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Home My WebLink AboutApplication & Supporting Documents-11 BERCOW RADELL FERNAN DEZ ZONING. LAND USE AND ENNOIRONYI/IENTAL LAW Direct: 305-377-6235 E-Mail: BFernandez(,BRZoningLaw.com www.BRZoningLaw.com VIA HAND DELIVERY March 4, 2010 Mr. Anel Rodriguez City of Miami Riverside Center Office of the Hearing Boards 444 SW 2nd Avenue, 7tt Floor Miami, FL 33130 Re: Schimmel - 350 NE 56t1, Street, Miami, FL Dear Mr. Rodriguez: This law firm represents Howard and Marlene Schimmel in relation to the referenced property. This letter shall serve as the Applicants' letter of intent in support of the rezoning of the property from R-2, Duplex Residential to C-2, Liberal Commercial. The Property. The property is approximately four thousand seven hundred and fifty (4,750) square feet in size and is located on the south side of NE 56t11 Street, and east of NE 4t11 Avenue. The property is a part of a larger C-2 zoned property that is developed with a warehouse building. Currently the property is vacant and has been vacant for more than ten (10) years. Rezoning. The Applicants are requesting a Comprehensive Neighborhood Plan Amendment and a Rezoning in order to extend the existing warehouse building and warehouse operation onto the property. The proposed expansion will be compatible with the surrounding area as well as the ten (10) story residential apartment building located directly across NE 56th Street from the property. WACHOVIA FINANCIAL CENTER • 200 SOUTH BISCAYNE BOULEVARD, SUITE 850 • MIAMI, FLORIDA 33131 PHONE. 305.374.5300 • FAX. 305.377.6222 • WWW.BRZONINGLAW.COM For all of the foregoing reasons, the Applicants request your favorable review and recommendation. BF/bl Enclosures Ben Fernandez BEPC®W RADELL & FERNAN ®EZ ZONING, LAN I7 USE ANC> ENVIRONMENTAL LAW Planning Designee Initial & Date HEARING BOARDS 444 SW 2nd Avenue, 7th Floor • Miami, Florida 33130 Telephone 305-416-2030 • Fax 305-416-2035 www.miamigov.com/hearing boards AMENDMENT TO THE MIAMI COMPREHENSIVE NEIGHBORHOOD PLAN Welcome to Hearing Boards! This application is intended to serve as a guide in assisting you with our public hearing process. Please feel free to contact us at the number above, should you have any questions. The deadline to file the complete application with supporting documents is the first five working days of each month from 8:00 am until 3:00 pm, except on the fifth day, at 12:00 pm. The application submittal date is the date stamped by Hearing Boards' staff on this page. 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 application 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. Should you wish, you could bring the materials to our office for review before the deadline to ensure completeness. 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. All documents, reports, studies, exhibits (8 %/2 x11 ") or other materials submitted during this process will be kept as part of the record. 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. 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. Copies of City Commission resolutions and ordinances 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. 12-16-08 fft Please refer to Section 62-32 of the Miami City Code for Comprehensive Plan information. 1. Applicant name(s): Ben Fernandez, Esq. on behalf of Howard and Marlene Schimmel 2, Subject property address(es) and folio number(s): 350 NE 56th Street (folio # 01-3113-065- 0481) 3. Current designation: Duplex Residential 4. Future designation: General Commercial 5. Has the designation of this property been changed in the last year? If so, when? No. 6. Do you own any other property within 200 feet of the subject property? No. If yes, has the property been granted a Land Use Change within the last year? 7. Obtain signature or initial and date by the Planning Department designee prior to submittal. 8. Two (2) 11x17" original and one (1) 8 1/2 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. 9. The subject property(ies) cannot have any open code enforcement/lien violations. 10. Copy of the lobbyist registration processed by the Office of the City Clerk, if applicable. 11. At least two photographs showing the entire property showing land and improvements. 12. A clear and legible copy of the recorded warranty deed and tax forms of the most current year showing the present owner(s) and legal description of the property. 13. A clear and legible copy of the subject property address(es) and legal description(s) on a separate sheet, labeled as "Exhibit A", to match with the current survey's legal description. 14. Original Disclosure of Consideration Provided or Committed for Agreement to Support or Withhold Objection Affidavit. 15. Original Public School Concurrency Management System Entered Requirements form (page 4 of the attached packet). 16. Certified list of owners of real estate within 500 feet of the subject property (see pages 7 and 8). 17. For all corporations and partnerships indicated: a) Articles of Incorporation; b) Certificate from Tallahassee showing good standing, less than one (1) year old; 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. 18. What is the acreage of the project/property site? ±0.10 acres 19. What is the purpose of this application/nature of proposed use? Warehouse expansion 2 Rev. 12-16-08 20. Is the property within the boundaries of a historic site, historic district or archeological zone?re Please contact the Planning Department on the 3rd Floor for information. No. 21. Is the property within the boundaries of an Environmental Preservation District? Please contact the Planning Department on the 3rd Floor for information. No. 22. Cost of processing according to Section 62-156 of the Miami City Code*: Application to Amend the Comprehensive Neighborhood Plan to: a. Conservation, Recreation, Residential Single Family, Residential Duplex b. Residential Medium Density Multifamily c. Residential High Density Multifamily, Office, Major Public Facilities, Transportation/Utilities d. Commercial/Restricted, Commercial/General and Industrial e. Central Business District (CBD) f. Surcharge for advertising each item Public hearing and public meeting mail notice fees, including cost of handling and mailing per notice $ 300.00 $ 450.00 $ 550.00 $ 650.00 $ 1,200.00 $ 1,200.00 $ 3.50 *Pursuant to Ordinance 12719, all planning and zoning fees in excess of $25, 000.00, shall be paid in the form of a certified check, cashier's check, or money order. Signature Name Ben Fernandez, Esq. Address 200 S. Biscayne Blvd. # 850 Miami, FL 33131 Telephone 305-377-6235 E-mail BFernandez(c,BRZoningLaw.com STATE OF FLORIDA -- COUNTY OF MIAMI-DADE The foregoing was acknowledged before me this day of March 2010, by Ben Fernandez, Esq. who is a(n) individual/partner/agent/corporation of Bercow Radell & Fernandez, P.A. a(n) individual/partnership/corporation. He/She is personally known to me or who has produced as identification and who +',, did not) take an oath. n/''/I (Stamp) Slg atur� Notary Public State of Florida • Dotty ILlerena • My Commission DD524988 Expires 03/05/2010 3 Rev. 12-16-08 AFFIDAVIT OF AUTHORITY TO ACT Before me this day, the undersigned personally appeared Ben Fernandez, Esq., who being by me first deposes and says: 1. That he/she is the owner or the legal representative of the owner, submitting the public hearing application as required by the Code of the City of Miami, Florida, affecting the real property located in the City of Miami, as listed on the foregoing pages. 2. That all owners who he/she 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, 0 including or 0 not including responses to day to day staff inquires. 3. That the foregoing and following pages are part of this affidavit and contain the current names, mailing addresses, telephone numbers and legal descriptions of the real property of which he/she is the owner or legal representative. 4. That the facts, as represented in the application and documents submitted in conjunction with this affidavit, are true and correct. Further Affiant sayeth not. Ben Fernandez, Esq. Applicant(s) Name Applicant(s) Signature STATE OF FLORIDA -- COUNTY OF MIAMI-DADE The foregoing was acknowledged before me this `""C II — day of March 2010, by Ben Fernandez, Esq. who is a(n) individual/partner/agent/corporation of Bercow Radell & Fernandez, P.A. a(n) individual/partnership/corporation. He/She is personally known to me or who has produced as identification and wh,9 did (did not) take an oath. (Stamp) Sign A Y Pt Notary PubllcState or —Florida Betty Llerena °7 Expires 3/05/201p 5249a8 4 Rev. 12-16-08 04, DISCLOSURE OF OWNERSHIP 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 necessary. Owner's Name(es) Howard and Marlene Schimmel Percentage of Ownership 100% Subject Property Address(es) 350 NE 56th Street (folio # 01-3113-065-0481) 2. List all street address(es) and legal description(s) of any property located within 500 feet of the subject property owned by any and all parties listed in question #1 above. Please supply additional lists, if necessary. Street Address(es): 382 NE 56th Street Ben Fernandez, Esq. Owner(s) or Attorney Name Legal Description(s): DIXIE HIGHWAY TR PB 5-24 W64FT LOT 1 & N3OFT OF W64FT LOT 21 & LOTS 2 & 3 BLK 4 LOT SIZE 14630 SQ FT OR 20477-1074 0602 6 (2) OR 20477-1074 0602 03 Owner(s) or Attorne Sign STATE OF FLORIDA -- COUNTY OF MIAMI-DADE ure The foregoing was acknowledged before me this `'+ ' day of March 2010, by Ben Fernandez, Esq. who is a(n) individual/partner/agent/corporation of Bercow Radell & Fernandez, P.A. a(n) individual/partnership/corporation. He/She is personally known to me or who has produced as identification and o ot) take an oath. (Stamp) 14otery Public State of Florida >' P��r Betty Llerena n DD524986 My Commisslo ^Eyp�tes03f0512010 5 A Rev. 12-16-08 Exhibit A Legal Description: Lot 4, Block 4, DIXIE HIGHWAY TRACT as recorded in Plat Book 5, at Page 24, of the Public Records of Miami -Dade County, Florida. This Instrument Was Prepared By: Marilyn D. Greenblatt. Attorney at Law Simon, Schindler & Sandberg, LLP 2650 Biscayne Blvd. Miami, Florida 33137 Record and Return to: Property Appraiser Identification No. 01-3113-065-0480 01-3113-065-0491 oranteeTs Tax Identification No. WARRANTY DEED KUCK 20477PG 1074 +02R383791 2002 JUN 20 10:22 DUCSTVDEE 21280.00 SURTX 1,710.00 HARVEY RUVINv CLERK DADE COUNTYv FL 111111Y01 This indenture made this ifday of June, 2002, by and between Scan -Am Trading, Inc., a Florida corporation, whose post office address is 3301 N.E. 2nA Avenue, Miami, Florida 33137, in the County of Miami -Dade, in the state of Florida (the "Grantor"), and Howard Schimmel and Marlene Schimmel, husband and wife, whose post office address is , of the County of Miami -Dade, in the State of Florida (the "Grantees"). W ITN .ES S E T H: That Grantor, for and in consideration of the sum of TEN DOLLARS ($10.00) and other good valuable consideration to Grantors in hand paid by Grantees, the receipt whereof is hereby acknowledged, has granted, bargained and sold to Grantees, their heirs and assigns forever, the following described land, to wit: See Exhibit "A" attached hereto and made a part hereof. Subject to: 1. All easements, conditions, covenants, restrictions, limitations and agreements of record, provided this shall not operate to reimpose the same. 2. Real estate taxes for the year 2002 and all subsequent years. 3. Existing applicable governmental building and zoning ordinances and other governmental regulations. WICK 2O477PGI075 And Grantor does hereby fully warrant the title to said land, and will defend the same against the lawful claims of all persons whomsoever. Wittnesses GRANTOR: Scan -Am Trading. Inc., a Witness Signature Florida corporation MRn-iCYA) ,2). (au�nt8 r.tnt Name of Witness c. ztnesa Signature I 1 Av.' 1 .fit-Wl (1\i Print Name of Witness STATE OP FLORIDA ) )SS: COUNTY OF MIAMI-DADE) Jan Petter Brmsoe, President T - f.. egning instrument was acknowledged before me this /43 day of lb-4 , 2002, by Jan Fetter Brimeoe, as President of Scan -Am ".ding, Inc., rporation, on behalf of the corporation who is sonally kno to me or who has produced a Florida driver's 1ientitication and who did not take an oath. cl)'L.A44%— Print or a'tamp Na/me: Notary Public, State of Florida at Large Commission No. My Commission Expires: -2_ ARILYN )OR@ENBLAtT emus! ! b HMV 1Np�N0lMV /N Mrd,rl�M,�&MIOm 1►f.AECII�, 20477PG1076 Exhibit "A" LEGAL DESCRIPTION All of Lots 2, 3, and 4; Lot 1, less the East 105 feet thereof; and the North half of Lot 21, lees the East 105 feet thereof, in Block 4, of DIXIE HIGHWAY TRACT, according to the Plat thereof, as recorded in Plat Book 5, at Page 24, of the Public Records of Miami -Dade County, Florida. Warr nor reCCOD Reca P iN HAENaINWcouRY BOUNDARY SURVEY 30' T 0.50' 0.85' Set Nail & Disc Cap No 3284 xe`1• • Concrete Block Wall (Typicical) VACANT LOT (No Improvements) x(\ x—Ijx—X—x—x—X— N 90'00'00" E 50.00' 0ak Diameter=36" Spread=50' Height=40' 0 Found 1/2" Pipe No Identification w O N 00) 0 0 in 9.09' Found Nail and Roof Disc. 0ak Diameter=24" Spread=50' Height=40' C � � O L J r I> COm o n w 0) M o ti Ems^, L E o 8.6t. 20 GRAPHIC SCALE 10 20 40 B0 ( MT FEET ) 1 inch = 20 ft. 14)11 BONE INSTANCES, CRAPRC RERIE50RA0I0R 11ALE B01 DIACGERATED 10 YORE MEANLY IJ1150A1E ROATU911P5 BUYER PIIY0CAL INPIOVEMBIIS RID/OR LOT ODES N ALL CASES DI1E715D115 SHOWN SNNL CCNWEI THE LOCATOR CF THE OPDOVENEN1S OWFN SCALED MINORS. 15)N0 A1IEIPT HAS EMI NABE 10 LOCATE ANY 1MRDAU BENEATH 111E SURFACE OF 11E CROWD. 15)IDNACI THE APR0RATE AVTIUIIY PRIOR 10 ANY DESIGN WORK U TE N101 DE5018FD PARCEL FOR BOLDRIC AND ZUIIG 11FORIARIX4 17) ADDINENS OR 01ElIIXl51D SURVEY YAPS U 00*011S BY OMER 11w1 TIE 9U0D PARTY 01 PAR11615 PRg1911ED 'M1NUT %ARP01 CU99O OF TIE SUING PARTY CR PANTIES F 0EVAT1IS ME MOWN, TRY ARE NASED EDI A CLOSED LEVEL LOOP USNIC NIWD ORCFR PROCEDURE AR ARE IMAM 1011E NATIONAL GEODETC YERICAL OATH OP 1921 AO 00101E5 COSMO BEVA11IX1 ELEVATION B00510 NE IRTUAL GEODETIC VERTICAL DATUM OF MEAN SEA LEIEL OF 1929 01DIMARN: U-35 ELEVATION: +10.41 LOCATOR INDEX, 3103 NE MARIN:5 00000N 00R 70 All I591NE0 VALUE U N 00.03.00. FELL RIE SUNL PoRR-OF-WAY LIE OF N.E. 56111 SWEET. nao 5101M WOO 2-B-10 SCALE i' - 2W WWI et Y.F. 01AM110 DATE 2-9-ID Fk 50RH D0A11110 1104 10-0069 R115CO DAM 01-01-10 (VACANT 1.01) NEW ORMO D IR: 10-0130 0 1 • 1 ' I • e10 !• E T f E a.• .. ISU .. sip. go • 12 13 14 15. 14 R is ID$fg. Rb . 1 Re LOCATION SKETCH NOT TO SCALE I e r - Lse) Its4:s 4.1 145 NIE•56th ST9E^cT4• w cFr 1E0AL OE9310P0010 Lel 4. Block 4, DINE EMMY TRACT, accadh9 to the Pbt kraal, as minded In PM Beek 5 at Page 24 el Ne PuN0 Recast, e1 Dada Canty. RUPa new Imam re lOanl-Dade GUN%. NaYa SURVEY Mk HOWAAD SCHNLIEL AND NARIDIE SCIINtEI 350-352 NE 5514 ST IUDL FURIDA 13137 I IERFBY mom That the 90100 OF SURVEY of the maw captionedproperly eat completed under my uuppeM,Nn 0A/01 Smile; to the beat of my bowl Mb may meets or etc wds the Yhlmam TM d 010110 a Bel krill by the i1 I Lod Sump,. h Mohr 610-17-5 Wrathy Cede. Pur0ON 472.027, Nelda Slaluln DELTA sUlIVEYroS 13092 SW 133RD RT 1 � • G/♦ ,' . /p WA11. FLUDA 33155 WALDO F..00 DAZE 9[1NO: • `' PROFESS:MA1 1204 R AN7 YAPP NO 3254 CERNNCAE OF AURdti7A1191 STATE OF LB ND. 518E STATE W FONDA 305-253-0901 FAN 305-253-0033 1)E1D1D 20NI0 K PANEL NO. colonel' N0. 120650 DA1E OF 11A➢I 0-11-09 2)11I131E NAY BE AAIRO1AL RESTRICTIONS 111AT AYE NOT 910YM ON lHS URVET NUT VAT BE FUND IN 11E P000C RECORDS OF 1115 COUNTY 301110.11IXI OF ABSTRACT OF 1111E WM HAVE 70 BE NM 10 DEIFANIE RECORDED 05'RWM1S F ANY. AFFEC1110 PROPERTY 4) TITS CERTRCATON IS ONLY FOR 111E LANDS AS DUMBED, 11 B NOT A PFR1000191 OF viz 2U0D, EAL0010R Ram OF 01UIBR0CFS. ABSTRACT NOT ONEAED 5)L10ATION 01ACCORDANCE MT000100/RECOR1PAT1�� F ANY ARE 910ANN 0010091IP IS SUBJECT 1O CROON OF TILE TYPE OF SURREY: B011DA0T SURVEY B 111E 1FA01 LAMMED PROPERTY WAS SURVEYED AND 13FSCOB0 DAM CFI v ME 5110M1 LEGAL OESCRIP1FAt FAMED BY CUBIT B)SUt0Y DAP AND NEPUT CR THE CORES THEREOF ARE NOT VAUD AND FCR BEERIDEE CI1Y, U1NES5 %WED AND SERER MIN TIE UIGNAL RASED SEAJ. CF A FLORIDA LICENSED 9MAEY91 RR VAPPDE 101115 FUR.0F 91A1EY. HAS BEM PIT0ARCO FU 111E EDU191E USE OP TIE 01T05 MANED 1DAOII. 11E c0NFlG1E DOES NM Et=HD 70 ANY UNNAED PARIS 11)543E10MM NINES ARE NOT DEPICTED HLRYN, COIRACT 10 APPROPRIATE AITNDRIIY PRIOR TO ANY DES0N YDR1 OR CRl51B0CTIN U TE PROPERTY HEIEN DES0100D. SURVEYOR SNAIL BE NOTRE➢ AS TO ANY DENARU FRU U111TE5 910141 K ECM. 12)11E SUMMIT OF RECU9 00E5 NOT 00103110E 0W1EA911P CF 1➢RFS AEA0DEV0115 910114 HE0V1 WILT PHYSICAL LCCA1DN BF FENCE 13)ACCURABT THE WEDDED USE OF LAND AS P rEFE R IRE WNW 1ECHNCLL SIAOARDS 61017-FAG), 15 '00E0CIAL' .10E 1111401 MAIM 0617110E ACURACY F TE TYPE OF BU1AIY SURVEY B 1 FOOT N 1D,000 FEET. 111E ACCURACY COWED BY NEm51D01N' AND CALCULATION OF A CEASED 4EUEMC ENCORE WAS romp ID IXmm IN6 REOUR]mR (DELTA SURVEYORS INC. 13052 S.W. 133rd COURT MIAMI, FL 33186 (305)253-0909 DELTAPAEZ®AOLCOM SEAL 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: Ben Fernandez (First Name) (Middle) (Last Name) HOME ADDRESS: 200 South Biscayne Boulevard, Suite 850 (Address Line 1) CITY: Miami HOME PHONE: 305-377-6235 (Address Line 2) STATE: Florida a ZIP: 33131 CELL PHONE: 305-978-2866 EMAIL: BFernandez@BRZoningLaw.com FAX: 305-377-6222 BUSS1NESS or APPLICANT or ENTITY NAME Howard & Marlene Schimmel BUSINESS ADDRESS: 382 NE 56th Street (Address Line 1) Miami, FL 33140 (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. Rezoning and a Comprehensive Neighborhood Plan Amendment 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 NO 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. N/A b. c. * Additional names can be placed on a separate page attached to this form. 4. Please describe the nature of the consideration. N/A 5. Describe what is being requested in exchange for the consideration. N/A ACKNOWLEDGEMENT OF COMPLIANCE I hereby acknowledge that it is unlawful to employ any device, scheme or artifice to circumvent Ordinance 12918 and such circumvention shall be deemed a violation of the Ordinance; or civil penalties that may be imposed under the City Code, upon determination by disclosure requirement was not fully and timely satisfied the following may occur: 1. the application or order, as applicable, shall be deemed void without effect; and 2. no application from any person or entity for the same ' sue considered by the applicable bo d(s) u til expiration of per nullification of the application r order. PERSON SUBMITTING DISCLOSURE:/ the disclosure requirements of and that in addition to the criminal the City Commission that the foregoing further force or shall be reviewed or of one year after the Signature Ben Fernandez Print Name Sworn to and subscribed before me this 4th day of March , Mc 201Q The. foregoing instrument was acknowledged before me by Ben Fernandez , who has produced as identification and/or is personally known to me and who did/did not take an oath. STATE OF FLORIDA CITY OF MIAMI MY COMMISSION Notary EXPIRES: Betty lerena 0 3- 0 5 -1 0 Print Name Enclosure(s) Doc. No.:86543 4 Notary Public State of Elonde Page 2 e Betty Lierena eF �° I Expres 03Commission DD524988 /05/201