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<br />OWNERSHIP AFFIDAVIT <br />FOR LIMITED LIABILITY COMPANY (') <br /> <br />STATBOF Florida Publiq Hearing No. <br />COUNTY OF MTi'lm; -Di'lcJf> <br /> <br />Before me, the undersigned authority, personally appeared~tJlJt:l...... q ~ 1c~P1= <br />, hereinafter the Affiant (s), who being first duly sworn by me, OD oath, deposes and says: <br /> <br />I. Affiant is the manager, or managing member of the Co H /lm;1\ U -e.E"-ACA\ ~ <br />Limited Liability Company wilh !he following <br />address: <br />I~ "E -%!.\AlJw.IE- ~~ ~LV/) , WrtIl\1Jb'rlE" 'Fe ~~eoll, <br /> <br />2. The Limited Liability Company owns or lease (circle one) the property, which is the <br />subjed of the proposed hcnring. <br /> <br />3. Tbe subject property is legally described as: <br /> <br />TATUMS SUB GOVT LOT 6 PB 10-64 NIOQFT TR 3 E OF STATE RD 140 PB 45-66 <br /> <br />~E"E ","~~~1I:i€> <br /> <br />4. Affiant is legally authorized to file this application for public hearing: <br /> <br />5. Affiant understands this affidavit is subject to the peDal ties of law for pt:Ijury and the <br />possibility of voiding of any zoning granted at public bearing. <br /> <br />6. Affiant understands that the matters attached to and made part of !he application are <br />honest and Inte to the best of my knowledge and belief. I understand this application must <br />be complete and accurate before the application can be submitted e earm <br />advertized. <br /> <br /> <br />Witnesses: <br /> <br />9~~./ <br />- <br />~ ~ign...!!ture L. <br />tv_ j.f c..,&,,- <br />Pri t _ <br /> <br />~atu~ I <br />. . 'At{ ((. (;//ttJ <br />, Print Name <br /> <br />Sworn to and subscribed before me on th~day of <br />Affiant is personally known 10 me or bas produced <br />Identification. <br /> <br /> <br />,20/;;1-; <br />as <br /> <br />Commission Expires: a~1/~ /3 <br /> <br />* See attached Letter of Intent <br /> <br />. ... -" ,'. -.. <br />City of Sunny Isles Beach <br /> <br />- n'.. .. <br />Community Development Department <br />