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HomeMy WebLinkAboutApplication & Supporting Docs,0, �F•i '*BINGO id 9RATED HEARING BOARDS 444 SW 2nd Avenue, 7t" Floor • Miami, Florida 33130 Telephone 305-416-2030 • Fax 305-416-2035 www.miami.gov.com/hearing boards PUBLIC HEARING APPLICATION FOR A SPECIAL EXCEPTION Welcome to Hearing Boards! This application is intended to serve as a guide in acquainting you with our public hearing process. By any means, please feel free to contact us at the number above, should you have any questions. ORDINANCE NO. 11469, CODIFIED IN CHAPTER 2, ARTICLE VI OF THE CITY CODE STATES THAT ANY PERSON WHO RECEIVES COMPENSATION, REMUNERATION OR EXPENSES FOR CONDUCTING LOBBYING ACTIVITIES TO REGISTER AS A LOBBYIST WITH THE CITY CLERK, PRIOR TO ENGAGING IN LOBBYING ACTIVITIES BEFORE CITY STAFF, BOARDS, COMMITTEES AND THE CITY COMMISSION. A COPY OF SAID ORDINANCE IS AVAILABLE IN THE OFFICE OF THE CITY CLERK (MIAMI CITY HALL), LOCATED AT 3500 PAN AMERICAN DRIVE, MIAMI, FLORIDA, 33133. Copies of lobbyist documentation with proof of payment must be submitted with the complete application. Ordinance No. 12918 states that each person or entity requesting approval, relief or other action from the City Commission or any of its boards, authorities, agencies, councils or committees regarding any issue, shall disclose at the commencement (or continuance) of the public hearing(s) on the issue, any consideration provided or committed, directly or on its behalf, for an agreement to support or withhold objection to the requested approval, relief or action. The Disclosure of Consideration Provided or Committed for Agreement to Support or Withhold Objection Affidavit included in this package must be submitted with the application. The applicant must, at the commencement of any public hearing on the issue, if there is any disclosure to report, read the disclosure into the record. Also, the applicant must supplement the affidavit if there is any new information or additional information to disclose. The deadline to file the complete application with supporting documents is the first five working days (1-5) of each month from 8:00 am until 3:00 pm, and on the fifth day, at 12:00 pm. The responses to this application must be typed and signed in black ink. Please note that pursuant to Section 1304.2.2 of the Miami Zoning Ordinance, no application shall be deemed to have been filed unless and until the applications shall have been completed. All pertinent and accurate information/documentation; i.e., the plans, reports, exhibits, shall be presented at the time of filing, in addition to the paid receipt. The applicant is responsible for the accuracy of the information contained in the application and all supporting materials. If you like, you could bring the materials to our office for staff review before the deadline to ensure the application is complete. Upon submittal, this application must be accompanied with a signed Zoning Referral. You will be responsible, if needed, to bring an interpreter for the English language to any presentation before city boards, committees and the city commission. A valid power of attorney will be required if neither applicant or legal counsel representing the applicant execute the application or desire to make a presentation before city boards, committees and the city commission. An additional fee to record Zoning Board resolutions will be charged and it is determined contingent upon fees charged at the time of recordation by the Miami -Dade County Recorder's Office at 22 NW First Street, First Floor. Upon arrival, ask for a certified copy. Please have the original recorded document mailed to the address above and bring the certified copy to our office. Copies of City Commission resolutions can be obtained at our website through the "Legislative Hub", or for certified copies, contact the City Clerk's Office at 305-250-5360. Applications given to customers do not constitute action from the City of Miami without plans review and written comments from the Office of Zoning. Rev. 09-04-07 Within the City generally, or within certain zoning districts, certain structures, uses, and/or occupancies specified, are of a nature requiring special and intensive review to determine whether or not they should be permitted in specific locations, and if so, the special limitations, conditions, and safeguards, which should be applied as reasonably necessary to promote the general purposes of the Zoning Ordinance and, in particular, to protect adjoining properties and the neighborhood from avoidable potentially adverse effects. It is further intended that the expertise and judgment of the Miami Zoning Board be exercised in making such determinations, in accordance with the rules, considerations and limitations relating to Special Exceptions (see Article 16 of the Zoning Ordinance). I, Gilberto Pastoriza and Estrellita Sibila on behalf of AMERICAN WELDING SOCIETY INC, a New York corporation, hereby apply to the Miami Zoning Board for approval of a Special Exception for the properties located at 550 NW 42 Avenue and 4227 NW 5 ST, having folio numbers 01-4105-031-0210 and 01-4105-031-0220, respectively. 1. The property/location listed does not have any open code enforcement/lien violations. 2. One (1) original survey prepared by a State of Florida registered land surveyor within six (6) months from the date of application. 3. One (1) original 2406" plan, signed and sealed by a State of Florida registered architect or engineer showing property boundaries and proposed structure(s), parking, landscaping, etc.; building elevations and dimensions and computations of lot area and building spacing. 4. Original plan needs to be stamped, dated and initialed by Hearing Boards designee first and then by (1) Public Works on the 8th Floor, (2) Zoning on the 4th Floor and (3) Planning on the 3rd Floor, prior to submittal. Note: Plans are to be submitted to Zoning for first time review starting from the 8th through the 20th of each month. Zoning will not be accepting first-time review plans after the 20th day of the month. 5. After obtaining signatures from the above departments, two (2) 11x17" and one (1) 8%x11" copies of the original plan, including the survey. 6. At least two photographs that show the entire property (land and improvements). 7. A clear and legible copy of the recorded warranty deed and tax forms of the most current year that shows the present owner(s) and legal description of the property. 8. A clear and legible copy of the subject property address and legal description on a separate sheet of paper, labeled as "Exhibit A" to coincide with the current survey's legal description. 9. Affidavit and disclosure of ownership of all owners and contract purchasers of the subject property (see pages 4 and 5). 10. Certified list of owners of real estate within 500 feet of the subject property (see pages 6 and 7). 11. What is the acreage of the project/property site? 1.29 acres What is the purpose of this application/nature of -proposed use? Special Exception in order to allow surface parking in property zoned R-2 with SD -12 overlay district. 12. Is the property within the boundaries of a historic site, historic district or archeological zone? Please contact the Planning Department on the 3rd Floor for information. NO Rev. 09-04-07 2 13. Is the property within the boundaries of an Environmental Preservation District? Please contact the Planning Department on the 3rd Floor for information. NO 14. For corporations and partnerships indicated, the following documents are to be submitted: a) Articles of Incorporation; b) Certificate from Tallahassee less than one (1) year old showing good standing; c) Corporate Resolution or a Power of Attorney signed by the secretary of the Corporation authorizing the person who signed the application to do so; d) Non-profit organizations: A list of Board of Directors less than one (1) year old. 15. Cost of processing according to Section 62-156 of the Miami City Code*: a. Special Exception requiring automatic City Commission review $ 2,000.00 b. Special Exception $ 800.00 c. Extension of time for Special Exception $ 500.00 d. Nonsubstantial modification $ 400.00 Public hearing and public meeting mail notice fees, including cost of handling and mailing per notice $ 3.50 Surcharge equal to applicable fee from item above, not to exceed eight hundred dollars ($800.00) except from agencies of the city; such surcharge to be refunded to the applicant if there is no appeal from the applicant or a property owner within five hundred (500) feet of the subject property. *Pursuant to Ordinance 12719, all paid in the form of a_gertifi'chep) Signature Name Gilberto Pastoriza L----�'' Telephone (305) 854-0800 ng fees in excess of $25, 000. 00, shall be or money order. ress 2525 Ponce de Leon Blvd, #700 Coral Gables, FL 33134 E-mail wastorizaCa),wsh-law.com The application submittal date is the date stamped bV Hearing Boards' staff on the front page. STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing was acknowledged before me this day of^�- 20 by Gilberto Pastoriza who is a(n) agent of AMERICAN WELDING SOCIETY NC, a New York' corporation. He is personally known to me or who has produced as identification and who did (did not) take an oath. (Stamp) Rev. 09-04-07 3 t_� Signature �pSAH � pUB`/c MAR1LYN S0AfppEV1LLq * MYCOMMISS10N#pp 141'0 o'ol BoodeldTh,B9eOmoerySe2j01 CERTIFIED CORPORATE RESOLUTION The undersigned hereby certifies that he is the Q_I�rz) Cyti,L ,�.4 of AMERICAN WELDING SOCIETY INC., a New York corporation (the "Cor oration"), that the following is a true and correct copy of the resolutions adopted by the its Board of Directors' at a meeting held on 'Q_ '. ,Z.oy, at the offices of the Corporation. RESOLVED by the Board of Directors' of this Corporation that the Corporation consents to and joins in the filing with the City of Miami of a rezoning and Special Exception application for the properties legally described in the attached Exhibit "A" (the "Applications"); and be it FURTHER RESOLVED that Gilberto Pastoriza, Esq., Estrellita Sibila, Esq. and Tony Recio, Esq. of the law firm of Weiss Serota HelfMan Pastoriza et al, are authorized, directed and empowered to execute any and all applications, affidavits, disclosures of interest, petitions, and other documents pertaining to the Applications. The adoption of said resolution was in all aspects legal; and that said resolutions are in full force and effect and have not been modified or rescinded. Dated this 1 C:" day of,7_ , 2008. A AN W LDING SOCIETY INC., ew York c rpora 'on By: Its: State of Florida County of Miami -Dade I HEREBY CERTIFY THAT on this day, before me, an officer duly qualified to take acknowledgments, personally appearedthe Cs=-(�)Vaqw:!� 6alc ffide of AMERICAN WELDING SOCIETY INC., a New York corporation, to me personally known �ror produced identification in the form of , and who executed the foregoing resolution and acknowledged before me that he executed the same for the purposes herein expressed. WITNESS my hand and seal in the county and state last aforesaid, this its day of December, 2008. HiDAILNUNEZ r' c N4WY Pubo • State of Florida s • • = My Commis w DOW Dea 12, 2011 z� f � 711,• a Commission 0 DD 741639 • Sondsd Through NslionM Nadal Apn Signature Signature o- ry Jbr, AFFIDAVIT OF AUTHORITY TO ACT Before me, the undersigned, this day personally appeared Gilberto Pastoriza, who being by me first deposes and says: 1. That he is the legal representative of the owner, submitting the accompanying application for a public hearing as required by the Code of the City of Miami, Florida, affecting the real property located in the City of Miami, as described and listed on the foregoing pages of this affidavit and made a part thereof. 2. That all owners who he represents, if any, have given his/her full and complete permission for him/her to act in his/her behalf for the change or modification of a classification or regulation of zoning as set out in the foregoing petition, including responses to day to day staff inquires. 3. That the foregoing pages are made a part of this affidavit contain the current names, mailing addresses, telephone numbers and legal descriptions for the real property of which he is the legal representative. 4. The facts as represented in the application and documents submitted in conjunction with this affidavit are true and correct. Further Affiant sayeth not. Gilberto Pastoriza Attorney Name STATE OF FLORIDA COUNTY OF MIAMI-DADE Attorney Signatu je foregoing was acknowledged before me this day of ", LA 200by Gilberto Pastoriza who is a(n) agent of AMERICAN WELDING SOCIETY INC, a New York corporation. He is personally known to me or who has produced as identification and who did (did not) take an oath. (Stamp) ..-...4.1 iruiary sgMa®s DISCLOSURE OF OWNERSHIP Special Exception List the owner(s) of the subject property and percentage of ownership. Note: The Miami City Code requires disclosure of all parties having a financial interest, either direct or indirect, with respect to a presentation, request or petition. Accordingly, disclosure of shareholders of corporations, beneficiaries of trusts, and/or any other interested parties, together with their address(es) and proportionate interest are required. Please supply additional lists, if applicable. Owner's Name(es) AMERICAN WELDING SOCIETY INC, a New York corporation Subject Property Address(es) 550 NW 42 Avenue and 4227 NW 5 Street Telephone Number (305) 854-0800 E-mail Address gpastorizaAwsh-law.com 2. Street address and legal description of any property owned by any and all parties listed in answer to question #1 located within 500 feet of the subject property. Please supply additional lists, if applicable. Street Address Legal Description N/A Owner Name Owner Signature STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing was acknowledged before me this K day of 2008, by ��,��� who is a(n) �of AMERICAN WELDING SOCIETY INC, a New York corporation. He is per onally known to me."" or who has produced as identification and who did (did not) take an oath. p1.o�yo� • 9wo9o9�f.FW1�&y9 • h�co�w�a,Iu�ofzl�� Signatu ..,.�' p��co,�mgyM, i�w.l�oe�.NY.DO 7416399y� Exhibit "A" Legal Description for Special Exception Lots 5, 6, 7, 8, 10, and Lot 9 less the East 15 feet thereof, Block 2, GOLF COURSE PARK, according to the Plat thereof, as recorded in Plat Book 43 at Page 3 of the Public Records of Miami -Dade County, Florida. Rev. 09-04-07 4 American Welding Society - 2008 Leadership Page 1 of 3 AWS LEADERSHIP AWS Officers I Past President Directors I Directors At Lame I District Directors AWS OFFICERS Gene E. Lawson Training and Development Victor Y. Matthews President, AWS u Vice President, AWS 2008 3319 Kashmir 2008 San Antonio, TX 78223 14254 Highway 23 0: (210) 353-3679 President Lawson is senior F: (210) 353-6779 Vice President Matthews is a territory sales manager for F: 504-799-1910 Global Customer Service ESAB Welding and Cutting Specialist and has been with Products, representing the Lincoln Electric Company company's southern since 1963. California, Arizona, and Hawaii territory. The Lincoln Electric Co. 7955 Dines Road ESAB Welding & Cutting Novelty, OH 44072 Products O: (216) 383-2638 25108 Marguerite Parkway F: (216) 383-2400 PMB #165 vie matthews@lincoln Mission Viejo, CA 92692 electric.com O: (949) 838-4868 F: (949) 470-0789 glawsoz. cr esab.com John C. Bruskotter John L. Mendoza Vice President, AWS Vice President, AWS 2008 2008 Vice President Bruskotter Vice President Mendoza is a operates Bruskotter Training and Development Consulting Services, WA Analyst at CPS Energy. working for an independent oil and gas operator. 3319 Kashmir San Antonio, TX 78223 14254 Highway 23 0: (210) 353-3679 Belle Chasse, LA 70037 F: (210) 353-6779 O: 504-799-1942 jlm_endoza.cr cpsenergycom. F: 504-799-1910 jbruskotter@ eplweb. com Earl C. Lipphardt Treasurer, AWS 2007-2009 Treasurer Earl C. Lipphardt is currently a welding consultant. 950 Avonia Road http://www.aws.org/w/a/membership/officers.html 12/24/2008 American Welding Society - 2008 Leadership Fairview, PA 16415 0: (814) 774-9511 F: (814) 774-0057 mlipphardt@hrblock.com Jerry D. Uttrachi Past President, AWS 4313 Byrnes Blvd. Florence, SC 29506 P: (843) 667-1334 guttrachi@aol.com aol.com DIRECTORS AT LARGE Osama Al-Erhayem JOM Institute Gilleleje Strandvej 28 DK -3250 Gilleleje Denmark 0: 011 45 48355458 F: 011 4548355457 j om_aws@postIO.tele.dk. Harvey R. Castner Edison Welding Institute 1250 Arthur E. Adams Dr. Columbus, OH 43221 0:614/688-5063 F: 6.14/688-5001 harvey__castner.c1.q wiorg William A. Rice 1411 Connell Road Charleston, WV 25314 wrce 1707acicom Page 2 of 3 Damian K. Kotecki Past President, AWS Past President Kotecki was a Technical Director for Stainless and high Alloy Product Development, the Lincoln Electric Company. He is now retired. Damian Kotecki Welding Consultants, Inc. 7888 Frontier Drive Mentor, OH 44060 P: (440) 255-2065 dam.ian@damiatikotecki.com damiankotecki.com Bruce Albrecht VP, Technology ITW Welding Technology Center 3624 West Lake Ave., Glenview, IL 60025 0: (847) 657-4210 F: (847) 657-7672 balbre@m.ill.erwelds.com m.illerwelds.com Dave L. McQuaid D. L. McQuaid & Assoc. Inc. 2306 Cassidy Drive Bethel Park, PA 15102 0: (412) 831-9177 F: (412) 851-4116 dlmc..q.uad1phanet Dean R. Wilson Wilson Industries Inc. 123 Explorer Street Pomona, CA 91768 0: (909) 468-3636 F: (909) 468-3640 dean@wilsonindustries.com http://www.aws.org/w/a/membership/officers.html 12/24/2008 State of Fl Department of State I certify from the records of this office that AMERICAN WELDING SOCIETY, INC. is a corporation organized under the laws of New York, authorized to transact business in the State of Florida, qualified on May 13, 1971. The document number of this corporation is 826168. 1 further certify that said corporation has paid all fees due this office through December 31, 2008, that its most recent annual report was filed on April 24, 2008, and its status is active. I further certify that said. corporation has not filed a Certificate of Withdrawal. Given under my hand and the Great Seal of Florida, at Tallahassee, the Capital, this the Second day of December, 2008 AE- F Secretary of State S- Authentication ID: 600138375256-120208-826168 GQDq T1s"" To authenticate this certificate,visit the following site, enter this ID, and then follow the instructions displayed. https:Hefile.sunbiz.org/certauthver.html AMAJ!"M W WWbs• $04d& is W »WT4*d .rw.*11.) vena, LAW OFFICES OF ROSENTHAL & YARCHiN 100TSOUTHUSTE2TSTREETINANCTAL CENTER MIAMI, FLORIDA 33131-2198 Thk Insirurnent Prepared by: CONSUELO C. FERNANDEZ, ESQ. A"saa: 5404 W, FLAGLER STREET WARRANTY Otto 4ROM CORPORATION, 030 JM 22 AM 11-- 51 ! 4596? 2363 151fo� RAMOO FORM 42 908232827 MIAMI, FLORIDA 33134 Docum�e}ntary Slumps Coaec,cd $—� •��c'i.)IiTi �1, is JIJI^•7 Rey Appralwa Parcel kitaNKlutlon (Fotb) Number(s): clnss"C" 01-4105-31-0220 (3rantaefs) S•S.rls):((__ kfclts,rd �i'.� L'�'i:'•�ur �•li,rk, C;:..0 C,.•i;'••i• `•T tc ����y����( ja`p UC -- 1r--- wAa AstonTWLimit FDR "0=6111411 DATA IfjAC! AapYt t1w tun saR oA/A I Itsiewo0 M DADS "con T •� llllib r�� Warranty Peed made and execiiied file 20TH day of JUNE ,%. n. 1990 by BROTHERS THREE'. ENTERPRISES, INC. Zcorporation existing tinder the laws of FLOR IDA and baring its principal place of business at 10480 S.W. 56 TERRACE, MIAMI hereinafter called the grantor, to AMERICAN WELDING SOCIETY, INC., A NEW YORK CORPORATION whose_postoffice address Is 550 N.W. le Jeune Road, Miami, Florida 33126 hereinafter called lite grantee: 1 Whenrrr .mrd Main the term. "tnntur" and "taunt." irelude all tht part,. to IN. imtrtt rnt and iht hrin. Irnl r,pr t,rjati,. and -oz o( indwtdwh, and the mrceama and vets., til torgn.timn) e USSA: Thal the tlronlor, for and in consideration of the sum of S 10.00 and other valuable cons lderolfalls, receipl whereof Is hereby acknoudedged, by these presents does gram, bargain, sell. alien, remise, release, convey and confirm unto the grantee, all that certain land situate in DADE County. Florida, 'I-; wlow,mmilalliff, Lot 10, in Block 2, of GOLF COURSE PARK, according tr,enasl+• to the Plat thereof, as recorded in Plat Book 43, s" at page 3, of the Public Records of Dade County, *'7`17 Florida. iRwil Count Subject to: Conditions, restrictions, limitations and easement of record, if any. Zoning ordinances applicable thereto. {�, Taxes for the year 1989 and subsequent years. �'ogether with all the tenements, heredilamenis and appurtenances Iherelo belonging or In any- wise appertaining. To have and to Hold, the some in fee simple forever. And the grantor hereby covenants with said grnnier, that it is lawfully seized of sold land in foe simple; 161, tl has good right and lawful authority to sell and convey said land; that It hereby (filly wan rants 16 title to said land and will defend the same against file lav fill claims of all persons whomsoever; V�,1 pr)d�ihaJ said land is free of all encumbrances C�{p�}�KAiin HllneSS Thereof Ihegrantor has cawed these presenlr to Q be executed In its name, and its corporate seal to be hereunto affixed. by its ' proper officers thereunto duly authorized• the day and year first above wrillen. .'..,� .• Cly. ,,ti 4 BROTHERS THREE ENTERP ISES, 1NC, SIriod, sealed and deli in the presence of: STA+E OF\JFWRIDA COUNTY OF DADE 1 IIEREBY CERTIFY that on thi, day. h.lnrt ,nr, an ntfir,r dulr authnriaed A tht Silt, and crony .1 -,"Id 1. afar xkaowkdatnran, W—asily eptw—d SIM 0 N CRUZ well kaon to tine to Fx Iht Prnident and ...prrlivelr til IN eerPot$tioa -mrd at anata in rhe I—g.ina deed. cad that t1h1Y -".ally atknowkdrtd r-tutinK the .ams in thr enrwnrr of two r6.Fn'Dine'rinwR't'{rrrh and .annt"lly utdrt authoriy duly ,nted In them by .aid ewpttatloa and that it. areal ofliard thertia it the true rotboeµt lett al did coporatian. WITNESS mr ;and and oifkial wd in the Counts and State 1a11 ala.atd this 20T}in b JUNE A n. 1490 �, .. ... ........-..FD- CL6,�ig.F�_.�.._.. ..�. ..,.,, MY COMMISSION EXPIRES: 5..3� :1vr ^„s it, , �NHOTARY PU$LiC / p�(( t 0;: MOR"; 300n ,►nom CUn PORAiION Ijl Ialh1 ��� ~� ��� �' r'.aAMCO ronM A-3 �,'8U •. ars t» • nrr- t: >� � C � Q �� itr.0 �.��6�• I s 481 lS �Ilbe 1t1Crp,' Made, this , 3rd (lay o/ September. A.D. 1980 PetlUeett WTIORINI 1NVWS7S M. V., -.a Netherlands Antilles corp. WQRAMVJX havirrrr ill principal place of brai»ess tit the Counly of Dads and Siak of F1'ori,da , and. AIMICAN WELD= SOCIETY, INC„ a New York corporation, not for profit 2501 N.W. 7th Street, Miami, Florida,__ of the Caunly of Dade and State of Florida patty of dee mcond part )Miinessrih: Thar the raid parry of the first parr, for acrd, in consideratinrr of the sum of TIMI DOLiAILS ($10.00) and other good and valuable consideration -7 ------------------------------- to it in hand pari/ by the rail party o/ the recon/ part. the receipt whereof u hereby acknnwlalged has granlerl, bargained and sold to the raid part y of the srcond part, suecessownd asJrgtu foreirr, the fallona'ng described land situale, VitS and heinq in the C'anrny of Dade and State of Florida, to, at Lots 5 through 9, inclusive, in Block 2, of GOLF COURSE PARK, according to the Plat thereof, as recorded in Plat Book 43, Page 3, of the Public Records of Dade County, Florida, SUBJECT T0: 1. Existing First Mbrtgage in favor of 'Travelers Insurance Company in the orimo ginal aunt of $1,000,000.00 dated June 21, 1973, and filed under Clerk's File No. 73R-143367. 2, Second Mortgage dated September 6, 1978 given by James E. Smith as trustee to Victor A. Damiano, et ux. in the original anrsunt of $1,202,000.00. 3, Subject to Purchase Money Mortgage of even date herewith in the amount of $266,369.09 with interest at 11% per annum given by the Grantee to the Grantor to secure the balance of the purchase price. 4. Conditions, restrictions, limitations, easements, zoning; ordinances of record, if any, and taxes for the year 1980 and subsequent years. bOffa�i{ lJLS7hkY �rATF r4rTL.�► iC7oID, :,UAf Ti.);OW.1.11, 1•IIARY: • ',V-JAP TAX 1 r-� r1 I L., -• I,i�•,:'�il „i,i•rn' r�ri. .f1. I SI P•4'!n ��'rKf '•a, .•.�''t J 19 9, 0 0 I ... _ ;i,- e•en fi,'tl`E %;1 :i 9. Q Q STATES 017 FLORID/0i :' [.,T!\T E I:ir'f=L©RIDA1 DIOCUIRCt.11",R'r S1AMP TAX; 01)"UMEIHAPY IAIA I TAXI ilr.Fi u, i+i.vi uiri'. �. I i,uii ,i ni iI riui ' f"' "11, 4'Ln I Ill0411d the sari! party of the lint pan docs hot /idly warrant the tide to s,nil larr,l and will defend the Iame.aYdiiul rhe howled charms of ,ell permnl whonnoclrr, 1111 Rilliese X01jerruf, thrraid pargrof thelint Ca rate or pan has r,nrscd thew prrcrnlr to be signed in iu Warne by ru prober a//irrrt, and if; corporate seal to he alfired, WWI- , rd by it r .wartary, thr day and yrar ahow olitters, i1 irgc'' Secretary. SAIMRINI INVESZM=S N.V. ,�i,�nell, aril td ode ' re1� in per rr of us: ;. , : •• �' •� Mq TEZA NADJAFI er1•yye� Managing Director rind Thi, liislrumenl V,nv prcp1% Liquidator. rumul9 J' Coala„za req. ur Brian I •'ague rcrd prrpnrerl by; �uzb: WACTERS, C066NZo, bi'l[LEii, 111) !U:LL 1600 S First Nations• Addrrrr ax 01TTMAm, Mlnrnuya of L°°, lem,UF�rida 33L31�% Q 'SUITE }001.106,a1MAYNE OLYU, Pioirr11 MIAMI, FLom10A 33132 Mute of Afariba, Fii i; 10860 dolt rtu of Pereb'g lgertifU that rirl /hilc t rloy u/ • `LSC."c`,• Ga "A, D. 19 FD , hrforrmel,rrmnallynplxarrd /00/1T6•2N hhakl ort and rr, rcnirl a %arc c•' / `•.1 �v y+�,n,n ; -o.. I y „5-jrN zOn/�,i lvj.;, ri ,•rj •�•'rr • fu I/ I i, co,lwroliollunrlcr Ihr III I'No/ �Nvrl c ``I to nrr litaim to hr lhr pemaf who njnrrd Ihr fore{joinq irvirnlllenl In ,arch offli•clt alai.u•Irrally rrclvuni'h•rlrvr! MI.r•.errrlhon thrrrnf to be thrirfrcr. Ila and dral•ot rrrc%1 officirn far Ihr arrr and parpl ics thrrrin iernuonol.alad /hal Ihry of fLrrrd thrrelo thr official val of and corpora- lion,:nnd thnl the mid injImmenl if thr art gaol dail o/ foal rorporation• Wit21eoz tnyn,'qualnn., and off aid mil al 'All -7^/ du the Connly of ,NO f road b%rllr q/ Ike doy and . ar lail a arraaid My cnnufio l Grpi --- �l�'1� �.�1 •_ .:. <_�ic l t -L .-._. — +atnnv hl:fll: 9TniC or nonn,n nt !nnrtr '•.� l•- uanoeo amu W-WIMIU Durolna AOOICY Nolary Ptlb„r�5(n1c•b)? �li9dH?; a bQCUNiEt4Tl,RY. f TA, F 1 ••, _ rn = n ren �,0 U � I n S f �� T- F ai F --j ORIDA I 9,_, nCJrTt, P. r ,Tn.tYl! .TnX w� •r UCI`1 DI PLVCn,Ii rte` F�� ,.n = all - ;rr-,•u•11��.�'�'��.� �� s �i Vii, � 11 � I,/ ) ;l IM, :14TI.RY :IA1,1P is .•' !� PS1'I In I!L'IUN' ^�'A• I Uq';1),%A-141^,R•r. ',Tr,WVr TAXI (. apl,”; 9 9 19 0 0 I 7 �lCllmi:tlTArir IA1lIp T': Y, i O � � rrwwDlu IM nuww ncw,ur nw, or DIDI 6DDHh, t10,1D4 n L<MD YI n11HD i PJCHARV 11, MUNKErg, 440 c1ACU1r Chug Uq';1),%A-141^,R•r. ',Tr,WVr TAXI (. apl,”; 9 9 19 0 0 I E O � � 1 i E CITY OFMIAMI DISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO Fi ��I. t1 FE itFlli ;w �# SUPPORT OR WITHHOLD OBJECTION The City of Miami requires any person or entity requesting approval relief or other action from the City Commission or any of its boards, authorities, agencies, councils or committees, to disclose at the commencement (or continuance) of the hearing(s) on the issue, any consideration provided or committed, directly or on its behalf, to any entity or person for an agreement to support or withhold objection to the requested approval, relief or action. "Consideration" includes any gift, payment, contribution, donation, fee, commission, promise or grant of any money, property, service, credit or financial assistance of any kind or value, whether direct or implied, or any promise or agreement to provide any of the foregoing in the future. Individuals retained or employed by a principal as a lobbyist as defined in See. 2-653, and appearing before the City Commission or any of its boards, authorities, agencies, councils or committees solely in the capacity of a lobbyist and not as the applicant, or owners' legal representative are not required to fill out this form. NAME: 4-1-dw 'S -16Z (First Name) (Middle) (Las HOME ADDRESS: '25-25 Qcn'i C-9— d —, L L-Q�1 L (Address Line 2) CITY. �'� �/SATE: Florida LIP: II()ML NION I.;: 11fi\.fJ}-lONL: FAX: E' N1 A I L:: Urt VyJ f f L l /� 1311SSINESS or APPI.,ICAN" or L;N7"1`i l' NAME 131.1SINF'.SS ADDRESS: V- �S 0 N 0& E (HClaresS Line l) _ fit `-?p)2 (Address Line 2) 1. Please describe the issue for which you are seeking approval, relief or other action from the City Commission, board, authority, agency, council, or committee. 2. Has any consideration been provided or committed, directly or on your behalf, to any entity or person for an agreement to support or withhold objection to the requested approval, relief or action? YES 0 If your answer to Question 2 is No, do not answer questions 3, 4 & 5 proceed to read and execute the Acknowledgment. If your answer to Question 2 is Yes, please answer questions 3, 4 & 5 and read and execute the Acknowledgement. Doc. No.:86543 3. Please provide the name, address and phone number of the person(s) or entities to whom consideration has been provided or committed. Name Address P11011e4 a. h. C. * Additional names can be placed on a separate page attached to this form. 4. Please describe the nature of the consideration. 1�) ) P\ 5. Describe what is being requested in exchange for the consideration. 1 �l ACKNOWLEDGEMENT OF COMPLIANCE I hereby acknowledge that it is unlawful to employ any device, scheme or artifice to circumvent the disclosure requirements of Ordinance 12918 and such circumvention shall be deemed a violation of the Ordinance; and that in addition to the criminal or civil penalties that may be imposed under the City Code, upon determination by the City Commission that the foregoing disclosure requirement was not fully and timely satisfied the following may occur: 1. the application or order, as applicable, sh II be d�emed void without further force or effect; and 2. no application from any person or ntity for t e same issue shall be reviewed or considered by the ap ' le board(s until a �ir ion of a period of one year after the nullification of the pplication • ord PERSON SUBMITTING DISCLOSURE: Signature I�E < Print Name S4rnrrl to and srrl>scrihed heore me this da - o �C�" '(It) The fibregoing, instrument ii, -as acknorrtedged before me by f----_--.-_._ T rrho hcas prochiced _-_--- _--. _ -- .-------_ -- - ccs Identification m is .�ersot7allp known to ne artd t+ Ito di dii! not take cru oath. VANESSA CASTILLO MY COMMISSION # DD 681010 STATE" OF FLORIDA * EXPIRE&JUIy11,2011 CI'T'Y OI' A.-11AMI y jt aJSc' C _ ,� .• sVBonded ThruNotaryPublicUndefflfitM MY COMMISSION �J r Print Name Enclosine(s) Doc. No.:86543 Page 2