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HomeMy WebLinkAboutApplication & Supporting DocsHEARING BOARDS 444 SW 2nd Avenue, 71" Floor • Miami, Florida 33130 Telephone 305-416-2030 • Fax 305-416-2035 www.miami.gov.com/hearin.q _boards Planning Designee Initial & Date PUBLIC HEARING APPLICATION FOR AN H 1 ID AMENDMENT TO THE ZONING ATLAS AND/OR OVERLAY DISTRICT Welcome to Hearing Boardsl 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. 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 for Zoning Change (Amendment to Zoning Atlas and/or Overlay District) and Land Use Change (Amend the Comprehensive Neighborhood Plan) will not be accepted unless it is signed or initialed and dated by the Planning Department designee. Rev. 09-04-07 ON/ I, Gilberto Pastoriza and Estrellita Sibila on behalf of AMERICAN WELDING SOCIETY INC a New York corporation hereby apply to the Miami City Commission for approval in accordance with Article 22 of the Miami Zoning Ordinance, and in support of that request, furnish the following: 1. Obtain signature or initial and date by the Planning Department designee prior to submittal. 2. The property/location listed does not have any open code enforcement/lien violations. 3. Address(es) and folios) of property: 4227 NW 5 Street, folio number 01-4105-031-0220. 4. Two (2) 11x17" original and one (1) 8'/ x 11 copy of the survey of the property prepared by a State of Florida registered land surveyor within six (6) months from the date of the application. 5. Present zoning designation(s): R-2 Statement as to why the present zoning designation is inappropriate: The R-2 District does not permit surface parking. 6. Future zoning designation(s): R-2 with an SD -12 Special Buffer Overlay District Statement as to why the proposed zoning designation is appropriate: The proposed zoning will allow surface parking to accommodate parking needs of the American Welding Society staff. 7. At least two photographs that show the entire property (land and improvements). 8. 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. 9. 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. 10. Affidavit and disclosure of ownership of all owners and contract purchasers of the subject property (see pages 4 and 5). 11. Certified list of owners of real estate within 500 feet of the subject property (see pages 6 and 7), 12. What is the acreage of the project/property site? 0.23 13. Is the property within the boundaries of a historic site, historic district or archeological zone? Please contact the Planning Department on the 3`Floor for information. NO 14. Is the property within the boundaries of an Environmental Preservation District? Please contact the Planning Department on the 3`Floor for information. NO 15. 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; Rev. 09-04-07 2 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. 16. All documents, reports, studies, exhibits (8 1/ x11 ") or other materials to be submitted at the hearing shall be submitted with this application and will be kept as part of the record. 17. Cost of processing according to Section 62-166 of the Miami City Code*: Change of zoning classification to: a. CS, PR, R-1, R-2, per square foot of net lot area $ .15 Minimum $ 635.00 b. R-3, R-4, O, G/l, HP per square foot of net lot area $ .20 Minimum $ 750.00 c. C-1, C-2, I, per square foot of net lot area $ .25 Minimum $ 900.00 d. CBD and all SD's, per square foot of net lot area $ .30 Public hearing and public meeting mail notice fees, including cost of handling and mailing per notice $ 3.50 *Pursuant to ce 12719, all planning and zoning fees in excess of $25, 000. 00, shall be paid in the formOr OVN,ertifled check, cashier's check, or money order. Signature ___1 Address 2525 Ponce de Leon Blvd #700 Name filbert Pastoriza & Estrellita Sibila Coral Gables, FI 33134 Telephone (305) 854-0800 E-mail GPastoriza(a)wsh-law.com The application submittal date is the date stamped by Hearing Boards' staff on the front page. STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing was acknowledged before me this day of eynn"J " 2008, by Estrellita Sibila 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) Rev. 09-04-07 3 Signature r°SAn'' No MARILYN SOMODf VILLA * MY COMMISSION # DD 704986 EXPIRES: Septem0er 13, 2011 1-9reaF��o�BmWThruUgelNotary8erulces CERTIFIED CORPORATE RESOLUTION The undersigned hereby certifies that he is the C li�v ,� of AMERICAN WELDING SOCIETY INC., a New York corporation (the "Co 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 Odic. ,Z-c,,y, 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 Scrota Helf nan 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 �' day of �-_) , 2008. A AN W LDING SOCIETY INC., ew York c pora '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 appeared V�_Q„oy_ the e ,d 0. of AMERICAN_ WELDING SOCIETY INC.,_a New York corporation, to me personally known or produced identification in the fora -n 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 V" day of December, 2008. VH' uy�iyy HICAIL W"MEZ No" Pubm - aims of Pladldr � � 1it11 COmmMl�lon # Mo 17, 70it ConnnirelAn 01) 711430 8gr+�ldil�tquphtlxYorWiNolr�yA . . Signature o -Rf _ T�ubl' 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 Signature T e foregoing was acknowledged before me this ` day of C'S 200, by 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. �n�.. rb (Stamp) �1 r ILVNSOMODEVILLA * My COMMISSION # DD 704869 �� op EXPIAIS: September is, 20ii ���FFLO� Bended Thru BudgetNelsry B@lYf9®� DISCLOSURE OF OWNERSHIP Zoning Change 1. 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) 4227 NW 5 Street Telephone Number (305) 854-0800 E-mail Address cipastorizaO-wsh-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 550 NW 42 Avenue Owner Name STATE OF FLORIDA COUNTY OF MIAMI-DADE Legal Description 5-8 of 9 less E15' COU SE PARK P 3 OwneCSignature e The foregoing was acknowledged before me this <- day of \-D w�*kesy-y. 2008, by �tir�•a� who is a(n) C .i of AMERICAN WELDING SOCIETY INC, a New York corporation. He is ersonally known to me ✓ or who has produced as identification and who did d1 at) take an oath. ' MDAIL NUf l£Z{ g r�r Puma • &W of Pl w" Si nat • �yCaa�Mplon E�plkMe Mc Itt, X011 r yco"Ms" I0�yDD 141Wo Exhibit "A" Legal Description for Zoning Change Lot 10, 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 Large I District .Directors AWS OFFICERS Gene E. Lawson Victor Y. Matthews President, AWS Vice President, AWS 2008 1 2008 President Lawson is seniorVice President Matthews is a O: (949) 838-4868 F: (949) 470-0789 glmQq@esab.com c{ _e_s_ab_,com territory sales manager for � -' 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 0:(216) 383-2638 25108 Marguerite Parkway F: (216) 383-2400 PMB #165 vie a matt John C. BruskotterJohn 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, HKA Analyst at CPS Energy, working for an independent oil and gas operator. 3319 Kashmir San Antonio, TX 7$223 14254 Highway 23 0: (210) 353-3679 Belle Chasse, LA 70037 F: (210) 353-6779 O: 504-799-1.942 j,lrn;endoza cr cpsen.ergy.,com. F:504-799-191Qna, ibruskott hews(c�lincoln Mission Viejo, CA 92692 electrio,com John C. BruskotterJohn 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, HKA Analyst at CPS Energy, working for an independent oil and gas operator. 3319 Kashmir San Antonio, TX 7$223 14254 Highway 23 0: (210) 353-3679 Belle Chasse, LA 70037 F: (210) 353-6779 O: 504-799-1.942 j,lrn;endoza cr cpsen.ergy.,com. F:504-799-191Qna, ibruskott ereplweb.eom 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 mlippjardt@-hrblock.com hrblock.com PAST PRESIDENT DIRECTORS Jerry D. Uttrachi Past President, AWS 4313 Byrnes Blvd. Florence, SC 29506 P: (843) 667-1334 guttrachi@aol.com DIRECTORS AT .LARGE Osama Al-Erhayem JOM Institute Gilleleje Strandvej 28 DK -3250 Gilleleje Denmark O: 011 45 48355458 F: 0114548355457 jom_aws@post l0.tele.dlc Harvey R. Castner Edison Welding Institute 1250 Arthur E. Adams Dr Columbus, OH 43221 O: 614/688-5063 F: 6141688-5001 harvey.... castt�ere�vi . org William A. Rice 1411 Connell Road Charleston, WV 25314 wrice1707k4-aol.com 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 damian q dam.iankotecki.com Bruce Albrecht VP, Technology ITW Welding Technology Center 3624 West Lake Ave., Glenview, IL 60025 O: (847) 657-4210 F: (847) 657-7672 balbre L2millcrwelds.com Dave L. McQuaid D. L. McQuaid & Assoc. Inc. 2306 Cassidy Drive Bethel Park, PA 15102 O: (412) 83 1 -9177 F: (412) 851-4116 dlm_ cCluaid@a_delpllia,ilct Dean R. Wilson Wilson Industries Inc. 123 Explorer Street Pomona, CA 91768 O: (909) 468-3636 F; (909) 468-3640 dean�wilsonindustries.com http://www.aws.org/w/a/membership/officers.html 12/24/2008 Applicant Fields :City .OfMiami Public School Concurrency Concurrency Management Systiam, Entered Requireftnts Applicant Fields Information Application Type Zoning Change 1 Special Exception Application Sub -Type Application Name * American Welding Society, Inc. % E. Sibila Application Phone * (305) 854-0800 Application Email * ESibila@wsh-law.com Application Address * 4227 NW 5 ST Contact Fields Information Contact Name * Estrellita Sibila Contact Phone * 305 854-0800 Contact Email * Esibila@wsh-law.com Local Govt. Name City of Miami Local Govt. Phone 305-416-1400 Local Govt. Email ci.miami.fl.us GDGay@ci.miami.fl.us Local Govt. App. Number (OFFICIAL USE ONLY Property Fields Information Master Folio Number * 01-4105-031-0220 Additional Folio Number Total Acreage * 0.23 Proposed Land Use/Zoning * R-2 with an SD -12 Special Buffer Overlay District (R-2 already exists Single -Family Detached Units * 0 Single -Family Attached Units (Duplex) * 0 Multi -Family Units * 0 Total # of Units * 0 Redevelopment Information (MUSPs) - Re -development applications are for those vacant sites for which a local government has provided vested rights; or for an already improved property which does not have to be re -platted as deemed by the local government. The number of units to be input into the CMS is the net difference between the existing vested number of units and the newly proposed number of units. Example: an existing 20 -unit structure will be torn down for redevelopment. The newly proposed development calls for 40 total un' s, L ca! government shall input 20 units in the CMS net difference between the 20 units vested less the newly vrojoosVd # qW1 Required Fields for Application Estrellita Sibila Owners)/Attorney/Applicant Name Signature STATE OF FLORIDA COUNTY OF MIAMI -DADS The foregoing was ac nowle ed before me this day of January 2009, by who is a(n) agent of American Welding Society, Inc. He/She is sonall know me or who has produced as identification and who did ( lc no a e an oatf . I OMODEVILLA C/ V MISSION # DI) 704966 EXPIRES: Seplember 13, 2011 ��9jFarnog`OP BMdodTh*W8WgetNulerySerrlces 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. I 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 t —1 Ify" Secretary of State -T d * * AuthenticationlD; 600138375256-120208-826168 Opp WE To authenticate this certificate,visit the following site, enter this ID, and then follow the instructions displayed. https://efile.sunbiz.org/certouthvar.html no" to: tatlfdlM IrllaldthMW 1111110 titrvatopal NL,- LAW OFFICES OF ROSENTHAL & YARCHIN SUITE 2300 100 SOUTHEAST 2TNANCIAL CENTER STP -BET MIAMI, FLORIDA 33131-21919 Ills 1111 t mitis t Pragrtd by; CONSUELO C. FERNANDEZ. ESQ. Ata— 5404 W, FLAGLER STREET WARMANTY Otto r►#oM paReaRATIOrr• M20 JUN 22 ASI 11' 51 r. RfG. 14 59642363 /5/f"?) RAMCC TbRM ae 9OR232827 MIAMI, FLORIDA 33134 is r Dacutrentary Stamps Ca:lec;cd $.—�Eli PTapatty "lows Pamal I h"Okatlan (Folio) Nltlnbarlal; 014105-31-0220 Class "C" I •lar,, :. '1 :.t Go,._c:,.;S } .. -- 6rrltlw(e1 S.s.*h11 h;r•;,:�rti P. L ir,�ur dark, C:�..r, C,..+,..;, r •'�• By n•--•— PMA AMM TNIt 1.1011.101FOR MOMIM DATA — ��W+E tMq t11M ronl 9 mtr� 1 6 Warranty Pttd Afadr and rxrruJeri air 20TH day of JUNE A. [1• Ip 90 by BROTHERS THREE'.ENTERPRISES, INC. a corporation existing under the laws of FLORIDA and hailing its principal place of 6usinpas at 10480 S.W. 56 TERRACE. MIAMI hereinafter called the gran lar• to AMERICAN WELDING SOCIETY, INC., A NEW YORK CORPORATION whore pasloffict, address Is 550 N.W. Le Jeune Road, Miami, Florida 33126 herpinafler called Ilse pranteel INlhrwrer uwd basin th, inm, ••�nnm," and "snnirr" imludr mn the mran m lhi. inaNnrnt and he Nein. Incl reprrrnmi— and ora x o! in d-idu.h, and the --Haran and .-!0, n[ awporni.w.} DitneMM' Thal lho tounior. for and In consideration of the ram bf S 1(] • 00 and other I-ahlable cans l devotions. rerripf wliereof is hereby nc4nbarlPdgPd, by these proments does grant, bargain, fell, alien, remise, release, canney and confirm lento the granter, all that certain sand siluale In DADE colurly, Flarida, vex: "main w, �r„aatsl� Lot 10, in Block 2, of GOLF COURSE PARK, according rwtoll 14.006111116 to the Plitt thereof. as recorded in Plat Book 43, srross sme at page 3, of the Public Records of Dade County, RI V. Florida. rt fpE tIICi1t7 Cour Subject to: Conditions, restrictions, limitations and easement of record, if any. Zoning ordinances applicable therel.o. Taxes for the year 1989 and subsequent years. '109tthtr with ail the Irnements, heredilaments and appartenanCes thereto belonging or in any- wise appertaining. '10 RON and tO R01d, he some in fro simple forever, fnd the grantor hereby covenant, with said grontre that it is lawfully seized of said land In foe simp%l that if has good rfaht and 6oful oul6arily to sell find convey said land; Thal it hereby fully way, male tlse Illlato said land and will defend the same apalnsl IAO lautful clolms of all persons whomsoever; Ut t trlti'tivd OW land is free of ail encumbrances In bitntss 16heruif the prantor has caused these prsrenls to ' I11A be executed in its name, and Its corporate seal to he hereunto of fired. by its i� proper off herr !hereunto duly nuthorlxrd, the doy and year first above writlen, BRQTHERS TF[REE ENTERPRISES, INC, '�•v... Stcuun ... .............r..-.. .. . .................. SI ,salad and delivered in the Pt'esencr oft r .tr ..,./ —.13 rr.,p... ... .. .Pm4l..i..�.. .. .. ,1 - STATE of\F�ORIDA COUNTY OF DADE 1 ItEltBBY CERTIFY chat nn Ihi, day, Wsre int, an .111r,r d.tlr R,A-A" Im the Sufi e,.d C -m, .Ierrnld en ta>,e ackromkdxrtwnr,, gasman, atWe.rrd SIMON CRUZ mr11 IInm.n to ,ne In be he P—idest aid ... p"Ct tr M ffia Aarpnkhlima Mimed a. snstmr in the farrsoin[ deed..nd rh.t AAT "mills .elnamledeed et euripl lhr ,a„w i. the 1'"We dl t.a rh dn'bine�itrwn jrrrh and mean+.rill .Mer wrhmritT Ur v ted In them by .aid rmry-00 n .nd Aber the -W Ili" rhern. it IIIA bMe toiurafr Mal d Mid eaYrpormlin.. I WITNM mr wad nmd na"i"l w -I In the Couerr sad State list aiernaid the, 20TILr # JUNE '• , A D. 1410 n HOT ,y54ti CITY OFMIAMI DISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO 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 Sec. 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. NAMI :��h lS_ (First Narrie) (Middle) (fast Name) I10MUS ADDREW: CY L fffy: � �© l�C S'A'TE:: Florida AW: � �J ilt)titl_i pl[ON 1; �6c- �� �p CELL1'iIONI:: 1?AX: I=A1A11,: S 1 fl -A LA V v" ! [ — Lr\�u�fl 131..ISSINLSS or APPLIC'AN or F-XF1'1"Y NAME r 131.itiTNFS`iAD1)RL-SS: P-)50 N�10 ` (AdflreSS Line 1) (Address Line 2) 0 V) C_ 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 <D 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. NoA6543 3. Please provide the name, address and phone number of the persou(s) or entities to whom consideration has been provided or committed. Name Address phonev a. b. C. " Additional names can be placed on a separate page: attached to this 1561-111. A. Please describe the nature of the consideration. 166—) 0\ 5. Describe what is being requested in exchange for the consideration. ACKNOWLEDGEMENT OF COMPUANC E 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 ll be d emed void without further force or effect; and 2. no application from any person or entity or t e same issue shall be reviewed or considered by the ap le board(s until a fir 'on of a period of one year after the nullification of the pplication ord IIERSON SLJTIM1'I HING D1SCL,OSt_�RF.: rgna ure SJ J -t LL� Print Name Sworn to and subscribed he/i)rr.� rrre this _- - duy of � 'l" ?Ql) 1- . 7he, for�egohi g instr•nment it us acknoivhdg d bcfiorc me b}' �- - who has pr•nrhrced ... — -- ........ .... . as kkmtification (r4 �r rs ger catcrfi}- lnacrri n tri re urr � c i : i id not fake crrr <ruth. VANF-GSA CASTILLO MY COMMISSION # DD 681010 S"l ATI; 01' I'l,()RIDA =*: EXPIRES:July11,201# CT•t'Y OFMIAMI /�q y � %ESC )Scl C 6ondad7hru kolaM Public Underwriters MY COMMISSION A�'�- -�J'� Print Name Enclnsare(s) Doc. No.:86543 Page 2 5582 N.W. 7th STREET SUITE 202 SURVEYNO. 6-0006015 -2 A 33126 rELEPHONEIAMI,1(D305) 220-3771 Noun u r v e g o rs � n v FAX: (305) 264-0229 LAND SURVEYORS SHEET No. 2 OF 2 I)RAWN BY.GEC! (LILY)_ Lor -5 BLOCK -2 U 7.B9 � F.I.P 112" NO CAP y U. P. 0.05'CL. No.1-lelghISPreaftametor . Name 1 16 7 2 3amboo PaIrr 2 8 7 1.B0 Bottle Palm 3 8 7 1.60 Bolfle Palm 4 40 20 2.00 Oak 5 40 20 1.70 Oak LOT -11 BLOCK -2 F.LP 112' NO CAP BOUNDARY SURVEY SCALE =1" : 20' Lor -6 BLOCK -2 W C.B.W. 797 IT + I_ o i a r I w LOT -8 F.I.P 1/2" BLOCK- 2 7.90 I k ' NOICAP y u.uu !III 24.15' . pEcopPFP M THE FLAT PaaH d; TACE T, OF THE 1'UeLIG pEcOAPS OFFINI6IPAOE GIXINTY, fl.ORIGA. \\ A PN 12. B5 + �. - �iNG,' 9Y: STIITl2O08 RONFRT IaARRQ {ORNOF WORK) 4227 NW 571j SIj2EEY RROFESSH9NAL LIMA SURVEYOR NO. 6437P3T MIAM(, FL 33126 STATEa FLORPOA SURVEYORSNOTES: (VALID COPI-S OF TINS SORVFY WELQFARVIEPAOS9 OSEAL OF f} M SHOWNBEAAUJCSRtER P P EO TOANASSEMF7JMERDM0YSAIDPLITIN 7EQE5—TIONOF THEPRQPERTY Mr AMSF45 LAND SURVEYOR). TWO STORY APARTMENT TWO STORY L, APARTMENT ¢ BLDG. # 4227 LOT -9 77a BLDG. # 4227 BLOCK -2 O'ENCR. F.F.E. = 8:67 FEET :e F.F.E. = 8.72 FEET 7B5 A. PN :. ` 8,01 ARKING: -k , -7f.77 24.9 5' LFGAt PkaCHWT1CN: SUPVEY oF LOTS SIG, &AGI( 2, OF GOLF con RSE PAW,, ASC 0WWJ0 TO THE PIAT THEREOF AO pEcopPFP M THE FLAT PaaH d; TACE T, OF THE 1'UeLIG pEcOAPS OFFINI6IPAOE GIXINTY, fl.ORIGA. GERFACATTONS: AMERICAN WELOWe s—IFTR PflOPEHTYAOORE55: 9Y: STIITl2O08 RONFRT IaARRQ {ORNOF WORK) 4227 NW 571j SIj2EEY RROFESSH9NAL LIMA SURVEYOR NO. 6437P3T MIAM(, FL 33126 STATEa FLORPOA SURVEYORSNOTES: (VALID COPI-S OF TINS SORVFY WELQFARVIEPAOS9 OSEAL OF f} M SHOWNBEAAUJCSRtER P P EO TOANASSEMF7JMERDM0YSAIDPLITIN 7EQE5—TIONOF THEPRQPERTY Mr AMSF45 LAND SURVEYOR). 1FNOT, TNENPEMb SAREREFERREQ TO COUNTY, MWNSM! ,I. 2}ALLELEVA"W SROVMAREREFERR£Q TONARONAL OF.OTI M VERTICN. QATLLNOF f929 d7YOFANAAIl OENCHANRK 7lOCATFO@ N $W..FT.. 6 NE44AV.. ATTHENE CORNER: N ELFVATIONA.#$ FEETWN.c.V0. OF 1978 S}THE CLOSUREIN R!E EMNOARYSLRVEYISAUOVE]:7H Or.. 1 NEN WYCFITAFP .THAT THf590LWOPRYSLYTVEY' Of lT IEPRCPERTYQESGRRtED HEREON. A5 RECENTLY SITRVEYEo —NIlLlINDEl2MY SUPETMS M CCMPLPSWITII— 4N MDUT GNN.'CAi STANPAROSA55ETFQRMRY THEFLMMA RCAftO nFPpOF[331ONAL iANn S[BTYFYDRSINCIWPTFR BfciT�, Fi ORIOAAO).nNASTPAPVE OOOF. PVRS UNIT T04]ZOZI, fLOHUM STAi11TE3 W E q S[JR YEYOR IS NOTE. s - Tbcre may he Easements recorded in the Public Records not shown on +is Survey. The purpose of this Survey is for use in obtaining Title Inenranoo and lhnancing and Should not be used for Construction pnrposes, SEAL