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<br />. <br /> <br />e <br /> <br />CITY OF LA PORTE <br /> <br />APPUCATION FOR CITY BOARDS I COMMISSIONS <br /> <br />Please tvDe or nrint clearly <br /> <br />Name: bAc..~'C.T' R ~L\>\'o\ <br />Last Fsm ~ <br />Address: \ ;lo.. \ rJ ?" ~~ \ "} (E ~ <br /> <br />City: \:.J... \) C.J9... ~ State/Zip Code: \"It <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 reappoinanent, 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 enmmiqions rests with the <br />.City Council. APPUCANT 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 ZONING <br />eOMMISSION MUST ALSO BE RESIDENTS OF ONE OF THE CITY <br />COUNCIL DISTRICTS FROM WHICH THEY ARE APPOINTED. <br /> <br />DATE: ~ - \ 0 ., ~ODD <br /> <br />( R .:f"JPhone (H) :J.B\ -4'\ \ .~L, J <br /> <br />MI (W).J..'&\ - 4~, - 5~ 8') <br />~r\ <br /> <br />~ <br /> <br />NOTE: <br /> <br />".'5:) , <br />Are you a registered voter in the La Porte City limits?: (!) <br />or ~ <br /> <br />or <br /> <br />N <br /> <br />Did you vote in the last City election?: <br /> <br />y <br /> <br />Please indicate your oreference bv number. 1-2-3. etc. <br /> <br />ADVISORY BOARDS AND COMMISSIONS <br /> <br />Airport Advisory Board <br />Fire Code Review Committee <br /> <br />DECISION MAKING BOARDS AND COMMISSIONS <br /> <br />~ Planning and ZcmiDg Commission <br />Zoning Board of Adjustment <br />Civil Service Commission <br /> <br />..~~s <br />.. <br /> <br />SEPARATE LEGAL El\frru.c5 <br /> <br /> <br />Porte Area Water Authority <br /> <br />undersigned am interested in serving on one of the above Boards 1 Commissions <br />. led. · <br /> <br />- <br /> <br />--.............'-. <br /> <br />L.\ - \ 0 - ::J..fYY) <br />I)arr: <br /> <br />levised Aprill~ <br />