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O <br />W <br />M <br />OWNERSHIP AFFIDAVIT <br />FOR LIMITED LIABILITY COMPANY <br />STATE OF �`�� C f�A Public Hearing No. <br />COUNTY OF oA tlfz <br />Before nte, the undersigned authority, personally appeared Cl u3`�d ly <br />hereinafter the Affiant (s), who being first duly sworn by me, on oath, deposes and says: <br />1. Affiant is t ne manager, or managing member of the 5'T• Tr JC-L Qe k:Al <br />We I a 0.er ..l' LC Limited Liability Company with the following <br />address: <br />2. The Limited Liability Compan owns o • lease (circle one) the property, which is the <br />subject of the proposed hearing. <br />3. The subject property is legally described as: <br />i6, 6 70 cc, 0 1 Id .A,(, ems ,-d, <br />4. Affiant is legally authorized to file this application for public hearing: <br />5. 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. Afflant understands that the natters 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 />advertized, <br />A 's Signature <br />G <br />Tint Name <br />Sworn to and subscribe efere-rhe on (lie 1 f day of 0r664114 l ,1YL , 20 3 5 , <br />Affiant is pxracarl GyLumvii to ta or has produced as <br />ldeutification i- <br />Notary atnp/Seal) <br />Commission Expires: 6,64k <br />U;:';;B�io PABLOARTEAOA <br />* * Commission N HH 486908 <br />of�Oe Expires htay 26, 2028 <br />City of Sunny Isles Beach Public Hearing Application Package Page 10 of 30 <br />