1500 Ocean Dr. Condo Assoc.
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S~1e-22Jla2 aSH 3Ia
CITY 1"'IIRVII SO; 0-l:t<K J.l1*' I
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:RECEIVED
CITY CLERK'S DEPT.
in
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Cltv' ofMJlmlIeed1 omce ofltll ~ Qer1<
17M ~ c.n~~, t41W &each, FL 33~ SE~I 3 22002
Em.tI. dlycllr1cOcI.Jr\1lm..bucMI,lII 'D,.j h
LOIIYXST JlEGXS1'RATlON 'ORM ! ~3'
(Otf of01llml-. Clll' QxIo ChIlllW 2, _ 3. -. ~ ,[Jm~
o Check Box If an Amendment
ROGEL DAVID H.
(LIst) (Fll'll) (MJ) DATI! Qth\IJIIZID AS LOemST
Blue Lagoon Drive, Suite 100, Miami, FL 33126
.
NAME OF 1.08B'l'1ST:
5201
BUSINESS ADDRESS~
(Nwntler Ind She\:)
(ctv)
(Sf.IlII)
(Zip CadI)
305 26204504
FAX HUMID.:
dro el@be~ker-poliakoff~com
!MAIl. :
I. LORn51' __10 BYI
1500 Ocean Drive Condominium Association, Inc.
NAMEO"~
..
1500 Ocean Drive Miami Beach
BUSINESS ADDIUSS: (Number and Street) (CIty)
(305) 534-0165 (305) 534-8465
Tll.EPHONE NUM8EJl: PAX NUMBS.: (0prJ0nII)
FL
(SlaW)
33139
12lp CadI)
condo1500@aol.com
~: (Cpl:IonaI)
, .
FII1 out tIIll HdIOft If prl.,e1pal .. . _onlle", Pn'IM'Ih'p or"" [SIctIan 2-482 (c)]
. NAMe Of! QtZIPl CPF1~ PAR"MR, CR. BJ:NEFICfARY:
. LJS"I' AI.L PP5CINS HOLDING, D1R!CT'LY OR INDJRECl1.Y, A 5~ OIl MOM CWfeSHIP INTIRE r"!N ~
CORPOAATtCN, PAl1'NERSttIP CR. 'I'RIJS'n
u. ..CIFIC.... sma
Aoplication of Jefferson Plaza, Ltd. for File No. 1581 - 1500.0cean Drive -
Isauuo bllobbIecI (De5aftleln dIrill): Outdoor/Open Air Entertainment
Ill. art .l'INCIII/INDMDUAUTO IE a.oJl!IDc
A) Full Name" ~(rIae 8)R*
Melvin Schlesser Planning B
Rob~rto Datorre Planning B
Jerry Libbin Planning B
Carlos Capote Planning B
Jean-Francois Lejeune Planning Bo
tOMldp
oard Member
oard Member
oard Member
-
oard Member
ard Member
-
Victor Diaz
Joe Garcia
Planning Board Member
Planning Board Member
lit"
-
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SEP-1e-~~2 09131
c t TV M I Ft1 I BCH CLERK IEPT
305 673'7254 P. 02
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~,
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tv. DUCLOSUJlE OF TiIlMS AND AMOUNTS ClP LOD'tlST caMP!NSAnc~ CDua.oa ~, '1ITHIIl HQU/U, JII;
FlAT IlAT.,. fJTHlR)
A) LOaIMST OlSC\.CSURE;
HOURLY @ $22S/hour
"
"
I) PR:t<4QpAL'S I)ISCJ,.OSUAE (OF t.C81't'IST CCM~5ATION)~
HOURLY @ $225/hour
v. IIGNA1\IIl! U"DEIl OATH:
ON oc:roalii-. Stir Of JACH YEAR, EACH LOIIYIST SHALL SIJ8M1TTO THe CXT'f ClJU( A SIGNED
STATlMINT UNDIR OATH, umNCiI La'IYlNG EXPENDlTUUS IN THE CZTY OF MI"MlIEAat fOP.
THE PUCl1>1NG CALENDAR YEAR.
Slgnlture of Prf"CIPll/Clent;
Fran
VI. LOIIYIST JDllimACATtC'4'
Ire true and correct and thlt I hi". read or am
42 of the Miami Bal:h City Code liS IImencled, and an
I <Ie solemnly swear that illn at fI
familiar With the pro\itslan n J
repcrtlng requirements.
Signature of l.abby(st.~
Q Produced m
Form of Identification
)J' Personally Known
vu. _runt.... AND STAMP OF NOTAIlY all D......", CLIU2
Stett of florida, COl.lnty at Miami-Cade
SWorn to ana IUbscrf~}I~ }Ill by David Ro6:~ ~ r ,.... ~
This J-O aayof S~2.0112. ~ ~
I~~';~ LYNN e. FOX.PEREZ Signature 'Of Public Notary - Sta1)! of Florida
-~~: :*i MY COMMISSION # DO 066286
". . i EXPIRES: November 19, 2005
. .iff..~ " Bonded Thru Notart PlilIic Underwriters
,
Print, stamp or type name of Notary pubnc
FOR CLIRIrS USE ON~ Y c:-. \ /} '2.} ;""\.
RegIstration: [~ (J ~D CATE: ~
If ,.,1CUd, It.- ~ __
RaQfCatrcn fee Plid: es [ ] ~o..~ u r)
[ ] Cash [ \jAIflfiJ; MeR. ~
PATA eNTRY OAT!: q Ia.-y Q9-- T 2002 ENTERED IY':
~ ArIt Ite4rtn - as/l,'/DZ
iOTA.. P. 02
~ .
...
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STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before me this 20th day of September, 2002,
by Frank Fiorentino, as President, 1500 Ocean Drive Condominium Association, Inc., a Florida not-
for-profit corporation, on behalf of the corporation. Who are personally known to me or have
produced ~~~ y... AWY\) as iden' ation and who did/did not take an oath.
(SEAL)
NOTARY PUBLIC SIGNA
STATE OF FLORIDA AT LARGE
My commission expires: