HomeMy WebLinkAboutPublic Comment Card CC - 06/07/2016 - Public Comment Card 06 06 16' "'
PUBL:IC COMMENT CARD (Please print & fill in completely)
Instructions:
1. Complete this card in it s entirety (DO NOT leave anything blank)
2. Give the card to the City Clerk BEFORE THE COUNCIL MEETING BEGINS.
HOM E OF ,-
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3. When your name is called , approach the podium and speak directly into the microphone and state your name and address .
Please complete the following information:
·~
~would like to make a General Comment that doe.s NOT pertain to an Agenda Item or Zoning Case. (S kip to Today 's Da te)
/TI I would like to speak about an Agenda Item or Zoning Case. **(Please indica te Agenda item No. below)**
Agenda Item No. : ______ _
Zoning Case No. : ______ _
TODAY'S DATE: ------....,.-..-;1----
L ~--'re.__ Q\e-fA&~ n ) NAME:
ADDRESS: /D fi>_ Z> 8 . (M'l 1~~ I~
{ty\ L) ~ 3uod)~
PHONE: ______________________ _
Please check ALL that apply:
o I am in SUPPORT of this Agenda Item
D I am in OPPOSITION of this Agenda Item
7 1 am a Milton resident
o I am a Milton bus iness owner
o I am a local lobbyist duly registered w ith the State Ethics Commission
o I am a paid representative of either the support or opposition
o I am affiliated with a Group or Neighborhood Name of Group/Neighborhood __________ _
o I want to speak about th is Agenda Item
o I DO NOT want to speak but I would like the following comments read into the record :
(Please use the back of this card for additional writing space .)
**Please read the following RULES regard ing Public Comment:
• Public Comment is allowed on an Agenda Item or a General Public Comment can be made about someth in g that is not
on the Agenda .
• NO Public Comment is allowed regarding Consent Agenda Items or First Presentation Items.
• All General Public Comments are allowed a total of five minutes .
• ALL Public Comments in SUPPORT of an Agenda Item are allowed a TOTAL of ten m inutes. Th is means that ALL
people who wish to speak in SUPPORT have a total of ten minutes as a group.
• ALL Public Comments in OPPOSITION of an Agenda Item are allowed a TOT AL of ten minutes. Th is means that ALL
people who wish to speak in OPPOSITION have a total of ten minutes as a group.
If you have made any campai n contributions to a Councilmember aggregating $250.00 or more, please
check "yes" or "no" : D Yes No.
When you have completed this card, please give it to the CITY CLERK before the meeting begins.
Please see the CITY CLERK if you have any questions regarding this Public Comment Card.
•
.• >
AFFIDAVIT FOR REPRESENTATIVE OF
HOMEOWNERS ASSOCATION, ORGANIZATION, OR GROUP AFFILIATION
I, L {;(_v r 0..... ~~ r ' do hereby warrant and represent that I am a member of
the P 1 e ~'1 u L ~" ..,. (!,\.. \ fV\ \ \ ~ and in that capacity have been duly authorized
by this organization to speak on behalf of the organization before the City Council, Planning Commission, or the
Boar~f Zoning App~ls of the City of Milton with respect to Zoning Petition(s) #
G~~ l.... <~ /YY."'\c<_ X\_. ~
This-~-day of ~20 I l?J
d e~Y ~
Signature
TO BE COMPLETED BY NOTARY PUBLIC ONLY:
State of Georgi ~ 1 County of rWJ fl>/11
I -n.f. rl; .A A /1 On this <I J.J-J-day of _~J~~~-"--_______ , 20 V!1
_ _,ltneM~-'-'-"---=-...__--~-=-=-~41<-'---'-'~-----------personally appeared before me .
~s personally known to me.
__ Whose identity I proved on the basis of ___________ _
(SEAL)
This form is to be filed in the OFFICE OF THE CITY CLERK, City of Milton, 13000 Deerfield Parkway,
Suite 107 AIB Milton, Georgia 30004.