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HomeMy WebLinkAboutapplicationsCITY OF MIAMI APPLICATION � � t FOR PLANNING ADVISORY BOARD and/or ZONING BOARD NAME: �Se e 1. a .a L RESIDENCE ADDRESS: -2— `(11 J L.-' 2-3 1 -ae, HOME PHONE: 3 O 3 - BUSINESS PHONE: 3o5— J 71 5-3// -778 Li City Code Sec. 2-884 states: "No employee of Miami -Dade County, Florida, or any municipality therein other than City of Miami employees, shall serve on or be appointed to any Board of the City of Miami." PRINCIPAL BUSINESS/EMPLOYER: BUSINESS ADDRESS: rc L,./ (./ e•• (Company Name) 1 z a ► Q (-, c4 ..e4 A ✓ e ; -lam Ito l wN 3 317l ( ec 144 f.-vicv Are you an employee of Miami -Dade County or any municipality therein other than the City of Miami? P' Would you like to serve on the Planning Advisory Board? jef Would you like to serve on the Zoning Board?S Please state if you have a preference for either board: 2•0 I Members shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City. Please fill in attached Residency Compliance form. Owners of property in the City of Miami, please answer the following question: Is all the property you own in the City of Miami in conformance with City Ordinances? 59, If "no," please give details below: <forms>pz application 3/19/2001 05- 0032,1-_ Will you be able to faithfully attend meetings of the board as required by Sectiooq 62-126 of the Miami City Code? Will you be able to attend Planning and Zoning seminars as required by Sectioa�4 of the Miami City Code? — `fc► VI :2 Do you foresee any conflicts of interest as defined in Miami City Code Ar,,V, Sections 2-611 - 619 and Miami -Dade County Code Section 2-11.1? (r•• • Are you prepared to file a list of real estate interests owned, either personallf -d Ot corporately within the City of Miami (see attached forms) with the City Clerk, pursuant tto Section 2-615 of the City of Miami Code? ' Are you prepared to file a statement of financial interests pursuant to Florida Statutes Sec. 112-3145 and/or Miami -Dade County Ordinance No. 77-13? ✓ : List your experience relating to the fields of planning and zoning: • /e P.41 L-Jg.. 4 ,Lti: ife / eJ+c dto,r, /25. 741-- f - -e' vf' On de !'K1 i! •rP .+, iti Zo.✓ems (r+ I``v. — .04aJe "+.t C., 4.1 Krlj Are you a United States citizen? _.L- Are you presently indebted to the City of Miami for animal or personal property tax, • license fee, or property lien? r'' If "yes," give details: • Signature: Date: <forms>pz application 3/19/2001 . CITY OF MIAMI, FLORIDA RESIDENCY COMPLIANCE FORM (IN CONFORMANCE WITH SECTION 2-884 OF THE CITY CODE) Please submit your completed form to: City of Miami Office of the City Clerk 3500 Pan American Drive Miami, Florida 33133 Date: I, gbseql. Co -ft-&_ 'v+ .- .O o .40 - w n •` P -41 , a mem, a MCMDCT af (name of board) (do/do not) "(a) MI members of City boards shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City..." comply with the residency requirement under Code Section 2-884, namely: (Note: If you do comply with the residency requirement (Code Sec. 2-884), please provide us with the following information.) A. I presently reside in the City of Miami at the following address: 2ysi st-..r 23 4.'& ��-vs,; f i J)/ Ids B. I own a business and/or real property within the City of Miami limits at the following address: (Note: Kindly specify if it is a business or a property) e rle y6y r' i )2/3/ C. 1 work within City of Miami limits. My business address is: 1'� I f3-..LQ' Ate' Signature , 4, Oh I *� - �� .t?cated within corporate limits of the 4 !f`A GV � . State of Florida County of Oita ' COL NOTARY PUBLIC SEAL OF OFFICE: CITY OF MIAMI, FLORIDA STATEMENT OF REAL PROPERTY OWNED THE (IN CONFORMANCE WITH SEC. 2-615 OF E CITY CODE) Legal Description SAMPLE ENTRY: Common Address 437 Northeast S4°i Street . Title L-Legal E=Equitable L Owned W-Wholly P -ln Part W Zoning Class R-1 Present Use Home Lot 7, Primrose Section 4, PB 52 P610 ('b8) Ls 21 3D Cfctr2a Zyl/ sw 2,,) ,1-c L. p le- t Ito....- OATH Sc Co r� , do solemnly swear that the above is a true and accurate statement of my interests in CITY OF MIAMI or 500 feet beyond the corporate limits of the CITY OF MIAMI. NAME: (Please Print) 'TO e Ca P' Tr1.FlPOSITtON WITH CITY OF MIAMI NAME OF BOARD/COMMITTEE (If Applicable) 77�' SIGNATURE: ���' On this the . N day of IQ rintxit.,206 before me the undersigned Notary Public of the State of Florida, the hewing instrument was acknowledged by (a (Name of person signing and his/her title (public officer. WITNEaSS jny hagd and official seal. (Names( Notary Public: Print, Stamp, or Type as Commissioned) • Personally knosm to me. or O Produced identification: DID take an oath, or O DID NOT take an oath (Type of identification Produced) . real property Document Name: Session2 STIN STREET ID: 054501 ARPS PROPERTY SYSTEM - STREET INQUIRY IN USE: YES --HOUSE RANGE-- QUAD 2401 - 2437 SW 23 FACE: ZIP CODE: CENSUS TRACT: CENSUS BLOCK: FIRE 901 ZONE: FIRE SFBC ZONE: NBHD CODE: SUB NBHD CODE: SOLID WASTE ROUTE: TRASH ROUTE: STREET CLEAN ROUTE: W 331453600 6900 5001 0412 3A 10 03 213 00 000 NEXT STREET: HOUSE NO: QUAD: ACTION: 1-CONTINUE NAME PRIMARY ZONE: SD1 ZONE: SD2 ZONE: DDRI ZONE: SEOPWDRI ZONE: HIST PRESVN DIST: SCENIC CORRIDOR: TYPE AV N N N N PEDESTRIAN PATHWAY: N OMNI TAX DISTRICT: N DDA DISTRICT: N CD TARGET AREA: 00 NAME: --SIDE-- 1 ODD (13) EMPOWERMENT ZONE: N LATIN QUATERS: N VOTING DISTRICT: 04 TYPE: ACTION: 01 XMIT: Date: 12/30/2004 Time: 1:33:12 PM ocument Name: Sessionl PNLE ARPS PROPERTY FOLIO NO: 01-4115-007-0880 GRP FOLIO: CANCELED: NO ORIGIN: DC OWNER NAME AND ADDRESS OSEPH CORRAL ILVIA D CORRAL 411 ¢W 23 AVE .IAMI FL ZIP: 331453603 LEGAL DESCRIPTION :ILVER BLUFF EST SEC B PB 10-68 :55FT OF LOTS 29 & 30 BLK 20 )R 16794-3246 0495 4 70C 21784-1457 09 2003 4 NEXT FOLIO KEY: NEXT ADDRESS ACTION: 1-CONTINUE SYSTEM - PROPERTY NAME / LEGAL INQUIRY (32) DATE: 01/04/2005 16:28:35 LEGAL ADDR: 2411 SW 23 AVE PROP ADDR: 2411 SW 23 AV BL PRESENT: YES ST EX: 00 00 CLUC: 01 VALUE HISTORY YEAR: 2003 2004 LAND: 81,536 118,322 BLDG: 130.382 133.445 TOTAL: 211,918 251,767 HEX: 25,000 25,000 WVDS: 0 0 TOTEX: 25,000 25,000 NONEX: 186,918 226,767 GRSS TX: 3,362 3,362 CNTY TX: CITY TX: 1,096 1,096 SALE AMT: 152,000 SALE DATE: 09/2003 04/1995 07/1993 SALE TYPE: 4/I 4/ 1/I KEY: ACTION: 01 XMIT: Date: 1/4./2005 Time: 4:29:36 PM CITY OF MIAMI APPLICATION FOR PLANNING ADVISORY BOARD and/or ZONING BOARD NAME: Rosso F RESIDENCE ADDRESS: 5 a.litightetzF1rot . HOME PHONE: Sot "(Y'l • 33q 1 BUSINESS PHONE: City Code Sec. 2-884 states: "No employee of Miami -Dade County, Florida, or any municipality therein other than City of Miami employees, shall serve on or be appointed to any Board of the City of Miami." PRINCIPAL BUSINESS/EMPLOYER: Cocowk cyrjte /c0t Ga` 6 (di ►u6 I tic • (Company Name) BUSINESS ADDRESS: CO % . 14 3 3 Gera, Crt6 [Ls , 1714. • Are you an employee of Miami -Dade County or any municipality therein other than the City of Miami? N o Would you like to serve on the Planning Advisory Board? Would you like to serve on the Zoning Board? o P�"` o n a Please state if you have a preference for either board: ` tics Tlann:ng fieA Members shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City. Please fill in attached Residency Compliance form. Owners of property in the City of Miami, please answer the following question: Is all the property you own in the City of Miami in conformance with City Ordinances? 4 is If "no," please give details below: <forms>pz application 3/19/2001 Will you be able to faithfully attend meetings of the board as required by Section 62-126 of the Miami City Code? litS Will you be able to attend Planning and Zoning seminars as required by Section 62-124 of the Miami City Code? 466 Do you foresee any conflicts of interest as defined in Miami City Code Article V, Sections 2-611 - 619 and Miami -Dade County Code Section 2-11.1? go Are you prepared to file a list of real estate interests owned, either personally or corporately within the City of Miami (see attached forms) with the City Clerk, pursuant to Section 2-615 of the City of Miami Code? log Are you prepared to file a statement of financial interests pursuant to Florida Statutes Sec. 112-3145 and/or Miami -Dade County Ordinance No. 77-13? y,.,: List your experience relating to the fields of planning and zoning: ethi a Cola G4les PPk c, wn114s - autss4ae4J *c.rgAti autf0h1 lrrk�fvy L: ,rd:44464s 4,4 44et , a • COaOMA GM& , u;►las. W`s� �-:vtt QV1 *te �o tuotvMOar4J m, fk t:ro4' G4,ot+0e QAcl C Are you a United States citizen? qt S am} Grnne• it.. fl G a'wd e kuldl ,u NuCtotr yea/4 Are you presently indebted to the City of Miami for any real or personal property tax, license fee, or property lien? bl p If "yes," give details: Signature: ___04.42._sq,..va.d,let Date: 1z • <forms>pz application 3/19/2001 •�: Illtellf 1 CF4 • ,. CITY OF MIAMI APPLICATION FOR PLANNING ADVISORY BOARD and/or ZONING BOARD NAME: /4iCh 4e ( C. 6.eoniOret_. RESIDENCE ADDRESS: (aOO NE _.?( S1- # I z, /41a veil icL 33137- HOME PHONE 0S'%6— /464 BUSINESS PHONE:C3Q?) S 3/-'79 7 City Code Sec. 2-884 states: "No employee of Miami Dade County, Florida, or any municipality therein other than City of Miami employees, shall serve on or be appointed to any Board of the City of Miami " PRINCIPAL BUSINESS/EMPLOYER: I '' "" `'='I C • 'r4, ' • A- . (Company Name) 11� ) ' BUSINESS ADDRESS : ,767 RAue- 64ed, /'i}(M'.? � ,/ 42- 33/`fo Are you an employee offvliami-Dade County or any municipality therein other than the City of Miami? 0 Would you like to serve on the Planning Advisory Board? �S Would you like to serve on the Zoning Board? es Please state if you have a preference for either board: geke Members shall either be pennanent residents of the City, own real property in the City, or work or maintain a business in the City. Please fill in attached Residency Compliance form. Owners of property in the City of Miami, please answer the following question: Is all the property you own in the City of Miami in conformance with City Ordinances? qeiIf"no," please give details below: <forms>pz application 3/19/2001 Will you be able to faithfully atfend meetings of the board as required by Section 62-126 of the Miami City Code? Will you be able to attend Plannwg and Zoning seminars as required by Section 62-124 of the Miami City Code? Do you foresee any conflicts of interest as defined in Miami City Code Article V, Sections 2-611 - 619 and Miami -Dade County Code Section 2-11.1 ? No Are you prepared to file a list of real estate interests owned, either personally or corporately within the City of Miami (see attacl}ed forms) with the City Clerk, pursuant to Section 2-615 of the City of Miami Code? Are you prepared to file a statement of financial interests pursuant to Florida Statutes Sec. 112-3145 and/or Miami -Dade County Ordinance No. 77-13? vet List your experience relating to the fields of planning and zoning: "el a ativn 1,Ji411410w die of eknern1 Q.,r,C 7 n.. a ..Arre ..mil Vl se - t frdn Are you a United States citizen? 1161 Matti geach. Are you presently indebted to the City of Miami for any real or personal property license fee, or property lien? N O If `yes," give details: Signature: JACALA.. / Date: <forms>pz application 3/ 19/2OOL CITY OF MIAMI, FLORIDA • RESIDENCY COMPLIANCE FORM (IN CONFORMANCE WITH SECTION 2-884 OF THE CITY CODE) Please submit your completed form to: City of Miami Office of the City Clerk 3500 Pan American Drive Miami, Florida 33133 Date: 3/ 6/o:— i, M7 G�4Gf' C- (tri60,-42... , a member of (name of board) o 0 comply with the residency requirement under Code Section 2-884, namely: (do not) "(a) All members of City boards shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City..." (Note: If you do comply with the residency requirement (Code Sec. 2-884), please provide us with the following information.) A. I presently reside in the City of Miami at the following address: (oao N 36 St / y'o Z . &I/4rr 33/3?- B. I own a business and/or real property within the City of Miami limits at.the following address: (Note: Kindly specify if it is a business or a property) C. l work within City of Miami limits. My business address is: CITY OF MIAMI, FLORIDA STATEMENT OF REAL PROPERTY OWNED (IN CONFORMANCE WITH SEC. 2-615 OF THE CITY CODE) Legal Description SAMPLE ENTRY: Common Address 437 Northeast 546 Street . Title L-Legal E-Equitable L Owned W-Wholly P-ln Part W Zoning Class R-1 Present Use Home Lot 7, Primrose Section 4, PB 52 600 OM 36str idt,2. L W .. Cow a - as+ys* L P T.4tuof' OATH 1, µ�'e _-. wit C. Cice",. , do solemnly swear that the above is a tune and accurate statement of my interests in real property located within corporate limits a CITY OF MIAMI or 500 feet beyond the corporate limits of the CITY OF MIAMI. NAME: (Please Print) e C. rfammn-- Stele of Florida County of NOTARY PUBLIC SEAL OF OFFICE: SKiNA On this the day of . , 20 . before me, the undersigned Notary Public of the State of Florida. the foregoing hatnmicnt was acknowledged by TIT.FIposrnON WR7i CRY OF MIAMI NAME OF BOAR • s MRTEE (It Applicabk) : 3 / Of--. (Name of person signing and hidher this (public officer. trustee or personal rep oenIMire) WIThESS my hand and official seal. NOTARY PUBLIC, STATE OF FLORIDA 1 �\�c�\� (Name of Notary Public: Print, Stamp, or Type as Commissioned) ���6-iy1 ^j `� o01r 0Personaly known to me. or. ;L `�► 13 PtodmcedWentificaUon: (Type of Identification Produced) 05a`(1 i1 13 DID take an oath, or Ra ra 13 DID NOT take an oath C \ Share/Fonn 3cument Name: Sessionl ?NLE ARPS PROPERTY FOLIO NO: 01-3230-046-0001 3RP FOLIO: 3230046001G =ANCELED: NO ORIGIN: DC OWNER NAME AND ADDRESS HARTER CLUB CONDO 600 NE 36 ST IAMI FL ZIP: 33137 LEGAL DESCRIPTION HARTER CLUB CONDO 6 ST BAYFRONT SUB PB 102-75 R A SYSTEM - PROPERTY NAME / LEGAL INQUIRY (32) DATE: 04/05/2005 08:53:55 LEGAL ADDR: 3301 NE 36 ST PROP ADDR: 600 NE 36 ST BL PRESENT: YES ST EX: 63 00 CLUC: 00 NEXT FOLIO KEY: NEXT ADDRESS ACTION: 1-CONTINUE Date: 4/5/2005 Time: 8:53:57 AM YEAR: LAND: BLDG: TOTAL: HEX: WVDS: TOTEX: NONEX: GRSS TX: CNTY TX: CITY TX: SALE AMT: SALE DATE: SALE TYPE: KEY: VALUE HISTORY 2003 2004 O 0 O 0 O 0 O 0 O 0 O 0 O 0 / / / ACTION: 01 XMIT: CITY OF MIAMI APPLICATION FOR PLANNING ADVISORY BOARD and/or ZONING BOARD NAME: cg; //Lake," -te_ S" RESIDENCE ADDRESS: &10 / Ai6 5 ) 74 grt* HOME PHONEXE— 2.5-7.- 0320 BUSINESS PHONE: City Code Sec. 2-884 states: "No employee of Miami -Dade County, Florida; .or any municipality therein other than City of Miami employees, shall serve on or be appointed to any Board of the City of Miami." PRINCIPAL BUSINESS/EMPLOYER: rdieed BUSINESS ADDRESS: (Company Name) Are you an employee of Miami -Dade County or any municipality therein other than the City of Miami? Would you like to serve on the Planning Advisory Board? Would you like to serve on the Zoning Board? 1-64-MAti 420..4 Please state if you have a preferre for either board" - Members shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City. Please fill in attached Residency Compliance form. Owners of property in the City of Miami, please answer the following question: Is all the property you own in the City of Miami in conformance with City Ordinances? it If "no," please give details below: <forms>pz application 3/19/2001 Will you be able to faithfully attend meetings of the board as required by Section 62-126 of the Miami City Code? ye),g Will you be able to attend Planning and Zoning seminars as required by Section 62-124 of the Miami City Code? c7GS Do you foresee any conflicts of interest as defined in Miami City Code Article V, Sections 2-611 - 619 and Miami -Dade County Code Section 2-11.1? ",o Are you prepared to file a list of real estate interests owned, either personally or corporately within the City of Miami (see attached forms) with the City Clerk, pursuant to Section 2-615 of the City of Miami Code? 9e4. Are you prepared to file a statement of financial interests pursuant to Florida Statutes Sec. 112-3145 and/or Miami -Dade County Ordinance No. 77-13? 4e. le List your experience relating to the fields of planning and zoning:. L- u h ve.H'X..hf Lem rC (/id .i.g �&Ifni.try( 24Det,tr- Tvi-it ne r�Cps,i�ds� nit"nit"L,iJe ltss eGdb.. eP [tere -AMir• trefeei SUpt -d Y1 �j/ aka cos, rSe <le% /940-2000 . ". .Z /Soy " Iny� "Md./alas, O,t 4' a. 01242 hafts sl 544a. ylO ri'G Mjsrvb ` Are you a United States citizen? c7. °' V 'A, Atha' ' de+ s(0+ 2CA0 3 — 2.404,'Ji. Are you presently indebted to the City of Miami for any real or personal property tax, license fee, or property lien? h e If "yes," give details: Signature: Date: <fonms>pz application 3/19/2001 Date: ille/r I, pet //c 7/4e.-7' l.r , a member of CITY OF MIAMI, FLORIDA RESIDENCY COMPLIANCE FORM (IN CONFORMANCE WITH SECTION 2-884 OF THE CITY CODE) _ti �_ TV O n N x, Please submit your completed form to: - � n • City of Miami air - A < 1 Office of the City Clerk =0 r.)11 3500 Pan American Drive yrin -4 -0 < TJ.l Miami, Florida 33133 �� -13 O 01 1111. 11 (name of board) comply with the residency requirement under Code Section 2-884, namely: (do/do not) "(a) All members of City boards shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City..." (Note: If you do comply, with the residency requirement (Code Sec. 2-884), please provide us with the following information.) A. I presently reside in the City of Miami at the following address: eo f 42.E .57f`1tv .547 B. I own a business and/or real property within the City of Miami limits at the following address: (Note: Kindly specify if it is a business or a property) C. I work within City of Miami limits. My business address is: Signature CITY OF MIAMI, FLORIDA STATEMENT OF REAL PROPERTY OWNED (IN CONFORMANCE WITH SEC. 2-615 OF THE CITY CODE) Legal Description SAMPLE ENTRY: Common Address 437 Northeast 546 Street . Title L=Legal E=Equitable L Owned W=Wholly P=In Part W Zoning Class R-I Present Use Home Lot 7, Primrose Section 4, PB 52 Ki 3, &,.. -e G4.•f boa 4/6 .6' n' L-- GcI ' 2— / /7 -e, /llo 2 1e6.1-lg OATH I. S Ft e k.t a- i e w s , do solemnly swear that the above is a true and accurate statement duty interests in real property located within corporate limits of the CITY OF MIAMI or 500 feet beyond the corporate limits of the CITY OF MIAMI. State of Honda County of (Lt shoo, -. r,d 9. NOTARY PUBLIC SEAL OF OFFICE: fir` NAME: (Please Print) TriLF1POSRWN WITH CRY OF MIAMI NAME A.F / On this the _ - day of 20 betbse au, the undersigned Notary Public of die of Plaids, the Ongoing Instrument was acknowledged by S14'1,/444-R7e 5. (Name of penal signhis and hb4ner tide (public officer, trustee or personal representative) WRN _,11i i° seal. S (If Applicable) 0 r/ e- Yt-u 61u, D 4 /j'ar+l ^i' try /140-- DATE: (2qs- NOTARY PUB ATE OF FLORIDA v07442 e720 (Name ofibitilyldl kMti, Stamp, or Type as Commissioned) O i f Id Ba to b.� kQ t' - 77/ .2 -1'od - t% j = (Type of Identification D AID IIFe an oiler ta/131D NOT take an oath Share/Fortin MOININGSIDE HISTORIC EDUCATION SOCIETY April 30, 2005 Ms. Priscilla A. Thompson City Clerk City of Miami 3500 Pan American Drive Miami, FL 33133 Dear Ms. Thornpson: 5901 NE 6TH COURT MIAMI, FLORIDA 33137 TEL: (305I 632-6060 momingsidehometour@d lrecway.com 9 I :ZI Wd Z- AVW SOOZ I am writing on behalf of the Morningside Historic Education Society, Inc. ("MHES"), in order to endorse the nomination of Sally Mertens to the City of Miami's Historic and Environmental Preservation Board. I became acquainted with Sally as a result of her having her home on the Momingside Historic Home Tour (MHES' major annual event). In fact, Sally's home was the 2005 tour's "flagship" house. Sally did not purchase her home in its current state, though. indeed, Sally's home was quite dilapidated when she purchased it. It was only through her diligent, "hands on" effort that Sally's home was restored to its current splendor. Given Sally's energy, intelligence, education, and pleasant disposition, I cannot imagine a better -suited candidate for the Historic and Environmental Preservation Board. Moreover, having restored a historically -designated home makes Sally all the more qualified. Please feel free to contact me should you require any further information. Sincerely, /# C Bruce B. Baldwin President Morningside Historic Education Society, Inc. ocument Name: Sessionl PNLE ARPS PROPERTY SYSTEM FOLIO NO: 01-3218-036-0570 GRP FOLIO: CANCELED: NO ORIGIN: DC OWNER NAME AND ADDRESS :AMUEL J YARGER &W SALLY M ;01 NE 57 ST IIAMI FL LEGAL ADDR: PROP ADDR: BL PRESENT: ZIP: 331372319 LEGAL DESCRIPTION 1AYSHORE UNIT NO 2 PB 9-98 ,OT 3 BLK 18 ,OT SIZE IRREGULAR )R 21245-1143 05/2003 1 NEXT FOLIO KEY: ACTION: 1-CONTINUE YEAR: LAND: BLDG: TOTAL: HEX: WVDS: TOTEX: NONEX: GRSS TX: CNTY TX: CITY TX: SALE AMT: SALE DATE: SALE TYPE: NEXT ADDRESS KEY: - PROPERTY NAME / LEGAL INQUIRY (32) DATE: 05/03/2005 09:11:18 601 NE 57 ST 601 NE 57 ST YES ST EX: 00 00 CLUC: 01 VALUE HISTORY 2003 2004 110,838 166,495 199,908 203,610 310,746 370,105 O 25,000 O 0 O 25,000 310,746 345,105 10,083 10,083 3,335 395,000 05/2003 1/I 3,335 160,000 03/2003 6/I 112,000 01/1987 1/I ACTION: 01 XMIT: Date: 5/3/2005 Time: 9:12:25 AM CITY OF MIAMI APPLICATION FOR PLANNING ADVISORY BOARD and/or ZONING BOARD NAME: C�/UNt+Q- 1✓ Gl Zj¢/v e- »( i'v l l L O RESIDENCE ADDRESS: /O W NC L irlG /7frZ sw!! y7awc /PNIVll,FL• 73/75' /� r¢ri•i✓,�c• rip HOME PHONE: 95q-QIV-ZraZ BUSINESS PHONE: 505- Zf 5- po5D City Code Sec. 2-884 states: "No employee of Miami -Dade County, Florida, or any municipality therein other than City of Miami employees, shall serve on or be appointed to any Board of the City of Miami." PRINCIPAL BUSINESS/EMPLOYER: UDC , L C_ L cm* AuD' o07GAd7 (Company Name) BUSINESS ADDRESS: JYt / $tA) 3' 4tJ 5 7 ce" %Lphi. LJ4 fie_ 33/z 9 Are you an employee of Miami -Dade County or any municipality therein other than the City of Miami? %V U Would you like to serve on the Planning Advisory Board? Would you like to serve on the Zoning Board? Please state if you have a preference for either board: yes ye5 /INN' /Z'Nltj Members shall either be permanent residents of the City, own real property in the City, or work or maintain a business in the City. Please fill in attached Residency Compliance form. Owners of property in the City of Miami, please answer the following question: Is all the property you own in the City of Miami in conformance with City Ordinances? yo If "no," please give details below: <forms>pz application 3/ 19/2001 Date: CITY OF MIAMI, FLORIDA RESIDENCY COMPLIANCE FORM (IN CONFORMANCE WITH SECTION 2-884 OF THE CITY CODE),-, Please submit your completed form to: City of Miami Office of the City Clerk 3500 Pan American Drive Miami, Florida 33133 //l o/Dlo (name of board) o not) , a member of comply with the residency requirement under Code Section 2-884, namely: "(a) All members of City boards shall either be permanent residents of the qty. own real pro ert in the City, or work or maintain a business in the City..." (Note: If you do comply with the residency requirement (Code Sec. 2-884), please provide us with the following information.) A. I presently reside in the City of Miami at the following address: B. I own a business and/or real property within the City of Miami limits at the following address: (Note: Kindly specify if it is a business or a property) C. I work within City of Miami limits. My business address is: ign matureature Will you be able to faithfully attend meetings of the board as required by Section 62-126 of the Miami City Code? /e > Will you be able to attend Planning and Zoning seminars as required by Section 62-124 of the Miami City Code? ye 5 Do you foresee any conflicts of interest as defined in Miami City Code Article V, Sections 2-611 - 619 and Miami -Dade County Code Section 2-11.1? /ub Are you prepared to file a list of real estate interests owned, either personally or corporately within the City of Miami (see attached forms) with the City Clerk, pursuant to Section 2-615 of the City of Miami Code? y e 5 Are you prepared to file a statement of financial interests pursuant to Florida Statutes Sec. 112-3145 and/or Miami -Dade County Ordinance No. 77-13? ref List your experience relating to the fields of planning and zoning: 023 yes .l)a,vie [-rm..) f' covs74,ticr..vsy tromIg,vf i0G f'C '47- 1. E , e Cesi .dam S /sv c C . ()fly ,,.c 11414- ,14., (t 3 wary .des. 3ta,Ld Are you a United States citizen? }/GAS Are you presently indebted to the City of Miami for any real or personal property tax, license fee, or property lien? pc" If "yes," give details: Signature: Date: /l/O a <forms>pz application 3/19/2001 CITY OF MIAMI, FLORIDA STATEMENT OF REAL PROPERTY OWNED (IN CONFORMANCE WITH SEC. 2-615 OF THE CITY CODE) Legal Description SAMPLE ENTRY: Common Address 437 Northeast 54mh Street Title L=Legal E=Equitable L Owned W=Wholly P=In Part W Zoningsent Use R--1ome Lot 7, Primrose Section 4, PB 52 b.-671-5 5ro,tv5 $(4.3 108° AVGC* 4'4/v0r. 4--- U% °" / J'PorCA-sT OATH I, (. 112I 4, , do solemnly swear that the above is a true and accurate statement of moperty Ioca ed within corporate limits of the CITY OF MIAMI or 500 feet beyond the corporatelimits of the CITY OF MI NAME: (Please Print) 1) /�A),) AAA- & • n // W State of Florida County of NOTARY PUBLIC SEAL OF OFFICE: TITLE/POSITION WITH CITY OF MIAMI NAME OF BO SIGNATU NQ OMMITT E (If Applicable) NA V��r_ On this the 1 day ofj 0♦j, before me, the undersigned Notary Public of the Statdof Florida, the foregoing instrument was acknowledged by "Donna E Uzabeth I-1i I o DATE: 0//3/0t) (Name of person signing and his/hcr titk (public officer, trustee or personal representative) S my hand : •...,,;, ial seal. LIC, i FLORIDA . Cerrcdo ernCarmen Juba Del Carrato • • y My Comnmmssan DD261385 «adr Expnes October 26. 2007 (Name of Notary Public: Print, Stamp, or Type as Commissioned) ❑ Personally known to me, or Produced identification: FL trivartS EiLD — (bG--bl — 7 z1— D (Type of Identification Produced) ❑ DID take an oath, or %. DID NOT take an oath Sharc/Fonns