HomeMy WebLinkAboutPZAB Application & Supporting DocsVACATION AND CLOSURE APPLICATION
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HEARING BOARDS , i
444 SW 2nd Avenue, 7th Floor • Miami, Florida 33130 • Telephone 305-416-2030
www.miamigov.com/hearing boards
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Welcome to the City of Miami! This application is intended to serve as a guide in assisting yd i
with our public hearing process. Please feel free to contact us, should you have any questions.
The deadline to file the complete application with supporting documents is the last five working
days of each month from 8:00 am until 3:00 pm, except on the fifth day, until 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. 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 (8Yx11") or other materials submitted
during this process will be kept as part of the record. Any documents offered to the Planning,
Zoning and Appeals Board and the City Commission, which have not been provided fifteen (15)
days before the meeting as part of the agenda materials will be entered into the record at the
discretion of the aforementioned Board and Commission.
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.
ACAIIQNNi,:ND CLOSURE APPLICATION
o Chapter 55 of the Miami City Code for Vacation and Closure information.
ersv Ltd ° tFiling
tationkLofts, LLC and Federal Aviation Administration [FAA/United
Two (2) copies of the TentativePlat: Ore (1) 24x36" and one (1) 81/2 x11" prepared by a State of
Florida registered; land'surveyor.
wo, (2)`'or,.iginal sketch;, off surveys One (1) 24x36" and one (1) 8Y2x11 , prepared by a State of
�loritla Registered Land Surveyors; ,,,One
only the area to be vacated or closed and the pertinent
legal description of the area, within one year from the date of application.
4. Two (2) 11x17" original and one (1) 8'Y x11 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. Opinion of Title addressing the reversionary rights, if any. Note: An update is required if more than
three (3) months elapse before Zoning Board or City Commission approval.
6. Signed Tentative Plat letter from Public Works indicating Plat & Street recommendation.
7. 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 to match the legal description on
the survey.
8. 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.
9. At least two photographs showing the entire property showing land and improvements.
10. Copy of the lobbyist registration processed by the Office of the City Clerk, if applicable.
11. Affidavit of Authority to Act and the Disclosure of Ownership of all owner —and contract purchasers,
if applicable —of the subject property.
12. 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.
Rev. 03-2011 2
ACATI'TN:�d.D CLOSURE APPLICATION
owners,of real' estate within 500 feet of the subject property.
Original, Disclosure of C
Objection Affidavit
�..
Tht e subject propery,(ies) cannot have any open code enforcement/lien violations.
orisideration. SProyided or Committed for Agreement to Support or Withhold
What is the acreage.Of the project/property site'? 1.6
hat is the purpope of this application`%nature of proposed use'? Closure of right-of-way for safety
maintenancepurposes -`
18 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
19. Is the property within the boundaries of an Environmental Preservation District? Please contact the
Planning Department on the 3rd Floor for information. No
20. Cost of processing according to Section 62-156 of the Miami City Code*:
Vacation of public right-of-way:
a. Original submittal:
1. Per square foot of right-of-way
2. Minimum
b. Re -submittals:
1. Per square foot of right-of-way
2. Minimum
3. Maximum
Public hearing and public meeting mail notice fees, including cost of handling
and mailing per n
*Pursuant to Ordi , ante 12719,
the form of a ce ; ified check, cas
Signature
Name Ryan D. Bailine, Esq.
Telephone 305-789-4179
STATE OF FLORIDA -- COUNTY OF MIAMI-DADE
$ .90
$ 1,200.00
$ .90
$ 1,200.00
$ 1,700.00
$ 3.50
11 planning and zoning fees in excess of $25, 000.00, shall be paid in
ier's check, or money order.
Address
E-mail
The foregoing was acknowledged before me this R 2day of
Bailine who is a(n) individual/partner/agent/corporation of
me or who has produced as identificatio
NOTARY PUBLIC - STATE OF FLORIDA
' Linda Christian
(Sta ; Commission #DD651416
°.,,,,,,,,•`` Expires: MAR. 23, 2011
BONDED THRU ATLANTIC BONDING CO,, INC.
Stearns Weaver Miller, et al
150 Museum Tower, #2200
rbailine cr,stearnsweaver.com
March 2011, by Ryan D.
Applicants. He is personally known to
ang who diddi- not) take an oath.
.gnatune
(S
Rev. 03-2011
3
D CLOSURE APPLICATION
?OF AUTHORITY TO ACT
Before me this day, the undersigned personally appeared Ryan D. Bailine
, who being by me first deposes and says:
',
at 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.
Y 5
2. That all>owners who. lie/she represents, if any, have given his/her full and complete permission for
him/hereto acfin his/her behalf for'the change or modification of a classification or regulation of zoning
as set out in `rthe 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.
Ryan D. Bailine, Esq.
Applicant(s) Name for Jersy Ltd., Filling
Station Lofts, LLC and FAA/USA ("Applicants")
STATE OF FLORIDA -- COUNTY OF MIAMI-DADE
A
licant(s) Signature
The foregoing was acknowledged before me this day of March, 2011, by Ryan D. Bailine,
Attorney for Applicants. He is ee sonally known to me or who has produced as
identification and who did (did not) take an oath.
„NOTARY PUBLIC - STATE OF FLORIDA
(St•
rp... Linda Christian
I;,:f= Lig Commission #DD651416
,•� Expires: MAR. 23, 2011
DONOOIED THRU ATLANTIC BONDING CO,, INC.
Signa7ure
Rev. 03-2011
4
AFFIDAVIT OF AUTHORITY TO ACT
Before me this day, the undersigned personally appeared Steven Gombinski,
President of Gombinski Realty, Inc., General Partner of Jersy Ltd.
who being by me first deposes and says:
1. That he 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 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.
Jersy Ltd.
Applicant(s) Name
Applican'f;(/s) Signature
F/ or"I PA4
STATE OF "'E-W—vno14__ COUNTY OF Ai /A4(t-J kt
The foregoing was acknowledged before me this fr day of id-t-/PA.4LA
20 10 , by Steven Gombinski, President of Gombinski Realty, Inc., General
Partner of Jersy Ltd. He is personallyy k,.n to me or who has produced
as identification and who did (did not) take an oath.
NOTARY PUBLIC - STATE OF FLORIDA
Linda Christian / (1,,44.,,
,,� Commission #DD651416
(Stamp) ; ���r tu e
Expires: MAR, 23, 2011
MIND TM tU ATLANTIC fl ONIVig e0,,1NO",
4 Rev. 12-16-08
H:\My Documents\Vacation and Closure of a Right-of-Way.Jersydoc.doc
AFFIDAVIT OF AUTHORITY TO ACT
Before me this day, the undersigned personally appeared Daniel Holtz, Manager,
Filling Station Lofts, LLC, who being by me first deposes and says:
1. That he 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 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.
Filling Station Lofts, LLC
Applicant(s) Name
Applicant(s) Signature
STATE OF FLORIDA -- COUNTY OF MIAMI-DADE
The foregoing was acknowledged before me this day of
20 / 0 , by Daniel Holtz, as Manager of Filling Station Lofts, LLC. He is personally
known to me or who has produced as identification and who did (did
not) take an oath.
(Stamp)
DAYAMI AGUTAR
oiPav ""E , Notary Public - State of Florida
, My Commission Expires Mar 16,
e: Commission # DD 644032
%";o F°' BondedThroughNational Notary
4
H:\My Documents\Vacation and Closure of a Right-of-Way.Fillingdoc.doc
Rev. 12-16-08
AFFIDAVIT OF AUTHORITY TO ACT
Before me this day, the undersigned personally appeared Chris Barnhill, Real
Estate Contracting Officer , 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, ❑ 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.
Federal Aviation AdministrationfFAAl USA (i �Lt ��dt(e
Applicant(s) Name Applicant(s) Signature
STATE OF GEORGIA-- COUNTY OF diakele&
The foregoing was acknowledged before me this /1/ day of
201f, by Chris Barnhill, Real Estate Contracting Officer
who is a(n) individual/partner/agent/corporation of the Federal Aviation
Administration [FAA] United States of America a(n)
individual/partnership/corporation. He/She is personally known to me or who has
produced a4 1 r: oils Ltc,as identification and who did (did not) taken oath.
(Stamp)
Notary Public
Coweta County Georgia
My Commission Exp. April 6,2013
4
Z-4
Rev. 12-16-08
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) Jersy Ltd. JJ
Percentage of Ownership One Hundred (100%) — 5 ,, Gah«17-
3/3 j
Subject Property Address(es) 1614 NE Miami Court; 1618 NE Miami Court; 1632 NE
Miami Court; 1601 N. Miami Avenue, 1625 N. Miami Avenue; and 1635 N Miami
Avenue:
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): Legal Description(s):
Jersy Ltd.
Owner(s) or Attorney Name Owner( Attorney Signature
FL(' e1 D,(
STATE OF MEVV-YeRIK -- COUNTY OF M I/}
The foregoing was acknowledged before me this (2 day of
20 t o , by Steven Gombinski, President of Gombinski Realty, Inc., General
Partner of Jersy Ltd. He is personally known to me or who has produced
_ as identification and who did (did not) take an oath.
NOTARY PUBLIC STATE OF FLORIDA
Linda Christian
(Stamp) ' ��°mmissinn#DD651416
:. Expires: MAR, 23, 2011
BONDED THRU ATLANTIC BONDING CO., INCH
5
H:\My Documents\Vacation and Closure of a Right-of-Way.Jersydoc.doc
Rev. 12-16-08
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) Filling Station Lofts, LLC
Percentage of Ownership One Hundred (100 /o)
Subject Property Address(es) 1650 NE Miami Court
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): Legal Description(s):
Filling Station Lofts, LLC
Owner(s) or Attorney Name Owner(s) or Attorney Signature
STATE OF FLORIDA -- COUNTY OF MIAMI-DADE
The foregoing was acknowledged before me this � day of
20 /0 , by Daniel Holtz, as Manager of Filling Station Lofts, LLC. He is personally
known to me or who has produced as identification and who did (did
not) take an oath.
(Stamp)
,,,,,,,,,� DAYAMIAGUTAR
ee , Notary Public - State of Florida
. - My Commission Expires Mar 16,2011
, Commission # DD 644032
,,,, Bonded Through National Notary Assn.
aptti
Si�naft�re
5
H:1My Documents\Vacation and Closure of a Right-of-Way.Fillingdoc.doc
Rev. 12-16-08
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) Federal Aviation Administration FFAA1 United States of America
Percentage of Ownership i,m
Subject Property Address(es) 21 NE 16th Court, Miami, FL 33137
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): Legal Description(s):
Federal Aviation Administration fFAA1 at -Led: s�S�4./�Uz,c2
Owner(s) or Attorney Name Owner(s) or Attorney Signature
STATE OF GEORGIA-- COUNTY OF ( o-e ta..
The foregoing was acknowledged before me this i1 day of;C G-2
20 )1 , by Chris Barnhill, Real Estate Contracting Officer ,
who is a(n) individual/partner/agent/corporation of Federal Aviation
Administration (FAA] a(n) individual/partnership/corporation. He/She is
personally known to me or who has produced &4. Pr; 0v5 L. as identification and
who did (did not) take an oath.
(Stamp)
Sig
Notary Public
Coweta County Georg' -16-08
My Commission Exp. April 6,2p13
5
Eau. af
February 9, 2011
Filling Station Lofts, LLC
c/o Daniel Holtz
4040 NE 2 Aven.ue, Suite 414
Miami, FI 33137
Jersy LTD.
c/o Steven Gombinski, President
3737 Collins Avenue, #1504
Miarni Beach, FI 33140
FAA
Attn: Chris Barnhill
Real Estate Group, ASO-53
1701 Colombia Avenue
College Park, GA 30337
TONY E. CRAPP, JR.
City Manager
JERSY
TENTATIVE PLAT #1771
LOCATED BETWEEN NORTH MIAMI AVENUE AND N.E. MIAMI COURT. AND BETWEEN
N.E. 16 STREET AND N.E. 17 STREET.
Dear Ladies and Gentlemen:
The City of Miami Plat and Street Committee, at its meeting of February 3, 2011, approved the
above tentative plat subject to the following revisions being made to the tentative plat, additional
information being provided and/or variances being granted. Please be advised that the
processing of your tentative plat cannot proceed until these conditions have been satisfied:
1. Location Sketch:
a) Show zoning designations and zoningdistrict lines.
b) Label the Lot and Block numbers, subdivision names, and Plat Book and Page
numbers of the underlying and adjacent plats.
c) Delete the label "SITE".
2. On the execution portion of the application for FAA/USA, two (2) witnesses to the
signature are required.
3. Confirm the Point of Beginning of alley's legal description. Also there is a discrepancy
between Exhibit A (344.75') and Tentative Plat (344.84').
4. Provide a copy of Exhibit A mentioned but not attached to the Opinion of Title.
5. Provide the underlying lots dimensions.
6. Providea tie to the nearest section corner, and provide a Certified Corner Record.
7. Provide all property addresses to the corresponding folio numbers applicable to this Plat.
8. Provide a bearing and distance for all the center lines along the face of the proposed
plat.
9. For the development intent, provide the number of buildings and units.
10. Specify whether the existing structures are to remain or to be removed.
11. In the Flood Criteria specify the elevation in FEET.
12. Expand the statement "AN EXPRESSED PURPOSE OF THIS IS TO CLOSE, VACATE
AND ABANDON FROM PUBLIC USE THAT PORTION OF THE ALLEY LYING WITHIN
THE LIMITS OF THIS PLAT".
DEPARTMENT OF PUBLIC WORKS
444 S.W. 2nd Avenue/ Miami, Florida 33130 / (305) 416-1200 / Fax: i305) 416-1278
Mailing Address: P.O. Box 330708 Miami, fL 33233-0708
13. Ve:rify with the Public Works Design Division that sufficient elevations are provided within
the right of way on the perimeter of the tentative plat site. Provide elevations on 50 foot
intervals.
14. In the legal description, only include the private property and not any portion of the alley.
The legal description for the alley shall follow the express purpose statement and include
the alley from street intersection to street intersection.
15. The Fire -Rescue Department requires an emergency access easement along the south
side of proposed Tract "A" continuously from N. Miami Avenue to NE Miami Court.
Contact Lt. Jose Paz, Assistant Fire Marshall, Fire -Rescue Department to coordinatethe
dimensions and location of the easement.
16. A letter from Comcast is required to determine if any adjustments to their facilities or
easements are required.
17. Verify with the Miami -Dade County that the proposed plat name is acceptable.
18. All encroachments across proposed tract and/or lot lines must be removed prior to final
plat submittal.
10. An opinion of title, in the City of Miami opinion of title form, must be provided at the time
of the final plat submittal.
20. Current backup documentation will be required for all who execute the final plat. A
resolution for authority to execute documents and a Certificate of Good standing from
the Secretary of State are required, if applicable.
21. Tentative plat application must be made with Miami -Dade County after receiving
approval from the City of Miami Plat and. Street Committee.
22. Be advised that an incomplete final plat package will not be accepted by the City of
Miami. It is the owner's responsibility to work with his surveyor and his attorney to
assure that everything is in order before submitting the final plat package.
23. Be advised that if all the requirements for scheduling the final plat for City Commission
action are not in order, the final plat will not be scheduled for a City Commission
meeting.
24, A letter of concurrency from the Miami -Dade. County School Board is required prior to
the final plat approval (see contact sheet).
25. The Plat and Street Committee has reviewed the tentative plat of Jersy and determined
that all technical requirements contained in the Miami City Code Subdivision Regulations
have been met and has approved the tentative plat. The members of the Plat and Street
Committee have further considered the request for vacation and closure of the alley with
respect to Miami City Code requirements and have voted 9 in favor and 0 denial of this
vacation and closure request, subject to the provision of an emergency access
easement approved by the City of Miami Fire -Rescue Department.
In addition to the above requirements, you should be aware of the following:
1. State and local laws require the installation of various physical improvements in the
public rights -of -way when property is. platted. These subdivision improvements
include paving, drainage, landscaping, sidewalks, etc. In some cases this could
represent a substantial investment on your part. OPTION: The submission of an
electronic copy of the tentative plat, in an AutoCAD version, to the City of Miami
Public Works Development and Roadway Plans Section will EXPEDITE the
preparation and enhance the ACCURACY of the subdivision improvement estimate
letter required for final plat approval.
2. The alteration, relocation or installationof :utilities such as storm and sanitary
sewers, electric, telephone, water, etc., caused by this plat will be at the property
owner's expense. Also, utility easements may .be required on the property being
platted.
3. A building permit will not be issued on the property being platted until the final plat is
recorded or as authorized by City of Miami Code Section 55-10 (h).. Also, the
Certificate of Occupancy for any building construction will be issued only after all the
required subdivision improvements have been completed.
4. Approval for fire flow requirements must be obtained from the Fire -Rescue
Department prior to the issuance of a building permit.
5. Additional items must be provided to the City of Miami Department of Public Works
before the final plat is submitted to the City Commission for approval. You will be
notified in writing as to what these items are after the amount of the bond has been
determined for the necessary subdivision improvements.
6. Tentative •plat approval is only valid for one (1) year and six (6) months frorn the date
of the. Plat and Street Committee meeting at which time is was approved.
If you have any questions concerning these requirements, please refer to the attached sheet for
the appropriate person to contact.
Sincerely,
Nzeribe Ihekwaba, Ph.D., P.E.
Director of Public Works
J'.
NI/JS/r'. /ms
2(y
Enclosure: Contact Sheet
c: Fortin, Leavy, Skiles, Inc.
180 NE 168 Street
North Miami Beach, FI 33162
Plat and Street Committee Members
Survey
Development and Roadway Plans
Central
Richard Blom,
Assistant Chief
PLAT AND STREET COMMITTEE
DISTRIBUTION LIST
(all 305s)
Police Department 579-6648
Field Operations Div.
400 NW 2 Ave., Room 413
Miami, FL 33128
Rick Ratcliff Florida Power & Lig.ht 377-6114
122 SW 3 Street
Miami, FL 33130
Horacio Pulido Public Works Dept. (4th FL) 416-1248
Nzeribe Ihekwaba Public Works Dept. (8th FL) 416-1200
Director
Steve Massie BellSouth Telecornmunications 786-489-6418
Project Manager 9101 SW 24 Street 305-222-8745
Miami, FL 33165
Craig Petrie AT&T
6000 Metro West Boulevard
Suite 201
Orlando, FL 32835
Anel Rodriguez Office of Hearing Boards 416-2038
Leonard Helmers Public Works Dept. (8th FL) 416-1221
P.E., Prof. Eng..IV
Juvenal Santana P.E. Public. Works Dept. (8th FL) 416-1218
David Hernandez Public Works Dept. (Ops.) 960-2873
Tim Smith Public Works Dept. (Ops,) 960-2876
Lt. Jose Paz Fire -Rescue Department (10th FI.) 416-1679
Victoria Mendez Law Department 416-1832
Francisco Garcia Planning & Zoning 416-1470
Franciso Gonzalez/ Planning & Zoning (4th FL) 416-1489
Barnaby Min 416-1491
Jose Camero General Services (Administration) 329-4854
Director
P& amp_ S_-_D I S TLI S T[ 1]
Revised 2/11/2011
Angel Quant
Regional Operations Manager
Ana Rijo-Conde
Vivian G. Villaamil
Sergio Garcia
Ha.yde Wheeler
VonCarol Kinchens
VonCarol Kinchens
Loren Daniel
TECO Gas 954-453-0805
5101 N.W. 21 Avenue
Ft. Lauderdale, FL 33309
Miami -Dade County Public Schools 995-7280
1450 NE 2nd Avenue, Room 525
Miami, FL 33132
Miami -Dade County Public Schools 995-7287
1450 NE 2 Avenue, Room 523
Miami, FL 33132
Miami -Dade Water and Sewer 786-268-5214
3071 SW 38 Avenue
Miami, FL 33146
Upper Eastside NET Office 795-2330
6599 Biscayne Boulevard
Miami, FL 33138
Little Haiti NET Office 960-4660
6421 NE 2nd Avenue
Miami, FL 33138
Model City NET Office 795-2303
1000 NW 62nd Street
Miami, FL 33150
Overtown NET Office 372-4550
1490 NW 3rd Avenue
Miami, FL 33138
Ana Rodriguez Flagami /West Fiagler NET Office 960-2890
4343 West Flagler Street, Suite 102
Miami, FL 33134
Liza Gallardo Walton N/E Coconut Grove NET Office 960-4650
2820 McFarlane Road
Miami, FL 33133
Pablo Canton East Little Havana/Coral Way NET Office 960-4650
1275 NW 1 Street
Miami, FL 33136
P&_S_-_DIS TLIST[ 1 ]
Revised 2/11/2011
Opinion of Title
To: CITY OF MIAMI, Florida a municipal corporation of the State of Florida
With the understanding that this Opinion of Title is furnished to MIAMI,
FLORIDA in compliance with Section 55-8 of the Miami City Code and as an
inducement for acceptance of a proposed final subdivision plat covering the real
property hereinafter described.
It is hereby certified that we have examined that Attorneys' Title Fund
Services, LLC Title Search Report No. 01-2010-015207; Title Search Report No. 01-
2010-013582; and Title Search Report No. 01-2010-015044 (collectively "Reports")
covering the period from the beginning to December 8, 2010, and Attorneys' Title
Fund Services, LLC Update Reports from December 8, 2010 to December 30, 2010;
and Attorneys' Fund Services, LLC Update Reports from December 30, 2010 to
March 15, 2011 at 11:00 PM, inclusive, of the following described real property:
See Exhibit "A", attached hereto
Basing our opinion on the Title Search Report and Update Report covering
said period, we are of the opinion that on the last mentioned datethe fee simple title
to the above described real property was vested in:
Jersy, Ltd., a Florida limited partnership.
Steven Gombinski, President of Gombinski Realty, Inc., a Florida
corporation, General Partner of Jersy Ltd., a Florida limited partnership is
authorized to sign on behalf of the partnership.
Filling Station Lofts, LLC, a Florida limited liability company.
Daniel Holtz, as Manager of Filling Station Lofts, LLC is authorized to sign
on behalf of the company.
United States of America/Federal Aviation Administration [FAA]/
Chris Barnhill, Real Estate Contracting Officer is authorized to sign on
behalf of the FAA.
Subject to the following encumbrances, liens, and other exceptions:
1
803598v1
GENERAL EXCEPTIONS:
1. All taxes for the year in which this opinion is rendered and
subsequent years.
2. Rights of parties in possession other than the above owner.
3. Facts that would be disclosed by an accurate survey.
4. Any unrecorded labor, mechanics or materialmen's liens.
5. Zoning and other restrictions imposed by governmental authority.
MORTGAGES, ASSIGNMENTS AND MODIFICATIONS:
6. Mortgage to City National Bank of Florida, Mortgagee, recorded in
Official Records Book 22947, Page 2166, as amended by Partial
Release recorded in Official Records Book 23217, at Page 3165
[Jersy].
7. Assignment of Leases, Rents, and Profits filed December 28, 2004, in
Official Records Book 22947, at Page 2185. [Jersy]
8. UCC Financing Statement between Jersy, Ltd., and City National
Bank of Florida, recorded in Official Records Book 22958, at Page
3811 [Jersy].
9. Mortgage to Lasse Moe, Mortgagee, recorded in Official Records
Book 20537, at Page 3384 [Jersy].
10. Mortgage to Ocean Bank, mortgagee(s), recorded under Official
Records Book 22801, Page 4565, as assigned to Versa Capital LLC,
assignee, by assignment recorded April 1, 2009, in Official Records
Book 26811, Page 2895, modified in Official Records Book 23385,
Page 1290, and in Official Records Book 24937, Page 109, and
collaterally assigned in Official Records Book 26811, Page 2901,
assigned in Official Records Book 27485, Page 2717 [Filling Station]
11. Assignment of Leases, Rents and Profits filed November 8, 2004, in
O.R. Book 22801, Page 4580 [Filling Station].
12. UCC Financing Statement recorded in Official Records Book 22801,
Page 4586, assigned in Official Records Book 26823, Page 4137
[Filling Station].
2
803598v1
13. UCC Financing Statement recorded in Official Records Book 25077,
Page 3260, assigned in Official Records Book 26811, Page 2906,
Official Records 26811, Page 2907 [Filling Station].
14. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-59707-CA-13, a Notice of Lis Pendens having
been filed August 14, 2009, and recorded in Official Records Book
26978, Page 638 [Filling Station].
SPECIAL EXCEPTIONS
15. All matters contained on the Plat of T.W. Palmer's Subdivision, as
recorded in Plat Book 4, Page 60.
16. Resolutions recorded in Official Records Book 12923, Page 2618;
Official Records Book 12923, Page 2622; Official Records Book
14258, at Page 2399; Official Records Book 14646, at Page 2513;
Official Records Book 15168, at Page 2413; Official Records Book
15615, at Page 1652; Official Records Book 16035, at Page 3996;
Official Records Book 16478, at Page 1048; Official Records Book
16872, at Page 1634; Official Records Book 17326, at Page 2605;
Official Records Book 17789, at Page 637.
17. Unity of Title recorded in Official Records Book 14083, at Page 3175.
18. Unity of Title recorded in Official Records Book 24401, at Page 1870.
19. Unity of Title recorded in Official Records Book 23005, at Page 1605.
20. Notification of an Extension to a previously approved Development of
Regional Impact (DRI) pursuant to subsection 380.06(19)(c), F.S.
2007, recorded in Official Records Book 26557, at Page 217, and in
Official Records Book 26557, at Page 223.
21. Notice of Compliance with F.S. 713.10 — No Liens recorded in Official
Records Book 27058, at Page 3320, in Official Records Book 27058, at
Page 3322; and in Official Records Book 27058, at Page 3324.
22. Order of Taking recorded in Official Records Book 7772, at Page
323; and Official Records Book 7772, at Page 324. [FAA Parcel].
23. Deed recorded in Official Records Book 13799, Page 220.
24. Claim of Lien recorded in Official Records Book 27145, Page 4766.
3
803598v1
25. Resolution No. 2006-1142 recorded in Official Records Book 24457,
Page 1167.
26. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-37583-CA, a Notice of Lis Pendens having
been filed May 11, 2009, and recorded in Official Records Book
26861, Page 1648, Official Records Book 26899, Page 4984, also:
Official Records Book 26893, Page 1713, Official Records Book
26904, Page 1001. NOTE: Claim of Lien recorded in O.R. Book
26690, Page 4482.
27. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-17012-CA, a Notice of Lis Pendens having
been filed March 5, 2009, and recorded in Official Records Book
26776, Page 55. Claim of Lien in Official Records Book 26739, Page
2390.
28. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-25934-CA, a Notice of Lis Pendens having
been filed March 31, 2009, and recorded in Official Records Book
26810, Page 1476. NOTE: Claim of Lien in Official Records Book
26709, Page 2795 and Official Records Book 26736, Page 2822.
29. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-25919-CA, a Notice of Lis Pendens having
been filed March 31, 2009, and recorded in Official Records Book
26810, Page 1621. NOTE: Claim of Lien in O.R. Book 26714, Page
678.
30. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-28410-CA, a Notice of Lis Pendens having
been filed April 10, 2009, and recorded in Official Records Book
26824, Page 2577.
31. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-13879-CC, a Notice of Lis Pendens having
been filed October 10, 2009, and recorded in Official Records Book
27047, Page 244. NOTE: Claim of Lien in Official Records Book
26728, Page 316.
32. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-36303-CA, a Notice of Lis Pendens having
been filed June 9, 2009, and recorded in Official Records Book 26895,
Page 476. NOTE: Claim of Lien in Official Records Book 26737,
Page 4756.
33. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-28115, a Notice of Lis Pendens having been
-4-
803598v1
filed July 22, 2009, and recorded in Official Records Book 26949,
Page 59. NOTE: Claim of Lien in Official Records Book 26725, Page
4678.
34. Proceedings pending in the Circuit Court of Miami -Dade County,
Florida, Case No. 2009-62976-CA, a Notice of Lis Pendens having
been filed September 3, 2009, and recorded in Official Records Book
27000, Page 2883. NOTE: Claim of Lien in Official Records Book
26675, Page 1533.
35. Bankruptcy Case No. 2010-13484-BKC, Filling Station Lofts, LLC, a
Florida limited liability company, Debtor. Official Records Book
27257, Page 3240, Official Records Book 27191, Page 819.
36. Bankruptcy Case No. 2010-20292-BKC, Filling Station Lofts, LLC, a
Florida limited liability company, Debtor. Official Records Book
27280, Page 556, Official Records Book 27284, Page 3841.
37. Ordinance recorded in Official Records Book 22936, Page 1136.
38. Declaration of Restrictive Covenants recorded in Official Records
Book 23520, Page 1636.
39. Hold Harmless and Indemnification Agreement recorded in Official
Records Book 24083, Page 3935.
40. Agreement for Water and Sanitary Sewage Facilities recorded in
Official Records Book 25305, Page 3832.
41. Easement contained in instrument recorded January 20, 2009, in
Official Records Book 26722, Page 1264.
42. Judgment in favor of Biscayne Construction Company, Inc. d/b/a
Biscayne Roofing and Waterproofing Systems recorded in Official
Records Book 27549, Page 663.
43. Judgment in favor of Gulf Plumbing Inc. recorded in Official
Records Book 27556, Page 3721.
44. Judgment in favor of B&R Engineering, Inc. recorded in Official
Records Book 27556, Page 3732.
All recording references herein are as to the Public Records of Miami -Dade County,
Florida.
5
803598v1
Therefore, it is our opinion that the following parties must join in the
platting of the above described real property in order to grant CITY OF MIAMI,
FLORIDA and the public, a good and proper title to the dedicated areas shown on
the final plat of the aforedescribed property, the subdivision thereof to be known as
JERSY.
Name
Jersy Ltd.
Filling Station Lofts, LLC
Federal Aviation Administration [FAA]
/United States
City National Bank, N.A.
Lasse Moe
Versa Capital, LLC
Interest
Fee Simple
Fee Simple
Special Exception #
N/A
N/A
Fee Simple 17
Mortgagee 6
Mortgagee 9
Mortgagee 10
I, the undersigned, further certify that I am an Attorney at Law duly
admitted to practice in the State of Florida, and am a member in good standing of
the Florida Bar.
Respectfully submitted this 2day of March, 2011.
STEARNS WEAVER MILLER
WEISSLER ALHADEFF &
SITTE ' :: * P.A.
By
N. r e: Ryan 1. Bailine, Esq.
Flo 'da B. -No. 0616850
150 Museum Tower
Suite 2200
Miami, Florida 33130
6
803598v1
Exhibit "A"
Legal Description
JERSY SUBDIVISION
All of Block "C", Less the North 7.00 feet, and the South 5.00 feet, thereof, of the
T.W. PALMER'S RESUBDIVISION, according to the plat thereof as recorded in
Plat Book 4, Page 60, of the Public Records of Miami -Dade County, Florida.
AND
All of Block "D", Less the North 5.00 feet the West 10.00 feet and the South 5.00
feet, thereof, all of the T.W. PALMER'S RESUBDIVISION, according to the plat
thereof as recorded in Plat Book 4, Page 60, of the Public Records of Miami -Dade
County, Florida.
AND:
A portion of a 10 foot wide Alley lying between Block "C" and Block "D", both in
T.W. PALMER'S RESUBDIVISION, according to the plat thereof as recorded in
Plat Book 4 at Page 60, of the Public Records of Miami -Dade County, Florida, being
more particularly described as follows:
Commence at the Northeast corner of Lot 1, Block "D"; thence SOO°39'45"W along
the East line of said Lot 1, Block "D" for 10.00 feet to the POINT OF BEGINNING;
thence continue S 00°39'45"W along the East line of said Block "D" for 344.75 feet;
thence N 89°59'52"E along the Easterly extension of the North line of the South 5.00
feet of said Lot 14 for 10.00 feet; thence N 00°39'45"E along the West line said Block
"C" for 344.75 feet; thence N 90°00'00"W along the Easterly extension of the South
line of the North 10.00 feet said Lot 1, Block "D" for 10.00 feet to the POINT OF
BEGINNING.
#803598 vl
7
803598vI
Exhibit "A"
Legal Description
All of Block "C", Less the North 7.00 feet, and the South 5.00 feet, thereof, of the
T.W. PALMER'S RESUBDIVISION, according to the plat thereof as recorded in
Plat Book 4, Page 60, of the Public Records of Miami -Dade County, Florida.
AND
All of Block "D", Less the North 5.00 feet the West 10.00 feet and the South 5.00
feet, thereof, all of the T.W. PALMER'S RESUBDIVISION, according to the plat
thereof as recorded in Plat Book 4, Page 60, of the Public Records of Miami -Dade
County, Florida.
AND:
A portion of a 10 foot wide Alley lying between Block "C" and Block "D", both in
T.W. PALMER'S RESUBDIVISION, according to the plat thereof as recorded in
Plat Book 4 at Page 60, of the Public Records of Miami -Dade County, Florida, being
more particularly described as follows:
Commence at the Northeast corner of Lot 1, Block "D"; thence S00°39'45"W along
the East line of said Lot 1, Block "D" for 10.00 feet to the POINT OF BEGINNING;
thence continue S 00°39'45"W along the East line of said Block "D" for 344.75 feet;
thence N 89°59'52"E along the Easterly extension of the North line of the South 5.00
feet of said Lot 14 for 10.00 feet; thence N 00°39'45"E along the West line said Block
"C" for 344.75 feet; thence N 90°00'00"W along the Easterly extension of the South
line of the North 10.00 feet said Lot 1, Block "D" for 10.00 feet to the POINT OF
BEGINNING.
#807520 vl
1
THIS INSTRUMENT PREPARED BY:
Stephen C. trick, Jr., Esq.
Hayden and Milliken, P.A.
5915 Ponce de Leon Boulevard
Suite 63
Miami, Florida 33146
WARRANTY DEED
I Ililll illll ll1A Ilill 1111111111 IIIU IIII IIII
CFN 2004R0890528
DR Bk 22722 Pss 2224 — 2225; (toss)
RECORDED 10/12/2004 11:26:04
DEED DOC TAX 13,6E0.00
SURTAX 10,260.00
HARVEY RUVIN, CLERK OF COURT
MIAMI—DADE COUNTY, FLORIDA
THIS WARRANTY DEED made the 13t day of September, A.D., 2004, by PLS REALTY,
INC., a Florida corporation, whose address is 45 NE 16th Street, Miami, Florida 33132, hereinafter
called the grantor, to JERSY LTD., a Florida limited partnership, whose address is 900 Lincoln
Road, Miami, Florida 33139, hereinafter called the grantee.
WITNESSETH that the grantor, for and in consideration of the sum of Ten and No/100
($10.00) Dollars and other valuable consideration, receipt whereofis hereby acknowledged, hereby
grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the grantee all that
certain land situate in Miami -Dade County, State of Florida, viz:
Description of Property on Schedule A, attached hereto.
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or
in anywise appertaining.
TO HAVE AND TO HOLD the same in fee simple forever.
AND the grantor hereby covenants with said grantee that the grantor is lawfully seized of
said land in fee simple; that the grantor has good right and lawful authority to sell and convey said
land, and hereby warrants the title to said land and will defend the same against the lawful claims
of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing
subsequent to December 31, 2003 and restrictions and matters appearing on the plat or otherwise
common to the subdivision. •
IN WITNESS WHEREOF, the said grantor has signed and sealed these presents the day and
year first above written.
Signe:. ed and delivered in the presence of:
Witne
cLtgv 3,/? ifx,1QZ
Prin Name
Witness
Print Name
COUNTY OF MIAMI-DADE
STATE OF FLORIDA
PLS
LEIF GRIFF , resident
orporation
SWORN TO and SUBSCRIBED before me this 13`" day of September, 2004, by Leff
Griffin, President of PLS Realty, Inc. on behalf of the corporation, who is personally known to me
and/or who produced f) Cr6/SS121-• YNg'aQ identification and v take an oath.
My Commission Expires:
Notary Public
,pY PUB OFFICW,NODAY]F/.
p , CUAUOM MIST
ccuwsa>cN NW 6F71
4ci4i1{
uYcoi.Ja 14cNIE4MES
F�'��DEC. 11,2004
Book22722/Page2224 CFN#20040890528 Page 1 of 2
OR BK 22722 r-G 2225
LAST PAGE
WARRANTY DEED
PAGE TWO
Schedule "A"
Description of Property
The South 12.5 feet of Lot 3, all of Lot 4, and the North 12.5 feet of Lot 5, Block C, and the South 5.0 feet
of Lot 4, all of Lots 5, 6, 7, 8, 9, 10, 11, 12, 13 and 14, LESS the West 10.0 feet thereof, and LESS the South
5.00 feet of Lot 14, Block D, T.W. PALMER'S RE -SUBDIVISION, according to the Plat thereof, as
recorded in Plat Book 4, Page 60, Public Records of Miami -Dade County, Florida.
LESS AND EXCEPT the land conveyed to the City of Miami by Warranty Deed recorded August 24, 1988,
in Official Records Book 13799, Page 220, Public Records of Miami -Dade County, Florida, described as
follows:
That Portion of Lot 13, LESS the West 10 feet thereof, and that portion of Lot 14, LESS the
South 5 feet and LESS the West 10 feet thereof, Block D, T.W. PALMER'S RE -
SUBDIVISION, according to the Plat thereof, as recorded in Plat Book 4, Page 60, of the
Public Records of Miami -Dade County, Florida, being more particularly described as
follows:
The external area of a circular curve concave to the Northeast having a radius of 25 feet and
tangents which are 35 feet East of and parallel with the centerline of North Miami Avenue
and 30 feet North of and parallel with the centerline of N.E. 16 Street.
Parcel Identification Numbers:
01 31360080110
01 31360080170
01 31360080180
--
01 31360080190
01 31360080220
Book22722/Page2225 CFN#20040890528 Page 2 of 2
111111111111111111111111611111111111111111
Prepared by and return to:
Virginia Prado
CFN 2004RO901193
DR Bk 22730 Ps 3433i (1p9)
RECORDED 10/14/2004 10:56:13
DEED DOC TAX 900.00
HARVEY RUVIN, CLERK OF COURT
MIAMI-DADE COUNTY, FLDRIDA
LAST PAGE
TITLE PARTNERS OF FLORIDA, INC.
900 WEST 49 STREET SUITE 514
Hialeah, FL 33012
305-824-9800
File Number: 040528
Will Call No.:
ISpace Above This Line For Recording Data)
Warranty Deed
This Warranty Deed made this (a day of , 2004 between Angier A. Rivera, a single woman
whose post office address is 1614 NE MIAMI COURT, Miami, FL 33132, grantor, and JERSY LTD. whose post office
address is 369 8th Street , Brooklyn, NY 11215 Care of Steven Gombinski, grantee:
(Whenever used herein the terms "grantor and "grantee" include all the parties to this instrument and the heirs, legal representatives, and assigns of
individuals, and the successors and assigns of corporations, trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum of TEN AND NO/100 DOLLARS (S10.00) and other
good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate, lying and being in Miami -Dade County, Florida to -wit:
Lot 6, Block C,T.W. PALMER'S RESUBDIVISION, according to the Plat thereof, recorded in Plat
Book 4, Page 60, of the Public Records of MIAMI-DADE County, Florida.
Parcel Identification Number: 01 31366080140
o tz,
J i
J•
Ji I— .
'cc
e:1
1
c:J
In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written.
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the
grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said
land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all
encumbrances, except taxes accruing subsequent to 12/31/2003 .
Signed, . r elivered in our presence:
•;me t e:
,,rr
ss ame: ZO%yV
Angt A. Rivera
State of Florida
County of Miami -Dade //'
The foregoing instrument was acknowledged before me this :r day of 2004 by Angier A. Rivera who
has produced a Florida Drivers license as identification.
;CommAsioni••�t,9
= Expires: Dec 22i _ 1:7
Bonded Ttuu
' Atlantic Bondijficu.tke.
P
My commission Expires:
Doub1.T,me.
Book22730/Page3933 CFN#20040901193 Page 1 of 1
A
I Iliiii 111111111111111 I11111111111111 IIII 1111
This instrument prepared by:
Thomas Davison IV, Esq.
228 Valencia Avenue
Coral Gables, FL 33134
(305) 441-8864
Grantee S.S. No.
Property Appraiser's
Parcel Identification No.
01-3136-008-0130
WARRANTY DEED
CFM 2005R1073093
OR 8k 23865 F95 4550 - 4551; (2P95)
RECORDED 10/12/2005 10:48:50
DEED DOC TAX 2►652.00
HARVEY RUVIH, CLERY. OF COURT
t1IAMI-DADE COUNTY, FLORIDA
THIS INDENTURE, made this L day of August, 2005, BETWEEN JOHN
DUARTES, a single man, whose post office address is 725 Adams
Street, Apartment 46, Dorchester, Massachusetts 02122, grantor*,
and JERSY, LTD., a Florida limited partnership, whose post office
address is c/o Steven Gombinski, 369 8'Street, Brooklyn, New York
11215, grantee*,
WITNESSETH, that said grantor, for and in consideration of the sum
of TEN and no/100 ($10.00) DOLLARS, and other good and valuable
considerations to said grantor in hand paid by said grantee, the
receipt whereof is hereby acknowledged, has granted, bargained and
sold to the said grantee, and grantee's heirs and assigns forever,
the following described land, situate, lying and being in Miami -
Dade County, Florida, to wit:
The South 37 % feet of Lot 5 in Block "C" of T.W.
Palmer's Resubdivision of certain lots and blocks in
Robbins, Graham and Chillingworth's Addition, according
to the Plat of said T.W. Palmer's Resubdivision, recorded
in Plat Book 4, at Page 60, of the Public Records of
Miami -Dade County, Florida.
John Duartes, the grantor, does hereby certify that he
currently resides at 725 Adams Street, Apartment 46,
Dorchester, Massachusetts 02122, that neither he nor any
of his dependents has ever resided upon the above -
described property or any contiguous property, and that
the above described property does not now and has never
in the past constituted his homestead.
SUBJECT TO taxes for the year 2005 and subsequent years;
conditions, restrictions, limitations, reservations and
easements of record, if any, and all applicable zoning
ordinances.
and said grantor does hereby fully warrant the title to said land,
and will defend the same against lawful claims of all persons
whomsoever.
Thomas Davison IV Attorney at Law
228 Valencia Avenue Coral Gables, Florida 33134-5906 Telephone (305) 441-8864 Fax (305) 442-0410
Book23865/Page4550 CFN#20051073093
Page 1 of 2
OP -OK 23865 PG 4551
LAST PAGE
*"Grantor" and "grantee" are used for singular or plural,
as content requires.
IN WITNESS WHEREOF, grantor has hereunto set
seal the day and year first above written.
Signed, sealed andelivered in our presence:
// ness signature
(printed name)
witness signature
/ h //i/at (//t V/If l 4
(printed name)
STATE OF FLORIDA
COUNTY OF MIAMI-DADE)
grantor's hand and
gran signature
JOHN DUARTES
(printed name)
725 Adams Street, Apartment 46
Dorchester, Massachusetts 02122
grantor's address
The foregoing instrument was acknowledged before
August, 2005, by JOHN DUARTES, a single man.
, �ti CE0N0R M. MAATiNEZ
1'i .: :1 MY COMMISSION f 00 358119
?1/47. / EXPIRES: January 28, 2009
_
me this /6-day of
Public - State of Fl
Personally Known OR Produced Identification
Type of Identification Produced /t1/9SS AR!V9, -s�-
Thomas Davison IV Attorney at Law
228 Valencia Avenue Coral Gables, Florida 33134-5906 Telephone (305) 441-8864 Fax (305) 442-0410
Book23865/Page4551 CFN#20051073093 Page 2 of 2
1111101111111111113111111111111111111111111
THIS INSTRUMENT PREPARED B Y:
Peter M. Lopez, Esquire
PETER M. LOPEZ, P.A.
2450 SW 137r" Avenue, Suite 234
Miami, Florida 33175
(Reserved)
CFN 2004-R0008163
OR Bk 21952 F9s 2190 - 2192; (3c9s)
RECORDED 01/06/2004 12:41:39
DEED DOC TAX 4,8003:00
SURTAX 3,600.00
HARVEY RUVIH, CLERK OF COURT
MIAMI-DADE COUNTY? FLORIDA
Property Appraisers Parcel Identification (Folio) No.(s): 01-31-=008=03-0ii;01-3136-008--0080;
Grante8e(s) Social Security No.(s): 01 3136--eo8-6�68;'01-3136-8()8-0040;
'-01.3136-00$-0-55e--
WARRANTY DEED
THIS WARRANTY DEED, is made this /9 day of 4leeem he , 2003, between
1650 N. Miami Ave., Corp., a dissolved Florida corporation whose post office address is c/o 2450
SW 137th Avenue, Suite 234, Miami, Florida 33175 (the "Grantor") and FILLING STATION
LOFTS, LLC, a Florida limited liability company, whose post office address is
(the "Grantee").
(Wherever used herein, the terms "Grantor" and "Grantee(s)" include all the parties to this
instrument and the heirs, legal representatives and assigns of individuals, and the successors and
assigns of corporations.)
WITNESSETH:
That the Grantor, for and in consideration of the sum of Ten and No/100 Dollars ($10.00) and
other good and valuable considerations to the Grantor in hand paid by the Grantee, the receipt
whereof is hereby acknowledged, has granted, bargained and sold to the Grantee, that certain parcel
of real proprty, situated, lying and being in Miami -Dade County, Florida (the "Property"), as
follows:
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A
PART HEREOF
This conveyance is subject to the following:
1.
2
Taxes for the year 2004 and all subsequent years;
Conditions, restrictions, limitations, easements and all other matters of record,
without reimposing same;
3. Restrictions and all other matters appearing on the Plat or otherwise common to the
subdivision; and
4. Zoning, restrictions, prohibitions, regulations_ and other requirements imposed by
governmental authority.
Book21952/Page2190 Page 1 of 3
and the Grantor does hereby fully warrant the title to the Property, and will defend the same
against the lawful claims of all persons whomsoever.
THIS WARRANTY DEED IS BEING GIVEN BY GRANTOR TO WIND UP AND
LIQUIDATE THE CORPORATION'S BUSINESS AND AFFAIRS.
IN WITNESS WHEREOF, the Grantor has caused these presents to be executed in its
name, the day and year first above written.
Signed, sealed and delivered
in the presence of:
•
GRANTOR:
1650 N. MIAMI AVE. CORP., a dissolved
Florida corporation
By:.-f''�(�,
e'er M' PEDRb HERRADA, as President and
Authorized Agent of the corporation in order
to wind up the affairs of the corporation
Sign & Print Name:
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
)SS:
)
I HEREBY CERTIFY that the foregoing instrument was acknowledged before me this I V
day of ] C'e/A.f f , 2003, by PEDRO HERRADA, as President and Authorized Agent of 1650 N.
MIAMI AVE., CORP., a dissolved Florida corporation, on behalf of the corporation and in order to
wind up the affairs of the corporation, who is personally known to me or who has produced a valid
Florida driver's license issued by the Department of Highway Safety and Motor Vehicles or other
identification as identification, and who did not take an oath.
OFFICIAL NOTARY SEAL,
GWENDF.LINATHOMAS
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. DD045963
_MY coMMIISSION 17"(105
rint Name:
NOTARY PUBLIC, State of Florida
Serial No:
My Commission Expires:
Book21952/Page2191
Page 2of3
OK BK 21952 PG 2192
LAST PAGE
Exhibit A
Legal Description
Lot 1, 2 and the North 37 %a feet of Lot 3, all in Block "C", T.W. PALMER'S
RESUBDIVISION, Plat Book 4, at Page 60, of the Public Records of Miami -Dade
County, Florida.
AND
Lots 1, 2, 3 and 4, except the South 5 feet of Lot 4, all in Block "D", T.W. PALMER'S
RESUBDIVISION, Plat Book 4, at Page 60, of the Public Records of Miami -Dade
County, Florida.
Book21952LPage2192 Page 3 of 3
THIS INSTRUMENT PREPARED BY:
DALE A. HECKERLING, ESQ.
Dale A. Heckerling, Esq.
7385 Galloway Road, Suite 200
Miami, FL 33173
111111111111111111111111111111111111111111111
CFF+I 201-1 Rn311-1305
OR Ek 23217 Pss 3166 - 3163; (3p95)
RECORDED 03/30/2005 11:47:58
DEED DDC TAX 2,300.40
SURTAX 1,725.31)
HARVEY RUVIN, CLERK OF COURT
MIAMI-DADE COUNTY, FLORIDA
STATUTORY WARRANTY DEED
THIS WARRANTY DEED made thecal day of t\---14(-0-k' 2005, by JERSY
LTD., a Florida limited partnership„ whose post office address is 369 8th Street, Brooklyn, NY
11215, hereinafter referred to as the "Grantor," to FILLING STATION LOFTS, LLC , whose
post office address is 701 Brickell Ave, Suite 2030, Miami Fl 33131, hereinafter referred to as
the "Grantee." Wherever used herein, the terms "Grantor" and "Grantee" include all the parties
to this instrument and their heirs, legal representatives and assigns.
WITNESSETH: That the Grantor, for and in consideration of the sum of $10.00 and
other valuable considerations, receipt whereof is hereby acknowledged, by these presents does
grant, bargain, sell, alien, remise, release, convey and confirm unto the Grantee a fee simple
interest in and to all of the following land situate in Miami -Dade County, Florida:
Lot 5 and the South 5.0 feet of Lot 4, Block D, LESS the West 10.0 feet thereof, Block
D, of T.W. PALMER'S RESUBDIVISION, according to the plat thereof, as recorded in
Plat Book 4, Page 60, of the Public Records of Miami -Dade County Florida.
Subject to restrictions and matters appearing on the plat or otherwise common to the subdivision,
public utility easements of record; taxes for the year of closing and subsequent years; and
comprehensive land use plans, zoning, restrictions and prohibitions and other requirements
imposed by governmental authority.
FOLIO NO.01-3136-008-0170
GRANTEE'S EIN:
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging
or in anywise appertaining.
AND the Grantor does hereby fully warrant the title to said land and will defend the same
against the lawful claims of all persons whomsoever.
IN WITNESS WHEREOF, the Grantor has signed and sealed these presents the day and
year first above written.
Signed, sealed and delivered
Book23217/Page3166 CFN#20050310305
Page 1 of 3
IN WITNESS WHEREOF, the Grantor has signed and sealed these presents the day and
year first above written.
Signed, sealed and delivered
in our presence:
Print Name:
kj1\142a-ii ik • Ckf555‘,.
Pnnt name: Y(.a(-41 (M, e'-i-""
(Witnesses as to all)
STATE OF NEW YORK
COUNTY OF KINGS
The foregoing
March, 2005, by Steven
of Jersy, Ltd., a Florida
r
produced -Drt Iv xK f l
) SS:
JERSY, LTD. , a Florida limited partnership
By: GOMBINSKI REALTY, INC., a Florida
corporation, its sole general partner
By
Stun Gombinski, President
[CORPORATE SEAL]
instrument was acknowledges before me this "Z-1 day of
Gombinski, President of Gombinski Realty, Inc., as sole general partner
Limited partnership, who are personally known to me and/or who have
C as identification.
Notary Public No.
Print name of Notary,
FR4iNZ RICHARD FAIRWEA7HER
Notary Public, State of New York
No. 24.01FA9441.66
Qualified in Kings County
Commission Expires Nov. 14,
Book23217/Page3167 CFN#20050310305.
Page 2 of 3
OR BK 23217 PG 3168
.. 4
LAST PAGE
Itcle.31,!.„.....,,......0.,,,.../..1.1.. jaw..c...\v..gz4:L%k!.,..ce,.!.L:xtr....a.\...•.!..%.v..c,k!/...c.lk,!i..e.zt•7!..akpll,I,!clr'..„czkt„,,„He-zl,,...t:=t,..,/..cT.,!...c't‘!,/g.r...,f!ZfYZ...":...p'cT»':.!.P••ll-•4Dal:'t•i•'t----'::.:
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I certify from the records of this office that FILLING STATION LOFTS, LLC, is a :i."..?( , f(!): :).. . .:.
....; .4%
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"1'60
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....= limited liability company organized under the laws of the State of Florida, filed on gli;
?al,. December 11, 2003.
• ...op
?•,f 8 r.
4: )5 41P, • •
170-4;
II: ri The document number of this company Is L03000052062
I further certify that said company has paid all fees due this office through • ?. •
.01 .
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AP: • •
.....".•• December 31, 2004, that its most recent annual report was filed on ;UP_
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October 13, 2004, and its status is active.
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Zig Given under my hand and the . .
..•..... Great Seal of the State of Florida
?IV,
Mr%
at Tallahassee, the Capitol, this the . .
Twenty-seventh day of January, 2005
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• nd .poxrdanont egareraint in 14 as. ma's fu.1y doscrib!sd in. pobednis
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IltraliFORX; 1, 1.n and by viirtOs af tlas ItiOst of • Congress Lappin:wad: t.
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• 193.1,• 46. Stat... 1421, 40•12:S.,C, .259 (a) t• the Psf:I Aat •of
' ... • • . •
19513, 72 Stat: 731, 49 U.C. :13011 tho tiarpSitiasat of irraniportatioii•
ttot, SO Stat. St33.) Litty,9274 ,85 avt:EraV• *4 . •••
• . . .
10 iimvat 1971i and, atart.hOrity tnd by. t.ba• 6.rcnottaxy o-
• Dolar.taso•ni of 7i-anspttioi th eve •••Adiainiata-itor of th*:1Vgliiis1.: •• • •
Aviatioo (32 Jr.X. 5607). So& 41-64414stJael to t14;
•
e,st Copy
114 FL 345 .7.
— i —
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• Administrator of tha Federal Aviatioo Adraniatratiom:.(27
3773 and 32 10 Y.R. 5611) , do•tiaLurby calA:a to 5-e ,filed .this : :••:,:-:.:..:.
Declaration of Taking end by
.,••• .•
-• .
t4tilitips and railroads. The fee rirw;)le i.ntereiet in to ba
t_O any existirig easoients for Imiblio hicrhvnyi; public •.:
and parroanont easement: 'the herain sbo7o decried,2.en4eubje.o•
hereby utaco that X have elected to acquire Ja fas ein;pla intersu,k
• •
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acquired• eubjat also to -the ericroeChatant dec,cribed• in Schedule
....
attached 1.,to rota ends nide a• pert • bersof„-Aands delon ' •;••:.',,,..';'; •
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. . . • •• "' •-**4-:.'.•.::.!••::::'..4*:•••.
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tho Atta03.s;3,:, drit.i ins, anrkad 6c:he:lute: 'N'''..•.,a6d- eado a. park.hereof.• ''•••.• :•:•.,:ju•••••••i'
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i• do hiyrobye1arso staid inteOsts.•in the; lii-td to b4•ta'Aen by : : •:....:!..-;;.;::::••••••••,..
authOrity of the atorneeid hats of C.ongrea and: that the public ...--li •-. :' •
. .. ....,„ .
.. • . . ... . .• „.
. purpose for Vh1ch said prOply• internitir ire taken' in •to provide'f'!Z.-;",...:.-..:',-;
. ...
.. .• . • • ••• ,•'••;•,-;!:......1•':.;i••:;1‘..
•'....:•••an Outeriker/Co:apnea i:Ocator ilic1.4..1.c..r.1 cuppral.$1Y *.-efetilkeilii:••:.•••::...:."•-••••• •'•
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AND X dci hereby declare that, oi ZUM of -money estimated' by ice. to ki..f::,..:,
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jutit .c:canp!ntti3tion fortbo taking of said fee sirvIda- interest and..f.:•1••,:
— •;':',3:....,.:.
. . •
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. • • . . • • • -••:-. permanent naso.nt' in :the account of sovnei ,t*usarad.. nine hni-O_red- , • • • . • . • . , •
oraventaan dollars •({t7,917.00):'is hereby deposited fate ths : • • .••:-„:::f........
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Regist
ry of the. court for the benefit of pare= or, pdareons : .: ; •i-• .
. - • - ...
• •,• ..:•••••••:
entitled: theratti ea more. fully described in -Schedule "A' attached li ,,••-•;
• • . . . . : ',''..' ..‘.'..:•:,..;,.•
barest° and•oado. a part hereof, and that tho personis.purg;zorted t*::'...-.• : ,•
...••
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outer marker , •
.• • • .•
have title to the liand are Salvatore )2.. and Veen
• •••••Potax and .74siaphian •Zaparialat ziarrance and C.AatiJi a tta P'renet.tol
and Philip lnd :Nunn' '.0aperial 1614 iort.bana:•
•••
•'Xiami'COurt,;•:/tieni.,:•iloride331327 '10 N. W,-7Sth Street, ..Xieski.
ntt.ltida 3311'07 1620 0:4114A...vonue, 4trooklyn, N4A1 .1.ork 11330, an4
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Z. Os of the optni.ua• that:.tbe ultimate *wary ar, `.:ii.taki . ar
aid feet pAapls. inturaet and permeherst saesmoitt•ui21 'his with.t
the limits tvraeoi'fYied'nqtrin*.'.
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'' -''' • . " ... ooritte and tr.airstein' the oxipting calr,„Narii loc•ata.r. entr.4nrgt poi° • -...,....:',*!•'•.'::
-:-• •.••,
-4-:. ,•••••• ... •vith ?tx:rde srr Maid Cablerr 4rad. e.iisting. t.'•Vx1rIrcl•-oi.ind radio aratez •.' •.; : :i..: •••
•• •• :. • -located on e pottlors of .1.'ot 6,. :lock C, T. W.
•••••" -.• • ubdiviaion• of riejoits 6,.:, 7:„ S, 14 And 15:of Aobbin, Orshire • . . ....;,:z.' •:.'''• :
;Ii:,-...f ..:,•.: '. : and k.-1Th irovor!th ' st MO of liOrth Iiiai., recor;:ted in Plat peck 4,,.. ...,. .‘......„•••.,• ••:.
i.:-.:•••'• '•••• . •Page: 6, PL11"11.1.c_•Recordig.'. Dade C-ou,nty, rlorids.. Thiel *nacre:ant .....:.....,....": -.• •••:.•
; •.' ... • : • omprises a en4.411. portion ,to. the icater of. staid. lot na e1-town. on • : , • . ' ... : • ...:•••
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•• 8crifichila "D" 4ncl giurporteidli-40inz the. proparty of Selivatore a.; ' ••• -.••. ..• •••:..•
•.:".:' • :-. and NA E: Ireverialop 14. No' rthozet 31i P),1 Court', Ninkil.,• Florid* : •• - • ,,
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:„.....:.„-:•33132.' . . .. .
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'.7.,'..f • •'.. :";;;*.:*••:71-ia• just cOmp-leine4tion: tar .illi Os ent hka bu.• dot a:ruined ..to- ••••-•,.....:•-••••••••,.
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••••...*.•... A •feainrpi.s intsre'st in Lot- 7 ;(1eisi the: South, 5. feut.• for. road.•••••••:: •••:;-;.:::•••.... •
,•!-• right-of,way, previously deeded• to the 'city ol'..241.emi.),. Block.
.• • • T.W, Paltrier Rasi*diviaion of Blocks 6, 7, 8, 14 and 15 of Rohbini;:'''.:
,•• .
•,- • •,• •'GraheErt and Chi111ngworth's.)Tap of North Miami., raOOr.dati in Plet•••••';'..J;•';,'•.
4:, ReCorda:,. Dade C,xik noridei,.: and 11,:;•inci."-.:••;,...,•,-
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tore. u y atm. aa a parc u..n9
7 .:7-",•"••••4416h4N....B.'16th*..Stre.at. end SO: feet ....in depth. • Th.i. Ilea • i.rvle.
• -•••• • . intereet. comlirititii the abO,va deticrit.red•Lot 7 ahorn era: Schedule'''..••••••••:..-• •
.". •.• "13 and purportedly being..the property• of Salvatore Rand
(:•• . • 3. X•n-rperieli,' .16/4 Northeast'. irciami•Cou.it,
ternd ,7sa ph Ipeia1,, 16N.-•:w. 713t:fi• tltreetr• ilkara.i••••-
• ...Florida • 331501 •Lawrarica• and Concatta Frenetta, 1620 Oc.ean•Avenuei.::•••1'.:*•F,,--o'-•-.;!:-
••• " • • BroOklyn, tlew 'fo11230g ad Thilip nd Xn.rie• reperiele.„ 1301•••:: •• 4:•J
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, • ••:•.•• -• • Avnuo..N, SroOklyn, Isle4 York 11214.. • '••• . , • • !..•
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. PrI•itt: Suet •corapentoition inteFeet latre.n:.".
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tarmind to be *6U75
. • • •• •
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•c : • ,•,or the rtar 'of .Lot: 6 inta:thenOrthweet-cOrTiar of list 7., The
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• existerice.ofthis inernechieent 'data. not interfere with the . • •
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CASE NO. 72-974
FILED 9-26-73
# 9526
U.S.A.
vs
SALVATORE-R. &
NEVA E. IMPERIALE, et al
LOT 7, less S 5' BLK C
AliAt- PALME-RS_.._SUB .
PB 4-/60
9/25/73
(,ofK Arof hv'4rL AI3U
FINAL JUDGMENT
(Amended)
4:0
CASE # 72-974 - %44,i pl yyv' -.(d S . FINAL JUDGEMENT
FILED 8-6-73
UNITED STATES OF AMER I CA ' ' o' 7
vs.
w Acre of land, m/i,
Situated in the County of Dade,
State of Fla. &
Salvatore R. & Neva E. Imperiale,
Philip & Anna Imperiale, his wife
& Peter & Josephine Imperiale,
his wife
ORDERED & adjudged:.:that the following property is
condemned:
LOT 6 & 7 BLK C
ROBBINS, GRAHAM & CHILLINGSWORTH'S SUB.
PB 4/60 & being more particularly
described as a parce of land having
1.00' in width alg. N.E. 16 St. & 501
in depth.
W.O. Mehrtens, Judge 8-10-73
two Pt-(i A- L/41 L A-f3 U
CI r'nt a •
1E9224-M
CASE NO. 72-974 United States of America L.P.
filed 6-22-72 vs
Salvatore R. and Neva E. Enaeriale,
Peter and Josephine lmperiale, et al
The action sought is the., condem nati on of the
following:
Lot 6 and Lot 7, (less S 5'), Bik. C
„. ' ' W. PALMER SUB.
Plat Book 4, Page 60, Dade County, Florida.
CA501 nr61_ A-1IrrL A-( (.�
CITY OF MIAMI
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:
Steven Gombinski
(First Name)
(Middle) (Last Name)
HOME ADDRESS:
(Address Line 1)
(Address Line 2)
CITY: STATE: ZIP:
HOME PHONE: CELL PHONE: FAX:
EMAIL: steven.gombinski@gmail.com
BUSINESS or APPLICANT or ENTITY NAME
Jersy, Ltd
BUSINESS ADDRESS: c/o Gombinski Realty, Inc.
(Address Line 1)
3737 Collins Avenue, #1504, Miami Beach, 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.
Application for Tentative Plat Approval
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.
MIADOCS 4862416 1
3. Please provide the name, address and phone number of the person(s) or entities to whom
consideration has been provided or committed.
a.
Name
Address Phone#
b.
c.
* Additional names can be placed on a separate page attached to this form.
4. Please describe the nature of the consideration.
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, shall be deemed void
without further force or effect; and
2. no application from any person or entity for the same issue shall
be reviewed or considered by the applicable board(s) until
expiration of a period of one year after the nullification of the
application or order.
PERSON SUBMITTING DISCLOSURE:
Signature
Steven Gombinski ident of Gombinski Realty. Inc.. General Partner ofJersv Ltd.
Print Name
Sworn to and subscribed before me this day of..1,31•,*. - , 2010. The foregoing
instrument was acknowledged before me by Steven Gombinski, as President of Gombinski Realty, Inc.,
General Partner, of Jersy Ltd., who has produced as identification
and/or is personally known to me and who did/did not take an oath.
STATE OF R o./l l
CITY OF 1M t Cr t
MY COMMISSION
EXPIRES:
Enclosure(s)
Notary
NOTARY PUBLIC - STATE OF FLORIDA
,1iiitrnChristian
Commission #DD651416
Expires: MAR. 23, 2011
BONDED THRU A LANTIC BONDING CO., INC.
Page 2
MIADOCS 4862416 1
t.
CITY OF MIAMI
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:
Daniel Holtz
(First Name)
(Middle)
(Last Name)
HOME ADDRESS:
(Address Line 1)
(Address Line 2)
CITY: STATE: ZIP:
HOME PHONE: CELL PHONE: FAX:
EMAIL:
BUSINESS or APPLICANT or ENTITY NAME
Filling Stations Lofts, LLC
BUSINESS ADDRESS: 4040 NE 2nd Avenue, Suite 414
Miami, Florida 33137
(Address Line l)
(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.
Application for Tentative Plat Approval
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.
MIADOCS 4862775 1
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.
* Additional names can be placed on a separate page attached to this form.
4. Please describe the nature of the consideration.
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, shall be deemed void
without further force or effect; and
2. no application from any person or entity for the same issue shall
be reviewed or consider by the applicable board(s) until
expiration of a period of \e year after t nullification of the
application or order.
PERSON SUBMITTING DISCLOSURE:
Daniel Holtz. Manager
Sworn to and subscribed before me this S day of
instrument was acknowledged before me by Daniel Holtz, as onager of Filling Station Lofts, LLC, who
has produced as identification and/or is personally known to me and
who did/did not take an oath.
Signature
Print Name
STATE OF FLORIDA
CITY OF MIAMI
MY COMMISSION
EXPIRES: //
Enclosure(s)
MIADOCS 4862775 1
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, .aY'r"� DAYAMI AGUIAR
ro`D °(. Notary Public • State of Florida
.E My Commission Expires Mar 16, 2011
%iif°�`§�, Bonded Thriough National Notary Assn.
, 2010. The foregoing
Page 2
CITY OF MIAMI
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:
Chris Barnhill
(First Name)
(Middle) (Last Name)
HOME ADDRESS:
(Address Line 1)
(Address Line 2)
CITY: STATE: ZIP:
HOME PHONE: CELL PHONE: FAX:
EMAIL:chris.barnhill@faa.gov
BUSINESS or APPLICANT or ENTITY NAME
Federal Aviation Administration/United States of America
BUSINESS ADDRESS: 1701 Columbia Avenue
College Park, GA 30337
(Address Line 1)
(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.
Application for Official Vacation and Closure of a Public Right of Way
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.
MIADOCS 4920976 1
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.
* Additional names can be placed on a separate page attached to this form.
4. Please describe the nature of the consideration.
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, shall be deemed void
without further force or effect; and
2. no application from any person or entity for the same issue shall
be reviewed or considered by the applicable board(s) until
expiration of a period of one year after the nullification of the
application or order.
PERSON SUBMITTING DISCLOSURE: ( L9- 4- L
Signature
Chris Barnhill. Real Estate Contracting Officer
Print Name
Sworn to and subscribed before me this 1 day of , 2010. The foregoing
instrument was acknowledged before me by Chris Bar ill, as al Estate Contracting Officer of the
Federal Aviation Administration/United States of America, who has produced
as identification and/or is personally known to me and who did/did not take an oath.
STATE OF GEORGIA
CITY OF
MY COMMISSION
EXPIRES:
Enclosure(s)
Al /Aty
Rvan 4
Nola
Print Name
Notary Public
Covweta County Georgia
My Commission Exp. April 6,2013
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