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OWNERSHIP AFFIDAVIT <br />FOR LIMITED LIABILITY COMPANY <br />STATS OF FLOSIDA Public Hearing No. <br />COUNTY OF MIAMI•DADE <br />Before me, the undersigned authority, personally appeared <br />hereinafter the Affiant (s), who being first duly sworn by me, on oath, deposes and says: <br />1. Affiant is the manager, or managing member of the LA PLAYA BEACH ASSOCIATES <br />Limited Liability Company with the following <br />address: <br />1300 SRICKELL AVE, MIAMI. FLORIDA 33131 <br />2. The Limited Liability Company owns or lease (circle one) the property, which is the <br />subject of the proposed hearing. <br />3. The subject property is legally described as: <br />SEE ATTACHMENT <br />4. Affiant is legally authorized to file this application for public hearing, <br />5. Affiant understands this affidavit is subject to the penalties of law for perjury and the <br />possibility of voiding of any zoning granted at public hearing. <br />[4 <br />Affiant understands that the matters attached to and made part of the application arc <br />honest and true to the best of my knowledge and belief. I understand this application must <br />be complete and accurate before the application can be submitted and the hearing <br />advertized. <br />Signature <br />Print Name <br />Sworn to and subscribed before mei�n the 21 day of ) , 24 9C , <br />Affiant is personally known to md'or has produced as <br />Identification. . Il - C _ �1 <br />Commission Expires: S -10%-2-0M <br />ANA WARIA GIL <br />Notary Pablio •State of Florida <br />Gommisslon N Flli 089412 <br />My Comm. Expires May 31, 2825 <br />8ondp:' -!cough Na6l �n4 Notary Assr <br />Page 10 of 23 <br />00 <br />N <br />