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OWNERSHIP AFFIDAVIT <br /> FOR CORPORATION <br /> STATE OF /'10G Public Hearing No. <br /> COUNTY OF d/ k5f/ <br /> Before me,the undersigned authority,personally appeared g, 4' e/ &ale <br /> ,hereinafter the Affiant(s),who being first duly sworn by me,on oath,deposes and says: <br /> 1. Af ant is thg president,vice-president or CEO of the 'Z,4 w Asiec <br /> S,fvliciT'an._Z. Corporation,with the following address: <br /> /.fig 1% Co/Ls ,tie4 t€ <br /> 2. The Corporation owns the property,which is the subject of the proposed hearing. <br /> 3. The subject property is legally described as: <br /> See 1a del <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 /> 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 /> advertized. <br /> Witne ' ,� <br /> j_o fn u. ( / , // Signature <br /> rin 7ne Print Name <br /> Lac ! L.Ck(vCifl 0 <br /> Print Name <br /> Sworn to and subscribed before me on the day of LI 0 VenbeX ,20 , <br /> Affiant is personally known to me or has produced as <br /> Identification. • <br /> .1111111■/ice <br /> �t.r <br /> Commission Expires: <br /> ''-, ,° I LAURA ALEJANORA LAUREANO <br /> 1'I MY COMMISSION#FF101178 <br /> ';:• :471 <br /> .'•o,A.?"•' EXPIRES March 12,2018 <br /> (407)398.0.153 FlorldallotarySeMce.corn <br /> City of Sunny Isles Beach Community Development Department <br />