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OWNERSHIP AFFIDAVIT <br />FOR LIMITED LIABILITY COMPANY <br />STATE OF �k Public Hearing <br />COUNTY OF d 'C <br />Before me, the undersigned authority, personally appeared <br />, hereinafter the Affiant (s), who being first duly sworn by me, on oath, deposes and says: <br />1. Affiant is the manager, or managing member of the .5 ✓hh 4 <br />adde.r rte_ i -7 Limited Liability Compa Ty with the following <br />address: <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: <br />'qel <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 />Witnesses: <br />SignaV,e/ <br />�/1'lr L% /�111 S <br />Print lame <br />Sworn to and subscribed before me on the 6—day <br />Affiant is personally known to me or has produced _ <br />Identification. <br />Commission Expires: dd'15-/J <br />Affiant's Signature <br />LNL. p <br />Print Narbe <br />20/,7— <br />Notary (Stamp /Seal) U <br />R DREAM ZEEMAN <br />MY COMMISSION A DD 544054 <br />' * <br />EXPIRES: Fabruarpl5,2013. <br />��lFOift�PAP BpA4A4 Thru BUdpel NOraryBMlOBi. <br />City of Sunny Isles Beach Development Department <br />b <br />