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<br />For any changes of ownership or changes in contracts for purchase subsequent to the date <br />of the application, but prior ta the date of final public hearing, a supplemental disclosure <br />of interest shall be filed. <br /> <br />The above is a full disclosure of all parties of interest in the application to the best of my <br />knowledge and belief. <br /> <br />/, <br />,%, //"? /,/ <br />Signature: - t;Ve- ,--- U"/< .-<("/..co-+- <br />. . :1,..<:.....-..- <br /> <br />(Applicant) ~;;~~ r4#E-i' PEl"e!,y-VEN;: /Iv'c- <br />, <br /> <br /> <br />, 2001 <br /> <br />. 'c".(S".j\'''''''.':''-''r <br />I.. ._~.. ," Ht'" .t. ~' .'. I \I'~ ',,_ <br /> <br />-., ". C0r.1r.;i5s~0n 'i~~ DD3j3~S9 <br />,,-" :~: hires: SEP. 05, 2008 <br />":"'''',;':''.''-' ;~.:~ "1 Bonded n:~u <br />....:::/~~I;..:.'::- l.~!<.ntit D('r,I~:,j~ (0'1 l[1c. <br /> <br />o/;~()' <br />My Commission EXPires:--#-p <br /> <br />* Disclosure shall not be required of any entity; the equity interest is which are regularly <br />traded an an established securities market in the United States ar other countJy; or any <br />entity, the ownership interest of which are held in a limited partnership consisting of <br />more than 5,000 separate interest and where no one person or entity holds more than a <br />total of 5% of the ownership interest in the limited partnership. <br /> <br />City of Sunny Isles Beach <br /> <br />Planning and Zoning Department <br />