4360 Collins LLC(C~K'Y ~ ~"n~ Be4ch, CKy Cocle C~l~4~r 2, Di~don 3, ~ 2.48D
[] Ch~ck Bc~ if ~n Amendment
Douqhert¥
~ ~ ~: (~)
1221 Brickell Avenue
305-579-0603
Lucia
Miami
(c~)
305-961-5603
' FAX NUMBI~
4360 Collins LLC
1717 N. View Drive
Miami
sus~s mx~_~S: (~mb~ ~d 9~) (C~)
305-523-3340 305-530-1328
Tn ~!~'.tONE N~ FAX N~--"K: (Op~0 '-
(st~t~)
F1 33231
~. C~) iii
doughertyl @~law. com
F1 43132
land development regulation amendment
EOOd
98T'ON-
FLAT RATE OR OTHER)~
[ do solemnly swear that all of L-he foregoing facts are true and correct and that I have read or aU
familiar with the provisio,s contained in Section 2-~8~ of the Miami Beach Oty Code as amended, i~d all
reporting requi~. ~/ ;~
Signature of ~bbyi~: . _ ii
Signature of Prind pal/Clien~. ~ ~ ~ ~ ~ ~~. I~![
F'°rm °f Id~Jl~c~U°n il
Sworn to and subscribed before me
Signature of Public No~
Print, stamp or type name of Notary P~ic
£00d
98~'0N