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HomeMy WebLinkAbout2005 05 17 Public Input Forms"PUBLIC INPUT" REQUEST [ANYONE WISHING TO ADDRESS THE CITY COMMISSION MUST COMPLETE THIS FORM.j PLEASE COMPLETE THIS FORM IF YOUARE ADDRESSING THE CITY COMMISSION ON ANYSUB.TECT OTHER THAN A "PUBLIC HEARINGS"AGENDA ITEM. DATE: ~ `~ ~ ~ W NAME: PI~"~N~~ ~SS~ (Please Print) ADDRESS: ~ ~j ~ ~~ }~ I~ ~~~~ ~ ~ ~~(~ ~ (Please Print) CITY: W / ~ i ~-' ~ ~~ r_ ~~ (~~C~.`~ STATE: ~ ZIP CODE: ~ ~ ~ ("~ (Please Print) 77 TELEPHONE NUMBER: ~ ~ ~' . ~~ _ ~ ~ /t- ; J ((~) (~~ ~ ~,,~, ` 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: t-} oo. i C~. gS ~ ~~0 3 --oo~ ~ 3 > a To address the City Commission on an Agenda Item that is on Tonig is Agenda, please complete 2) through 4) -not including "Public Hearings." ~'~:~ __r-~,~ 2) WHICH AGENDApp ITEM DO YOU WISH TO COMMENT ON: ~~;~ ~ X1`1 Cx./y~-~ ~-'1~~Q.._~ W ~X 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 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, "PUBLIC INPUT" REQUEST ANYONE WISHING TO ADDRESS THE CITY COMMISSION MUST COMPLF.TF, THIS FORM.I PLEASE COMPLETE THIS FORM IF YOUARE ADDRESSING THE CITY COMMISSION ON ANYSUBJECT OTHER THAN A "PUBLIC HEARINGS" AGENDA ITEM. NAME: ~ I r ' ~ 7 .~ ~ (Please Print DATE: ~ ~ o~ ~/ U S .--/-~~ ADDRESS: ~ ~ b ~ ~ ©~'~ ~,.,~ ~ n ~( C (Please Print) CITY: ~ f -1 f e r` ~~ )/ y~ i v~-~ ..5 (Please Print) ~ 'TELEPHONE NUMBER: (~~~ STATE: ~ ~ ZIP CODE: J ~ ~ ~~ -SIG To address the City Commission on a subject that is not on tonight's Agenda, please complete 1): l) WHAT SUBJECT WOULll 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 "Parhlic IT~~rarin~•._'" 2) WIIICH AGENDA ITEM DO YOU WISH T'O COMMENT ON: 3) FOR THE RECORD, ARE YOLJ: IN FAVOR OPPOSI?,D 4) DO YOIJ WISH TO VERBALLY ADDRESS THE CITY COMMISSION ABOUT THIS AGENDA ITEM? YES NO, I DO NOT WISH TO VERBALLY ADDRESS THE CITY COMMISSION NO'CES: 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 documentlitem 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 thxee (3) minutes to speak. Thank you for your participation. "PUBLIC INPUT" REQUEST [ANYONE WISI-LING TO ADDRESS THE CITY COMMISSION MUST COMPLETE THIS FORM.] PLEASE COMPLETE THIS FORM IF YOU ARE ADDRESSING THE CITY COMMISSION ON ANYSUBJECT OTHER THAN A "PUBLIC HEARINGS" AGENDA ITEM. DATE: ,,)j~ j~i~~~.~ `I NAME: ~ L ~ U r C?/' ( ase Print) ADDRESS: ~ Z;1 ~~~ ~ ~, d ry ~ ~ ~ ~~ ~ ~ l rz (Please Print) I CITY: ~ !-`~ _E-~ ~~ ~~ ~ ,~i ~ S - STATE: '~ L_ ZIP CODE: ~~ ~,°'7(~ (Please Print) '' TELEPHONE NUMBER: ~~~ To address the City Commission on a subject that is not orr tonight's Agenda, please complete 1): l) WHAT SUBJECT WOULD YOU LIKF, 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 "Pctblic Hearings. " 2) WHICH AGENDA ITEM DO YOU WISH TO COMMENT ON: C~l <~,y1 ~, j~;~:1 ~~~~, 3) FOR "I'IIE 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. "PUBLIC INPUT" REQUEST [ANYONE WISHING TO ADDRESS THE CITY COMMISSION MUST COMPLETE THIS FORM,] PLEASE COMPLETE THIS FORM IF YOUARE ADDRESSING THE CITY COMMISSION ON ANYSUBJECT OTHER THAN A "PUBLICHEARINGS"AGENDA ITEM. NAME: ~~~(~ r Please Pri t ( ) ~.. ADDRESS: ' (Please Print) CITY: j~ ~ /1 ~~ '? " 1 /~ ~~ `~ STATE: ~ ~-- ZIP CODE: ~~~C1 (Please Pnnt) ` 'mil t~- TELEPHONE NUMBER: ~~ 7 ~~ ~~ 7 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: n _---.; 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 ON: ~( ~~ ~ I 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 giving any document(s) to anyone on the dais, the "Original" must be given to the City Clerk as tl:e "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. L ~-~, ~-f h~~- DATE: _ , ~ ~,~ Thank you for your participation.