HomeMy WebLinkAboutPublic Comment Card CC - 07/16/2013MIl~ToGN \t
.'" E.5 TABLISHED 2006 ,. '.. '
AFFIDAVIT FOR REPRESENTATIVE OF
HOMEOWNERS ASSOCATION, ORGANIZATION, OR GROUP AFFILIATION
J, ~~A t-.1 ,do hereby warrant and represent that J am a member of
the JiiN 1\IcC6 PCA-and in that capaci Q:. have been duly authorized
by this organization to speak on behalf of the organization before thcc:ity CounciO P lanning Commission, or
the Board of Zoning Appeals of the City of Milton with respect to Zoning Petition(s) #'g.ZJ3-1'-f;
tlr #.e. , 'T&JJ I~'Ull3./ itSJ..w-·a:J ~I-vld /YIuf,"JI '
This )'5 day of :J:bj , 20 I ~
~ ~~----------
ETED BY NOTARY PUBLIC ONLY:
State of Georg' J
County of ~1,n
On this ,sJ!. day of~______ 20 /3'1k~/,v:..o...lp/-.+---"
----Jl----'~o~nf.&.,.f___ '---=-----------~...:,)fC-"'Lu\:..EL-.LO.r--'d'---'-'n personally appeared before me,
_~_,Who IS personally known to me ,
__ Whose identity I proved on the basis of ___________
L Whose identity I proved on the oath/affirmation of !obyN. m~ible witness .
Sworn to ~~MJ!~iJ before me this /tflL day of ~fA.,' '20/3 '
:\" e. A M G I" ~ ~ ~••••.••.• 0 ~ ,/ /Notary!~~~OtI.MISS/"o;;{<>~ 'I/} ~~ ~ NOr4~ ~•• -z.... t/ ( =en ",,>,.4~::: i I /My C ' si&n ~lfWt. -i;-:-#'--'-.--Z:....:"'~. ~_____i£~ "So "\~-~LIC ... '"~ ~ .~"... •• r-::-~ CO···.. 2e . 20'~.·· n,.'-J ~(SEAL)~ ;,,, ~ •••••••••'!f:,O""f..",'
'I'll 'Nry GIII,,,,',,,,,'\",
This form is to he filed in the OFFICE OF THE CITY CLERK, City ofMilton, 13000 Deerfield Parkway,
Suite 107 AlB Milton, Georgia 30004.
nr ...;ie.. rlcord /?1r . VK'lC~1
/'115 U)('l-tF/f-trD f &ifc..u.-t<cl
.er1'1 A!fi?AVi + -I-D 11rsen f .A1,./t().'fl 'R.ALC. 1nA-.
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Date:
or
-f2/~-Ju -~r-YtPUBLIC COMMENT CARD (Please prin t & fill in coJJ pletely) Vt,
(Circle One) ~
p ubrc Comme nt I A enqa Ite m No . 1 Zonina Case No. : 13 I" 't
~Z 13 ~/Lf
I am a Milton res ident . N Yes 0 No
I am a Milton bus ine ss owner 0 Yes 0 No
Phone No . 6~L..f::.!l:lL~.1 "'~_:~· ~.:...:O (,~_"7"""""~==~~_ . ,--''r-
a l oe allobbyist duly registered with the State Ethics Comm~io n 4-'
Group Affil iat ion (if any) 0 Ap pli can a pa;d rep ' spn ;ve o f e;the"h6~'fj)'ft~L ~
or neighborhood ilOther
Check wha t may apply :i'l w ish to speak or I do not wish to speak, but want my comment s re ad into the record .
Comm'ent Card Instructions:
1. Complete the ca rd including ca se number, you r name, address, and phone. number;
2. Submit the card to th e City Clerk staff
3. W hefl your name is called and you wisb to spea k. approach the podium spe~king directly into the microph~ne sta ti ng your n.am e and addres s for the re cprd: . .
QuesUon/Com:..:.:m e n:.:"'--_f--___________~--..;...~______
~::.:t;:_-'--_______-:"'_________ ~_
If rezoning hearing (only) check what may apply: NO"Within the (2) years immediate ly preceding the fili ng of this
z:onin
meeting . Purs uan t to C.C.G.A. § 36-67A-4, knowi ng failure t o com ply with this requi re ment constitutes a misdemeanor. Accordingly, an ind ividual
who has made con tributions exceeding th e above amount within the past two years wh o has not complied with this d isclosure requ i re m ent is
strongly adv i se d not to parti cipat e i n pu blic comme nt oppos i ng the application.