hearing. <br />6. 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 application must <br />be complete and accurate before the application can be submitted and the hearing <br />adverti zed. <br />Witnesses: <br />Signature <br />Rork D-4-6 (,- <br />Print Name <br />' ZE-� <br />Signature <br />Print Name <br />I A,N .i :1/ r <br />Sworn to and subscribed before me on the day ofTt L-Zc20� , <br />Affiant is personally known to me or has produced Storz A C>r7�er .PnCP as <br />Identification. <br />(,6 r Notary (Stamp/Seal) <br />Commission Expires: Z � <br />ON RAN LEE <br />MY COMMISSION M GG 956135 <br />o� ^�E,^XJJPTMIIR�,E�,S:: Febrru�ary 6, 2024 <br />WndedThV Notary"blIc UndeWter8 <br />Page 10 of 23 <br />31 <br />