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CITY OF WINTER SPRINGS, FLORIDA - PUBLIC INPUT FORM
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Address: �/ � ( N "� P n 1 N (N Ck— -e_
Email: r/ �' �% / 0 1-6IJ aXt Phone # (optional):
Do you wish to address the Commission with regard to an issue: ❑ Yes ❑ No
Ifyou mark No'above, the Mayor or presiding Commissioner will indicate your noted support or
opposition for the record but will not call you forward to speak.
On the Agenda,<em Number: __ 5 0 �—
For the record, regarding this agenda item, are you IN FAVOR ❑ or OPPOSED
Not on the Agenda ❑ Subject:
Revised 06/14/2021
THIS FORM ISA PUBLIC RECORD. Individuals comments are limited to 3 minutes and
persons representing a group or organization are limited to 5 minutes, unless otherwise
determined by the City Commission
Date:
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CITY OF WINTER SPRINGS, FLORIDA - PUBLIC INPUT FORM
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Name:
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Address: () 3 i=/VAT l'� tX�
Email: �%/r�/r_!� (5),4121,6c?171 Phone#(optional):
Do you wish to address the Commission with regard to an issue: ❑ Yes ❑ No
Ifyou mark No' above, the Mayor or presiding Commissioner will indicate your noted support or
opposition for the record but will not call you forward to speak.
On the Agenda ❑ Item Number:
For the record, regarding this agenda item, are you IN FAVOR ❑ or OPPOSED ❑
Not on the Agenda ❑ Subject:
Revised 06/14/2021
THIS FORM IS PUBLIC RECORD, Individuals comments are limited to 3 minutes and
persons representing a group or organization are limited to 5 minutes, unless otherwise
determined by the City Commission
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