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<br />T <br /> <br />. <br /> <br />. <br /> <br />CITY OF LA PORTE <br /> <br />APPLICATION FOR CITY BOARDS / C01\fMISSIONS <br /> <br />NOTE: <br /> <br />As an applicant for a City Board or Commission, your name, address and phone <br />number will be available to the press and the public. All other information will remain <br />confidential. You will be contacted before any action is taken on your appointment. <br />Incumbents whose terms expire are automatically considered for reappointment, upon <br />request. A member who is absent for more than 25 % of called meetings, for other than <br />medical reasons, will be subject to removal by City Council. Final decisions on <br />appointment and reappointment of members of Boards and Commissions rests with the <br />City Council. APPLICANT MUST BE A CITIZEN OF THE UNITED STATES; A <br />RESIDENT OF THE CITY OF LA PORTE; AND A QUALIFIED VOTER IN <br />THE CITY OF LA PORTE. MEMBERS OF THE PLANNING AND ZO~G <br />COl\1MISSlON MUST ALSO BE RESIDENTS OF ONE OF THE CITY <br />COUNCIL DISTRICTS FROM WlDeH THEY ARE APPOINTED. <br /> <br />DATE: ~05~" <br /> <br />Phone (H);J8' f 't 7)-~ <br />(W) 7/3- SJz.~>..ff <br /> <br />..:;~ . <br /> <br />Please type or orint clearlv <br /> <br />.I <br />Name: '-1//1/4- <br /> <br />~ 'cJl.JH~J <br /> <br />Last First <br />Address: 1.. 'l-2- OI9)i.~ J- <br />City:M]l "j.e... State/Zip Code: 77'S6 '1 <br /> <br />MI <br /> <br />Are you a registered voter in the La Porte City limits?: (J) or N <br /> <br />Did you vote in the last City election?: ~ <br /> <br />or <br /> <br />N <br /> <br />Please indicate your Dreference bv number. 1-2-3. etc. <br /> <br />ADVISORY BOARDS AND COMMISSIONS <br /> <br />Airport Advisory Board <br />V Fire Code Review (:ommittee - D i ST ( ; Cr...5" e~ place m-e~ <br /> <br />DECISION MAKING BOARDS AND COMMISSIONS <br /> <br />Planning and Zoning Commission <br />Zoning Board of Adjustment <br />Civil Service Commission <br /> <br />" <br /> <br />..:~... <br />.~ <br /> <br />SEP ARA TE LEGAL ENTITIES <br /> <br />La Porte Area Water Authority <br /> <br /> <br />interested in serving on one of the above Boards / Commissions <br />. <br /> <br />,~!2 <br /> <br />Revised April 1999 <br />