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RECEIVED <br />y Use Only <br />to Rec ivecCe P 2021 <br />to Issu d .. <br />UN NG DEPT. <br />City of Sunny Isles Beach, Fl. <br />APPLICATION FORM <br />Svp1NY IS4 <br />u <br />P <br />yF 9>+ FLOF\O 5� <br />C/TY OF SUN PCO <br />TRANSFER OF DEVELOPMENT RIGHTS <br />PROGRAM CERTIFICATE <br />I. APPLICANT INFORMATION <br />N <br />�J} W00Y� IVP—AJ, <br />Clerk of Court Use Only <br />/.. Z -G11 Ak1A,VPe7Z �,60V/Vj1, f0 l <br />PHONE- E-MAIL 04tz) 31 C�C�T��. FAX <br />ADDRESS s 3� �4 C�/�i,�s I�� f�i�r .Sc�x, Al 15%C34 r1 s31CO <br />CITY AND STATE SG,1C�N'N SSI ES ZIP CODE 3,31 r O <br />II. RECEIVER SITE INFORMATION AS APPLICABLE <br />OWNERS NAME A10Q4AJa e'2 16000 XM AC Y <br />PHONE E-MAIL FA <br />ADDRESS /�W CI e©/1JA/S '06 '-' /80Z. <br />CITY AND STATE S (JAIA! l% /s/6n ZIP CODE -3,3/6 0 <br />PROPERTY ADDRESS/LOCATION 17 9 V C7 e©1lit"M S' AVE # /SP:Z . <br />LEGAL DESCRIPTION 19AID1V /' /6"L-79/715 1-1V�/M d(V1JAf0AW Er%/PT� <br />,OFF irec z9a7Jq, as -v6 <br />FOLIO NUMBER 3/ 14Z//- d$3 '65-4 P CURRENT ZONING <br />PROPERTY SIZE `7 ��J ��� PURCHASE DATE <br />NPlanning and Zoning Department <br />