HomeMy WebLinkAbout2005 07 19 Public Input - Rene E. Baez"PUBLIC INPUT" REQUEST
TO ADDRESS THE CITY COMMISSION MUST COMPLETE THIS FORM.I
.~LETE THIS FORM IF YOU ARE ADDRESSING THE CITY COMMISSION ON
~NYSUBJECT OTHER THAN A "PUBLIC HEARINGS" AGENDA ITEM.
DATE:
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NAME: , ~~ C ~ ~ !~'~~ C~
(Please Print)
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ADDRESS: / r~~ D `/ C~ ~~~/I~~~ ~ '.
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CITY: ~ ~~ ~ <S ~ STATE: L.._ ~ ZIP CODE: _~ ~ ~~
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TELEPHONE NUMBER: ~C/ 0 - ~ / ~~ ' / ~fI ~
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 includin,~ "Public Heariri~s. "
2) WHICH AGENDA ITEM DO YOU WISH TO COMMENT ON:
3) FOR'rHE 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 giving 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 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.