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<br />NOTE: <br /> <br />e <br /> <br />e <br /> <br />CITY OF LA PORTE <br /> <br />APPLICATION FOR CITY BOARDS I COMMISSIONS <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 Conunissions 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 ZONING <br />COMMISSION MUST ALSO BE RESIDENTS OF ONE OF THE CITY <br />COUNCIL DISTRICTS FROM WlDCH THEY ARE APPOINTED. <br /> <br />DATE: <br /> <br />~ 12/20Do <br /> <br />Please tvDe or orint clearlv <br /> <br />Last <br />Address: ~52{O <br />City: \.0. QQ-< ~ 2 <br /> <br />Name: <br /> <br />1:xl\dw IN ~<nQ.'Q L <br />Gr \aQw L\ ~~t La. n e., MI <br /> <br />Phone (H) 2~' cr 30 l<:fer I <br />(W) 113 ~I~ ~-Ul <br /> <br />State/Zip Code: 11 51 I <br /> <br />Are you a registered voter in the La Porte City limits? =0 or N <br />Did you vote in the last City election?: 0 or N <br />Please indicate vour preference bv number. 1-2-3. etc~ <br /> <br />ADVISORY BOARDS AND COMMISSIONS <br /> <br />Airport Advisory Board <br />Fire Code Review <.:ommittee <br /> <br />DECISION MAKING BOARDS AND COMMISSIONS <br /> <br />/ Planning and Zoning Commission <br />Zoning Board of Adjustment <br />Civil Service Commission <br /> <br />SEP ARA TE LEGAL ENTITIES <br /> <br />La Porte Area Water Authority <br /> <br />I the undersigned am interested in serving on one of the above Boards / Commissions <br /> <br />as:cat~. ?/5/,J()OO <br /> <br />SiguaD1R: of Applicant Date <br /> <br /> <br />Revised April 1999 <br />