MIAMI-DADE COUNTY APPLICATION FOR PUBLIC HEARING FOR A CHANGE IN ZONING REGULATIONS *AMOUNT OF FEE: $1,272.31 Total including applicant fee, imaging fee and 8% surcharge ________________ Date Receipt Stamp PROCESS NUMBER: ___________ This application, with all supplemental data and information, must be completed and filed with the MIAMI-DADE COUNTY DEPARTMENT OF PLANNING AND ZONING in accordance with regulations contained in Chapter 33, Code of Miami-Dade County, before the same will be advertised for hearing. IMPORTANT: The applicant or applicant’s representative must be present at the hearing. 1. Name of Applicant (PRINT) ___________________________________________________ 2. Mailing Address ____________________________________________________________ ____________________________________________________________ 3. Telephone No. __________________________ FAX _____________________________ 4. Section and paragraph of zoning regulations to be amended: (State number, and copy in detail the phraseology of the existing regulation to be amended). Include attachments, if necessary. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 5. Phraseology of the proposed amendment of regulations: (If part of the regulation is to remain, the new part is to be underscored). Include attachments, if necessary. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 6. Please give the reason why the application should be approved. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 7. Photos, plans, specifications, and other data as the same may be applicable, should be attached to the application. Applicant’s affidavit is also required with this application. *NOTE: AN 8% SURCHARGE WILL BE ADDED TO ALL FEES EXCEPT DERM AND CONCURRENCY. American LegalNet, Inc. www.FormsWorkFlow.com APPLICANT’S AFFIDAVIT OWNER OR TENANT AFFIDAVIT  owner  tenant of the property described and which is the subject matter of the proposed hearing; that all the answers to the questions in this application, and all sketch data and other supplementary matter attached to and made a part of the application are honest and true to the best of my knowledge and belief. I understand this application must be complete and accurate before the application can be submitted and the hearing advertised. _____________________________ Signature Sworn to and subscribed to before me this _____ day of ___________, _____ ____________________________ Notary Public Commission Expires _______________________ ************************************************************************************************************* CORPORATION AFFIDAVIT We, _______________________________, being first duly sworn, depose and say that we are the  President Vice President, and Secretary Asst. Secretary of the aforesaid corporation, and as such, have been authorized by the corporation to file this application for public hearing; that all answers to the questions in said application and all sketches, data and other supplementary matter attached to and made a part of this application are honest and true to the best of our knowledge and belief; that said corporation is the owner tenant of the property described herein and which is the subject matter of the proposed hearing. We understand this application must be complete and accurate before the application can be submitted and the hearing advertised. _____________________________ President's Signature (Corp. Seal) ATTEST: _____________________________ Secretary's Signature Sworn to and subscribed to before me _____________________________ this day of, Notary Public Commission Expires ____________ ************************************************************************************************************* PARTNERSHIP AFFIDAVIT We, the undersigned, being first duly sworn depose and say that we are partners of the hereinafter named partnership, and as such, have been authorized to file this application for a public hearing; that all answers to the questions in said application and all sketches, data, and other supplementary matter attached to and made a part of this application are honest and true to the best of our knowledge and belief; that said partnership is the owner/ tenant of the property described herein which is the subject matter of the proposed hearing. We understand this application must be complete and accurate before the application can be submitted and hearing advertised. _____________________________ Name of Partnership) By _____________________________ ______% By ___________________________% By _____________________________ ______% By ___________________________% American LegalNet, Inc. www.FormsWorkFlow.com Sworn to and subscribed to before me this ____ day of ____________, _______. _____________________________ Notary Public Commission Expires ____________ ************************************************************************************************************* ATTORNEY AFFIDAVIT I, _______________________, being first duly sworn, depose and say that I am a State of Florida Attorney at Law, and I am the Attorney for the Owner of the property described and which is the subject matter of the proposed hearing; that all answers to the questions in this application, and all sketch data and other supplementary matter attached and made a part of this application are honest and true to the best of my knowledge and belief. I understand this application must be complete and accurate before the application can be submitted and the hearing advertised. __ _________________________________ Signature Sworn to and subscribed to before me this _____ day of ___________, ______. _____________________________________ Notary Public Commission Expires ____________________ American LegalNet, Inc. www.FormsWorkFlow.com