HomeMy WebLinkAbout2004 10 19 Public Input Request - Kevin Michael Furno"PUBLIC INPUT" REQUEST
[ANYONE WISHING TO ADDRESS THE CITY COMMISSION MUST COMPLETE THIS FORM.]
PLEASE COMPLETE THIS FORM IF YO U ARE ADDRESSING THE CITY COMMISSION ON
ANYSUBJECT OTIICR THAN A "PUBLIC HEARINGS" AGENDA ITEM.
NAME: ~~ Vi /l ~I t G)14 G' ~ ~V -~iil (;~
(Please Print)
DATE: ~ ~ "~ ~ " ~
ADDRESS: ,~ I (,~ '~ /-'~>~-y~l~ L. '~
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CITY: LJ / /" 1 ~i' ~- S~''"- ~}.!~ STATE: ~~
(Please Print)
ZIP CODE: S ~ 7U~
TELEPHONE NUMBER:: ~~ U %~ ~ ;~ % - ~ 7,/~ C~
To address the City Commission on a subject that is not on tonight's Agenda, please complete 1):
I) 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 HearinQS. "
2) WHICH AGENDA ITEM DO YOU WISH TO COMMENT ON: ~/ ~(> I ti ~`~ G,~l p f /,1, E ~ ; ; - ~, ~ ~ ~~ ~~, ~ ~
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 ADDRESS THE CITY COMMISSION
NOTES:
a) If you need additional space, please use the reverse side of this form.
b) If you are givr`~:g any document(s) to anyone on the 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 ni-:e (9) of each document/item to tlae 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 participntion.