Jose & Zunilda Pacheco
.
m
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerktalci. miami-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS TO ENCOURAGE
THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECISION OF ANY COMMISSIONER; ANY
ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR COMMITTEE; OR ANY ACTION, DECISION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER iN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION,MAKING
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CiTY
COMMISSION, OR A CITY BOARD OR COMMITTEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
1)
Lobbyist Name: Telesco
Last Name
Thomas
First Name
J.
Middle Initial
Business Phone (305) 8661014 Message Phone (_)
Business Name and Address: TELESCO ASSOCIATES INe.
260
No.
95th Street
Street
203
Suite
Surfs ide
City
Florida
State
33154
Zip Code
Email Address:ttelesco@the-beach.net
2)
Principal Retained by: Jose & Zunilda Pacheco
1430 Michigan Ave.
If different from above Street
City
Florida
State
Suite
33139
Zip Code
Miami Beach
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiary or interests.
3) Subject Matter (Describe in Detail):
We are requesting a Certificate of Appropriateness to construct a two story, single,family residence on a vacant lot @
1436 Michigan Avenue
~
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied:
The City of Miami Beach Planning Department, Historic Preservation Board
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
o The City Commission
o City Commission Subcommittee
o City Staff
I!!I City Board or Committee Historic Preservation Board
o Personnel
o Identify Others
2001
. 2001
. 2001
2001
,2001
2001
on
on
on
on October 9th
on
on
6. State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above- None Whatsoever
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregOi~cts are true and correct and that I have read or am familiar
with the provisions cont . ed in Section 2- 2 of the Miami Beach City Code as amended, and all reporting
requirements.
Signature of Lobbyist: ~C>L:::> ~
I!!I Persona!ly known
0 Produced ID
Identify
0 Did take an oath, or
0 Did not take an oath
State of Florida. County of Miami-Dade
Sworn to and subscribed before me
This Eighth day of October .2001.
JOSEPH MERLO
.. & My Comm E>p. 4110/04
PUOLlC / No. cc 926199
~~lJOIhIrI<D.
~o~Clerk
-be.\!<Pt-\- Hod"CZ.I_r~
If Notary, print, stamp or type as commissioned
Registration:
0CCEPTED
FOR CLERK'S USE ONLY
[ ] REJECTED DATE I c/ g / [
( J
If rejected, state reason:
Registration fee paid:14 Yes [ ] No [ ] Not-for-Profit Organization
~ Cash [ Check MCR # ;z..t.fo ~ .
DATA ENTRY DATE: ' ,2001 ENTERED BY: ,n '