HomeMy WebLinkAboutApplication & Supporting DocumentsN
HEARING BOARDS
444 SW 2nd Avenue, 7t" Floor • Miami, Florida 33130
Telephone 305-416-2030 • Fax 305-416-2035
wvvw.miamigov.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 24x36" 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) 8Y/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 3 d 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 aL.9.artitRcheqj
Signature
Name Gilberto Pastoriza--®-�'�
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 gpastoriza(aD-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^c-°'�%
20 by Gilberto Pastoriza who is a(n) agent of AMERICAN WELDING SOCIETY SNC, 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
��� 4 �t.��
Signature
��KANY pG0
* MyPOOMMISS10NONAofoDyD*EVILLA
AlFOF V.,ol 80"dedThru9909 ber 2886
CERTIFIED CORPORATE RESOLUTION
The undersigned hereby certifies that he is the ° !�'v `t��c,�� �� c <� (� � 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 Oo_�. 1{_i,-ej 2 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 Helfinan
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�,_ , 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
(�„•� ,vG �, of AMERICAN WELDING SOCIETY INC., a New York corporation, to
me personally known or 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 V; day of December,
2008.
HIDAIL NUNEZ
Ngwy Pubm • Stats of FWWI
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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
The foregoing was acknowledged before me this day of
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.
(Stamp)
— -V., imaly lJorw9®e5
DISCLOSURE OF OWNERSHIP
Special Exception
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) 550 NW 42 Avenue and 4227 NW 5 Street
Telephone Number (305) 854-0800
E-mail Address gpastorizaLo)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
Owner Name
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
Legal Description
Owner Signature
The foregoing was acknowledged before me this V9 day of m_
2008, bywho is a(n) ;-cq �000f
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.
�,t �ubMrt • No of Flow
h aw'c �on�,q�r.�o�a�z,zot� Signature ,--
Cw"" M 00 141639
0 kWWTlr *NtYoiMt=Aw►.
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 Large I District Directors
AWS OFFICERS
Gene E. Lawson
Victor Y. Matthews
President, AWS
Vice President, AWS
2008=
2008
President Lawson is senior
Vice President Matthews is a
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
j.l..m.e..ndoza.c ppsenergy.co...m.
Hawaii territory.
The Lincoln Electric Co.
ibruskotter@eplweb.com
7955 Dines Road
ESAB Welding & Cutting
Novelty, OH 44072
Products
O: (216) 383-2638
25108 Marguerite Parkway
F: (216) 383-2400
PMB #165
vie a,lincoln
Mission Viejo, CA 92692
_matthews
electric.com o
O: (949) 838-4868
F: (949) 470-0789
gl:awson@.e....s...ab..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,
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
j.l..m.e..ndoza.c ppsenergy.co...m.
F: 504-799-1910
ibruskotter@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
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
0: 011 45 48355458
F: 011 4548355457
j om_aws@post l O.tele. dk
Harvey R. Castner
Edison Welding Institute
1250 Arthur E. Adams Dr.
Columbus, OH 43221
O: 614/688-5063
F: 614/688-5001
harvey_castner.a ewi.orgg
William A. Rice
1411 Connell Road
Charleston, WV 25314
wrice 1707.aael..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@damiankoteeki.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 om.illeiwelds.com
Dave L. McQuaid
D. L. McQuaid & Assoc. Inc.
2306 Cassidy Drive
Bethel Park, PA 15102
O: (412) 831-9177
F: (412) 851-4116
dlmcquaid_adelphia.,.net
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
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
f
- -= Secretary of State
Authentication ID; 600138375256-120208-826168
To authenticate this certificate,visit the following site, enter this
ID, and then follow the instructions displayed.
https:Heiile.sunbiz.org/certauthver.html
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LAW OFFICES OF ROSENTHAL & YARCHIN
100TSOUTHUSTE2TSTREETINANCIAL CENTER
MIAMI, FLORIDA 33131-2198
This Insilrumenl Pn WW by:
CONSUELO C. FER'NANDEZ, ESQ.
A� 5404 W. FLAGLER STREET
WARRANTY Otto
I►.ROM CORPORATION -
030 JW 22 AM I1', 50
RCC.
1459642363
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RAMCC FORM if
9OR232827
MIAMI, FLORIDA 33134 d _
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NV" Apprslws Punt IdwAlflostion (Fab) Number(s): C1nss "C" LLinn; l..t G1'
01-4105-31-0220 k, p C,..+
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fits,ltee(s) s.s.�(a): (;y _VJNJj ��Lji gNL.(Q-da-.9")C
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lhk Warranty Beed made and pxeruled Ike 20TH day of JUNE V D. tp 90 by
BROTHERS THREE -.ENTERPRISES, INC.
a corporation existing under the laws of FLORIDA and having Its ,principal place of
business at 10480 S.W. 56 TERRACE, MIAMI
hereinafter called Ike grantor to
AMhRICAN WELDING SOCIETY, INC., A NEW YORK CORPORATION
who$, posioffice address Is 550:N..W._Le Jeune Road.,. Miami, .Florida 33126
hereinafter galled the grantee
IWh,tnrr uvd l,rrrin the Iran, "*tutu," rad "pmin" it lurk ■11 the Palm In thit imtrutnent AM
tht hrin, 4W r,pr—afl,t and A xn, of lod,widusl,, rad Thr wr,e ■nd Anipn nl taPoratina,)
URRES59th: That the {Irantor, for and In consideration of the sum of S, 10-00 and other
valuable considerations, receipt whereof is hereby achnoudedged, by these presents does grant, bargain, sell,
alien, remise, release, rnnney and confirm unto the grantor, all that certain land situale in DADE
County, Florida, viz:
w,o,,rpruw Lot 10, in Block 2, of GOLF COURSE PARK, according
MTV. IRaw& to the Plat thereof, as recorded in Plat Book 43,
'~ at page 3, of the Public Records of Dade County,
V. 1 Florida.
;IRCIl1T WT
Subject to; Conditions, restrictions, limitations and easement of record, if any,
Zoning ordinances applicable thereto.
Taxes for the year 1989 and subsequent years.
'100ether with all the fenements, hereditaments and appurtenances thereto belonging or in any-
wise appertaining.
�To Taut and to Hold, Ike some in fee simple forever.
■Nsd the grantor hereby covenants with said grantep that it is lawfully seized of said land in foe
simple; that it has good right and lawful authority to sell and convey sold land; that It hereby fully war.
rants Ilea tate to said land and will defend the same against the lawful claims of all persons whomsoever;
prlti,ihat aMd land is free of all encumbrances
U IN ,
� '� •� t^ ip t
-+ ,,SIA�1 In UltneSS Thereof the grantor has cabled these presents to
A be executed In its name, and Its corporate seal to he hereunto affixed. by its
D proper of f ivers therpunto duly authorized, the day and year first above written,
1
BROTHERS THREE ENTERP,JISES, INC,
,................ ....................... ....
SI sealed and delivered in the presence of: „
s•rn�e OF , �FE,ORIDA }
COUNTY OF DADE J
1 HEREBY CERTIFY that nn thi, day, h.lnre ,r t, en oIlk,, duly autho,ired i• lh Sle, ted County -1—ld to ale aelao.kdatnenh,
p,—.Ily appeared SIMON CRUZ,
.ell In— to me to Is, th Prnidenl end rnpt'lN ly, at tie eapoo1 tion rutted as anntor
In th Irtneoinl deed. Aad that thT v,erally "1-nkd4,d ett,utinA the umr is the ►rnence ai two r6'&*iney inrtrrt'lull? and voluM-4
undo authority duh H,Md in them by uid twpotnion sad that lh eat alltatd tbertlo it Ih aut eottyoeAlf "ad wad coaporativa.
WITNESS my Fend and oitkiai d in the County And State Let afanatd thu 20TILY tq JUNE '' , A n. 1990
re
n
•o. "I L f;yT.yiJu�
NOTARY PU Y,YC.:r"FER40DEZ....._..,-.
IBES. S"3C'" — -
tiormium
t�OR^;�:100�1
IfpOM conPon ATION '•� ofifl SEP -4, PH 5,+ p nAMCO MOnM A -a
' U
,•� arrant �Drtb
1.0860. ,:� 4� 1. p
.
to 11beriture.' Made, thin , 3rd day of September- d, D. 1980
Pti.Weell SANTORINI INVESI!rM I'S N.V.,'•a Netherlands Antilles corp. ,~
ha"ni in pnneipal place o/
busi»tss in the Count of Dads and Stas of Florida
and
AI+lERLCAN WEEDING SDCIL~i'Y, INC., a New York corporation, not for profit
2501 N.W, 7th Street, Miami, Floridal_
of the County of Dade and Sate of Florida
parry of the second part xiinesse#il:
That the mrd party of the fiat part, for and, fir conirderatian of the Jum of TEN DOLLARS ($10. 00)
and other good and valuable consideration --------------------------------may
to it in hand paid by the void party of The second pari, the receipt whereof u hereby ac,Faowledgrd hal gmntal,
bargained and cold to the said part y of the second parr, suecessowud omti to forrlrr, the fohauang described
land dimale, lying and kir lq in the Cbuuly of Dade and Slate of Flarida, 10' t;
Into 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 Dlortgage in favor of 'Travelers Insurance Company
in the original acmunt of $1,000,000.00 dated June 21, 1973, and filed under
Clerk's File No, 73R-143367.
. 2, Second Nbrtgage dated September 6, 1978 given by James E, Smith as
trustee to Victor A. Damian, et ux. in the original amount of $1,202,000.00.
3. Subject to Purchase Nbney Mbrtgage of even date herewith in the
amount of $266,369.09 with interest at 11% per annus 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.
_C7{`�'ID/�. F"L.01
wi.• hcrltrAr:r�TAYy :,TarAr Ti'.); r)f�rllMlI'II,A(t'f: iT;'VwP T -AX
r:: Ufl�t iii I'L it.tal!• Pn S. ..'... I �..-• I,l i•I"lil ul ,l•,III' rr1,. .,. �. � I
— I,II su' e'en t`: '!�J 9 9. 00 I 0 0 I
z„ i
STATF ol= FL_�1=11 C1��,! �ITl�TE FLORIDA
cir
h;O_CUMENIAR'( ',TAW TA;;, V)rUMti1lI,WY `,.TAMI.'.TAXI
i. i. ' UI: P.I UI PLVI IIIII-r1•j� 4. I -• UCI�I �,I u1.714U1 �' '' � I
'' I, _ ,I"I _ :.I, . r•aa1 /;1 fl 9 9, 0 L) I 9 9 9, 0 0
rIITlllrra the sari, party of the first, part docs Germy fully snrrarn the iWr to raid lanl and nrll defrud the
same.agdtiut the lawful daunt of rill prraun whonnowt;
Ohl w1111ICBB �I11111errof, theroid parlyof flit fits,
�Ca ale
��r� pan lur.l I-anred tlrrx' pmrents to be si,'gntd in in narncby
ns pmpr'r of fkrn. arrd !li corporals x a/ to be a f fGrcrl, nftul�
rd by its .tarriag, the rhly aual yar abrrtr urinen,
Secretary.
,i�ned, Beal ld de ' red in tare rr of no:
WTIORINI INVESD=S N.V,
M7R'I= NADJAFI 1E3 Ont
e[�ryx�' Managing Director atnd
o' �� Tht, lristrument wn proRr�r,l Liquidator
rumtr{icnt prrpnrrrl hy; �5ustr_o Coeta„:o Hrian P. • Vague
wACTERS; COSTAMzo, MILLER, Rus�;IIt 1600 5f Birgit Nations.
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MIAMI FLORIDA 33132
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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.
NAME:
(First Name) (Middle) {Las
HOME ADDRESS:
Q��,, C -,Q- LSI
/ (� - n (Address Line 2) /
CITY: / � L� S STATE: Florida ZIP:
J l Q l�
CE'LL 1110Nr. FAX:
I'-" N. -I A I I LA & VvJ — L A " � G/o��
i3L1SSINE?SS or APPL,ICAN'`or E;NT.I.I--Y NA -1E,
en (- ,
l3[.ISINL;SSAIDDRESS: C) NOAD
f -A
(AparesS Line T) _
�kA-POA-1,A f L-- ` -- 3G
(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 )K 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 Phone#
a. {
b.
C.
4' Additional names can be placed on a separate page attached to this form.
4. Please describe the nature of the consideration.
J�) ) �A\
5. Describe what is being requested in exchange for the consideration.
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 11 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 •16ir ion of a period of one year after the
nullification of the pplication ord
P6RS(.)N SUBMIT'T'ING DISCLOSURE;
Signature
;Ell
Print Name
, 'worn to and subscribed befre ine this clay oJ'�✓C ... ?00 _'y /'he foregoin�T
insirument crus acknowledged befi)re me by 1 -----_—.•.-__.� who has produced
_ as identification cry- czr• is ersonull} known lu ne and t+ ho di .,did not take an ouch.
VANESSA CASTILLO
MY COMMISSION # DD 661010
STATE" 0U FLORID: EXPIRES: July 11, 2011
CITY 01" MIAMI VG P SS`t I
Bonded Thm Notary Publw Underwriters
MY COMMISSION
Print Name
Enclosures)
Doc. No.:86543 Page 2