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AFFIDAVIT
Before me, the undersigned authority, this day personally appeared Patricia M.
Ba loyra , who being by me first deposes and says:
That he/she is the owner, or 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 which he/she represents, if any, have given their 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 accompanying petition, s4 including
responding to day to day staff inquires; 0 not including responding to day to day staff
inquiries in which case he/she should be contacted at 30 5. 5 3 6. 8 4 81,
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/she
is the owner or 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.
Patricia M. Baloyra
Applicant Name App icant Signature
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
t
The foregoing instrument w acknowledged before me this I- , day of�.,�i24`Y' /1
2Q by Patricia M. Ba`�tsoyra who is a(n)
individual/partner/agent/corporation of Pivotal Holdings, r,Tf
a(n) individual/partnership/corporation. He/She is Orsonalry know to me or who has
produced as identification and who did (di not) take an oath.
(Stamp) F•
,
Wilda Montenegro
Corm[ssiofi ` 'Lf1700
Expires: Nov2007
Bondeu Tim/
Atlantic l;ondi; r Co., in .
Signature
r-0
Rev. 07-15-04
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