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7'UR 2011 ell <br />(PROVIDE CERTIFICATION FROM CITY'S CHIEF CODE INSPECTOR) <br />IX, CERTIFICATION OF RESOLUTION FOR YOUR PROPERTY AND INCLUDING <br />ADJACENT LOTS <br />X. PROPERTY OWNER CERTIFICATION AND ACKNOWLEDGEMENT <br />I HEREBY CERTIFY THAT <br />1) THE INFORMATION FURNISHED ON THIS APPLICATION AND THE ATTACHEMNTS <br />ARE TRUE <br />2) I AM THE OWNER OF RECORD OF THE PROPERTY DESCRIBED IN SECTION (II)(i1 <br />(circle applicable number). <br />3) IF THE APPLICATION, AS MODIFIED OR AMENDED DURING THE REVIEW AND <br />APPROVAL PROCESS, IS GRANTED, I AGREE, IN CONSIDERATION THEREFORE, TO <br />INDEMNIFY AND HOLD HARMLESS, AND PROMISE NOT TO SUE, THE CITY OF <br />SUNNY ISLES BEACII, INCLUDING ITS OFFICERS AND EMPLOYEES, IN <br />CONNECTION WITH ANY CLAIMS OR OTHER ACTIONS ARISING OUT OF SAID <br />REVIEW AND APPROVAL, <br />4) 1 HEREBY ACKNOWLEDGE AND AGREE THAT IF THE PROPERTY IS APPROVED AS <br />A SENDER SITE, IT SHALL BE CONVEYED TO THE CITY AS VACANT PROPERTY <br />WITHOUT ANY STRUCTURES LOCATED THEREON, UNLESS OTHERWISE <br />AAPROVED BY THE CITY MANAGER. THE REMOVAL OF STRUCTURES FROM THE <br />SITE SHALL BE AT NO COST TO THE CITY. <br />S) I HEREBY ACKNOWLEDGE AND AGREE THAT, AT THE EXPIRATION OF THE FIVE <br />YEAR PERIOD COMMENCING WITH THE DATE OF THE CITY COMMISSION <br />APPROVAL OF THE PROPERTY AS A SENDER SITE, ANY UNUSED DEVELOPEMNT <br />RIGHTS TRANSFERRED FROM THE SENDER SITE SHALL EXPIRE, TERMINATE AND <br />BECOME EXTINGU - 3D AND UNUSABLE. <br />5- Ab A <br />SIGNATURE OF OVRER (APPLICANT) DATE <br />SIGNATURE OF CO-OWNER (CO -APPLICANT) DATE <br />STATE OF FLORIDA <br />City of Sunny Isles Beach 4 Planning and Zoning Department <br />496 <br />