HomeMy WebLinkAbout2004 10 19 Public Input Request - Floyd Riley"PUBLIC INPUT" REQUEST
[ANYONE WISHING TO ADDRESS THE CITY COMMISSION MUST COMPLETE THIS FORM.]
PLEASE COMPLETE THIS FORM IF YOU ARE ADDRESSING THE CITY COMMISSION ON
ANY S UBJF. CT OTHER THAN A "P UBLIC HEARINGS "AGENDA ITEM.
NAME: ~~~
(Please Print)
5. /~Y
DATE: / ~~.~~.
ADDRESS: ~ / ~ U`~-1"1 '~~ i ~ ~~'~ ~ ~~.
(Please Print)
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CITY: ~,./, tiJ'~'(~ fjl dJ i ~ ~ ~~.~ STATE: ~r~._- ZIP CODE: ~ / ~
(Please Print)
TELEPHONE NUMBER: ~~ ~" ~9-~'- ,`7,~ ;
To address the City Commission on a subject that is not on tonight's Agenda, please complete 1):
1) WHAT SUBJECT WOULD YOU LIKE TO ADDRESS THE CITY COMMISSION ABOUT:
To address the City Commission on an Agenda Item that is on Tonight's Agenda, please complete
2) through 4) -not including "Public Hearings."
2) WHICH AGENDA ITEM DO YOU WISH TO COMMENT Off: -
3) FOR THE RECORD, ARE YOU: IN FAVOR
OPPOSED
4) DO YOU WISH TO VERBALLY ADDRESS THE CITY COMMISSION ABOUT THIS AGENDA ITEM?
YES ~ NO, I DO NOT WISH TO VERBALLY AllDRESS THE CITY COMMISSION
NOTES:
a) If you need additional space, please use the reverse side of this form.
b) If yon are giving any document(s) to anyone opt tl:e dais, the "Original" must be given to the
City Clerk as the "copy of record" -and as everyone on the dais should receive the same
information, please provide nine (9) of each document/item to the City Clerk.
c) If you are speaking on behalf of a group or organization, you will (usually) be given five (5) minutes to
speak; otherwise, as an individual, you will (usually) be given three (3) minutes to speak.
Thank you for your participation.