HomeMy WebLinkAbout10-03-2024 PZ AttachmentsfEBASTIAN CITY OF SEBASTIAN SPEAKER CARD AND AFFIDAVIT
(Please Print- * Asterisk Denotes Required)
*NAME: a P—(./ � i I-C-. I,/- -e ,-
*STREET ADDRESS: 7 3%_ L le il�_' IC_NU') A
*CITY 4% IV *STATE �L : *zip 3a ps3
CONTACT PHONE:
CITY RESIDENT: ES NO CITY BUSINESS OWNER: YES / NO CITY PR PERTY OWNER: YES / NO
AGENDA ITEM NO: 7 ORGANIZATION REPRESENTING: �Qr �c�kS ww,J�j�c
SUBJECT:
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AFFIDAVIT:
am aware of the rules of this proceeding and I swear or affirm, under penalty of perjury, that
all statements an info�rwm tion that I provide in this matter will be truthful.
*Signature:+�J�
Proceeding Speaker Rules:
- Complete card prior to introduction to item
- Hand the completed card to City Clerk/Secretary
- Speaker will have 5 minutes to address the subject
- Additional time may be extended if speaking for an organization or applicant
- Speakers will be called upon by the Mayor or Chair
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SEBASTIAN CITY OF SEBASTIAN SPEAKER CARD AND AFFIDAVIT
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(Please Print- * Asterisk Denotes Required)
*NAME:
*STREET ADDRESS: % 3z /-t- _ (¢
*CITY *STATE !C5�L- *ZIP L-2 958
CONTACT PHONE: '77-2- 766 -67,2g
CITY RESIDENT:/ NO CITY BUSINESS OWNER: YES /&& CITY PROPERTY OWNER: �O / NO
AGENDA ITEM NO: % �A- ) ORGANIZATION REPRESENTING: Sc 1 d j,,r
SUBJECT: �, �t /`'1't��.v . �- �%un. kr:1 �o e ✓ �5
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AFFIDAVIT:
I am aware of the rules of this proceeding and I swear or affirm, under penalty of perjury, that
all statements and information that I provide in this matter will be truthful.
*Signature:
Proceeding Speaker Rules:
- Complete card prior to introduction to item
- Hand the completed card to City Clerk/Secretary
- Speaker will have 5 minutes to address the subject
- Additional time may be extended if speaking for an organization or applicant
- Speakers will be called upon by the Mayor or Chair