Department of Planning and Zoning 111 NW 1 Street 11th Floor Miami, Florida 33128 CHILD CARE CHECK LIST FOR CHARTER SCHOOLS A signed charter contract from the Miami-Dade County School Board must accompany this application which matches the location, # of students and grade levels of the proposed application. School Name: ___________________________ School Address: __________________________ Tax Folio # 30 ____________________________ Total size of site: ___________ acres Is this an expansion to an existing school? _____Yes _____ No If yes, indicate the # of students and grade levels previously approved: ________________________________ and the Resolution # _______________________________ Number of children/students requested: __________ Grade Levels: ____________ Ages: _________ Number of classrooms: ____________ Total square footage of classroom area: _________________ Total square footage of non-classroom area (offices, bathrooms, kitchens, etc.) _________________ Total square footage of outdoor recreation/play area: ______________________________________ Number of parking spaces provided for staff, visitors, and transportation vehicles: ________________ Days and hours of operation: ______________________________ THE INFORMATION ABOVE IS COMPLETE AND IS CORRECT TO THE BEST OF MY KNOWLEDGE. Signed, sealed, executed and acknowledged on this _____ day of _______________ at MiamiDade County, Florida. WITNESSES: _______________________________ _______________________________ STATE OF FLORIDA COUNTY OF MIAMI-DADE I hereby certify that on this ______ day of __________________, __________, before me personally appeared________________________________, to me known to be the person described in an who executed the foregoing instrument and he/she acknowledge to me the execution thereof to be his/her free act for the uses and purposes therein mentioned. My Commission Expires ______________________ 4/1/08 American LegalNet, Inc. www.FormsWorkflow.com