HomeMy WebLinkAboutPublic Comment Card CC - 02/12/2018 - Scott Fields - Providence ParkM 1 LTC) N'�
PUBLIC COMMENT CARD (Please print & fill in complete/ ESTABLISHED 2006
Instructions:
1. Complete this card in its entirety (DO NOT leave anything blank)
2. Give the card to the City Clerk BEFORE THE COUNCIL MEETING BEGINS.
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:
111 would like to make a General Comment that does NOT pertain to an Agenda Item or Zoning Case. (skip to Toda.y's Date)
,eTI would like to speak about an Agenda Item or Zoning Case. **(Please indicate .agenda Item No. below)**
Agenda Item No.:
Zoning Case No.: % r,
TODAY'S DATE: //Z / If"
NAME: fi F I c ur).
,
ADDRESS: (�1 � � � u t (LC P, N -C -
PHONE:
Please check ALL that apply:
❑ I am in SUPPORT of this Agenda Item
❑ I am in OPPOSITION of this Agenda Item
❑ 1 am a Milton resident
❑ 1 am a Milton business owner
❑ 1 am a local lobbyist duly registered with the State Ethics Commission
❑ I am a paid representative of either the support or opposition
pf am affiliated with a Group or Neighborhood*** Name of Group/Neighborhood ✓fir e
***You are required to fill out an Affidavit before speaking on behalf of the group you are r presenting.
want to speak about this Agenda Item �ii�r•+ /055 C> sou✓ o G'r1�'��1 1 f
❑ 1 DO NOT want to speak but I would like the following comments read into the record: Veri/`�1
sir- Fiut3 ., V 1
(Please use the back of this card for additional writing space.)
**Please read the following RULES regarding Public Comment:
• Public Comment is allowed on an Agenda Item or a General Public Comment can be made about something 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 minutes. This 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 TOTAL of ten minutes. This means that ALL
people who wish to speak in OPPOSITION have a total of ten minutes as a group.
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If you have made any campaign contributions to a Councilmember aggregating $250.00 or more, please
check "ves" or "no" : []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.
HOME OF ` 'IFR FS T r?UALITY OF LIFE IN GEORGIA'
M I LTON4t
ESTABLISHED 2006
AFFIDAVIT FOR REPRESENTATIVE OF
HOMEOWNERS ASSOCATION, ORGANIZATION, OR GROUP AFFILIATION
do hereby warrant and represent that I am a member of
the and in that capacity have been duly authorized
by this organization to speak on behalf of the organization before the City Council, ,
of theCity of Milton with respect to f s}#-�JbY'�. ,�2 S S i6/V
p Feb . [26Z.Za, �,�.� - - •.. ____ 1�,'sc > > o.J of ro�� d�-e„L< ?Ar IL
This % 2� day of rC d2 uNt / , 20 %8
Signature
TO BE COMPLETED BY NOTARY PUBLIC ONLY:
State of Georgia
County of
On this day of F rI&AY–LA 20 �g ,
personally appeared before me.
✓ Who is personally known to me.
Whose identity I proved on the basis of
Whose identity I proved on the oath/affirmation of , a credible witness.
Sworn to and subscribed before me this /Z--)X—day of F ,
ry G% �'/moi/�' / g pj'U
Nota Public: �� 43C
My Commission Expires: 2 �O • d �' �/ _ ��- Tr
(SEAL) ,GBS IG�,�''
This form is to be filed in the OFFICE OF THE CITY CLERK, City of Milton, 2006 Heritage Walk, Milton,
Georgia 30004.