/
400%
200%
100%
75%
50%
25%
The URL can be used to link to this page
Your browser does not support the video tag.
BMRC Complete Agenda Packet 12-4-08
CITY OF ATLANTIC BEACH BOARD MEMBER REVIEW COMMITTEE December 4, 2008, 5:00 PM REVISED AGENDA CaII to Order 1. Approval of the minutes of the BMRC meeting of September 25, 2008. 2. Discuss and review the current members on the Community Development Board whose terms expire on 12/31/08 and applicants listed below and make a recommendation. (There are three members with terms expiring on 12/31/08 and no other vacancies). Current members whose terms expire on 12/31/2008. A. Lynn Drysdale B. Joshua Putterman C. Chris Lambertson Applicants for the Community Development Board A. Jonathan Daugherty B. Nicholas Dodaro C. David Jeffery D. Harieston Parkes 3. Other Business Adjoumment Note: Item 2A -F was revised on December 4, 2008. Ray Coleman and Kelly Elmore are no longer interested in serving on the Community Development Board; therefore, their names were eliminated from the previous list and renumbered as shown above. • MINUTES Board Member Review Committee Meeting September 25, 2008 Call to order The meeting was called to order by Mayor Pro Tem Mike Borno at 6:05 pm. Those in attendance included Mayor Pro Tem Mike Borno (Chairman), Code Enforcement Officer Alex Sherrer, Board Member Review Committee members Jim Smith and Glen Fisher, City Manager Jim Hanson and City Clerk Donna Bartle. 1. Approval of the minutes of the BMRC meeting of June 12, 2008. Motion: Approve minutes of the Board Member Review Committee meeting of June 12., 2008. Moved by Glen Fisher, seconded by Jim Hanson Motion carried unanimously 2. Discuss /review possible reappointments of current members of the Code Enforcement Board whose terms expire on September 30, 2008 including Juliette Hagist and Ron Pendleton. The committee members discussed the attendance of the two members as well as their contributions to the Board. Motion: Recommend reappointing Juliette Hagist and Ron Pendleton to the Code Enforcement Board for another term. Moved by Glen Fisher, seconded by Jim Smith Motion carried unanimously 3. Other business The Committee discussed the rental inspection program. The Committee set the next meeting for November 13, 2008 to address the upcoming vacancies on the Community Development Board. Adjournment There being no other business, the meeting adjourned at 5:47 pm. Mike Borno Chairman CITY OF ATLANTIC BEACH COMMUNITY DEVELOPMENT BOARD 2 -year terms; 4 consecutive term limit; per Ordinance 5 -03 -42 adopted July 14,2003 Regular meetings are held in the Commission Chambers at 7.•00 pm the third Tuesday of each month. NAME & ADDRESS EXP. DATE BUSINESS HOME / MOBILE /EMAIL Christopher "Blaine" Adams 12/31/2009 673 -7063 330 Aquatic Drive (1 term) chadams25 @yahoo.com Atlantic Beach, Florida 32233 Lynn Drysdale 12/31/2008 356 -8371, ext.306 249 -3154 1768 Ocean Grove Drive (3 term) 356 -8285 (fax) lynn.drysdale @jaxlegalaid.org Atlantic Beach, Florida 32233 434 -3154 (cell) Ellen Glasser 12/31/2009 249 -8935 421 Oceanwalk Drive S. (1st term) 472 -6262 Atlantic Beach, Florida 32233 glassere @comcast.net Joshua Putterman 12/31/2008 359 -1357 270 -2667 (home) 129 12th Street (1st term) 631 -8427 (cell) Atlantic Beach, Florida 32233 macputter @comcast.net David Boyer 12/31/2009 246 -4941 2061 Beach Avenue (2nd term) davidb1187 @aol.com Atlantic Beach, Florida 32233 Chris Lambertson 12/31/2008 348 -2803 241 -5251 2038 Beach Avenue (2" term) 241 -0146 (fax) Atlantic Beach, Florida 32233 Kirk Hansen 12/31/2009 910 -9660 2393 Ocean Breeze Ct. (1st term) 241 -7859 Atlantic Beach, Florida 32233 241 -7786 (fax) Schmirkley @bellsouth.net Alan Jensen, City Attorney 246 -2500 AJensenLaw @aol.com 935 North Third Street 246 -9960 (fax) Jacksonville Beach, Florida 32250 Sonya Doerr, Planning Director 247 -5826 sdoerr @coab.us 800 Seminole Road 247 -5845 (fax) Atlantic Beach, Florida 32233 F: (City Clerk\Comm., Bds. & Committees\CDB Members (1- 1- 08).doc Community Development Board member attendance - 2008 Meeting Blaine David Lynn Ellen Chris Kirk Joshua Date Adams Boyer Drysdale Glasser Lambertson Hansen Putterman Absent (Had a 01 -15 -08 prior Absent Present Present Present Present Present when appointed.) 02 -19 -08 Present Present Present Present Present Present Absent 03 -18 -08 Absent Present Absent Present Present Present Present 04 -15 -08 Present Present Present Present Present Present Present 05 -20 -08 Present Present Present Present Present Present Absent 06 - 17 - 08 Meeting cancelled; no business. 07 - 15 - 08 Present Absent Present Present Absent Present Present 08 - 19 - 08 Meeting cancelled; no business. 09 -16 -08 Present Present Present Present Present Present Absent 10 -14 -08 Present Absent Absent Present Present Present Present 11 -18 -08 Present Present Present Absent Present Present Present (excused) 12 -16 -08 Attendance record meetings meetings meetings meetings meeting meetings meetings missed missed missed missed missed missed missed c c c c c c :::::::o 0 0 0 0:> > : ::0 0 0 , .::::;o 0 o' > c c c 3 3 3 3 3 < : c •C ( a - •':> n> v v w v v v »; : 3 3 3 3 3;;'! m m m< >:: a '''''; y : ' DDDDDD «<� 0 0 0 ; m o .... N Cn N Cn co (7) ::: C C) C) C) ::::::::::: 0 i»h::: 2 :::::::> S?o S?o S?o S?s' S?o x• ::: ; :: > : ' .::: 0 D C D CD CD p :::: >:;::::: CD (D (I :: : : : : : :'.::> (D 3 :: a) :: : ;:;:;: CDCDCDm:::: >:: > : 3 33 5 :: : C A D C ( C 0 ( ` ?% : CD CD CD CD CD 5. = 3 5 D .4%. 0f! >i v co 0 : : DDDDDD::: 3 3 3 3 3: ; ;; 0 0 0 >: >:: i,::: a) >:<:>:: a a a a a a ::: (D (D (D (D (D ::::: > v a) :: :;.. 0 0 0 0 0 0: <: > << co 00 0o CO oo; '.1 ° ti<; : >� : ° ° co v m a) „ „,: ::: >:: 3 0.i;::: 333333;:' c ° D ' >::3 3 3 3 3 3 :!::< :: !: ED i: :<: (D D : CD CD CD CD C:: :: : ?:> 0 CD CD (D CD CD '....:::.g :.: III 0.. • * 0 0 (15 Z c- 0 ."....:::::::: 71/4 -h -7 8- ,:::::::::::::. s. . =::::::::::::, i Z 0 S =0 Z z :::': D o :::: : CD O N * 0 i: < CD C O :: ::: N C) O C M i•••••••••::::::: a) C') N ::;1;:;! ( 0_ CD o :;: ii: 0• o 0 •••:-.;::;:::-. ((D :::::«;: :::: >:::::: d co n.)::::::::::::: W co D ca N is :: — — N 0 N ::::: W N N \ N O : >::::: .- -+ ° N ::: 0 ° N :::::> N n 0:::<: ::::: : :. : 888 S? o0 ::::: - S? > >:: >::O O O co co O O O< O O O O :::;:: v 0 :: >::::: CO 3 N W W a1 Ca 1i : 0 0 CD O 3`>: >': >: >: > 0 co 0) co W W N: N N N N O >::< O N 0 :::: ::: co : :: :: >: --... W W W co co 0 : ;.; :;:::: � W W W� > : > :: � N 00 : >:::>: 0:.;:.;: :: N N N N : N N N N ::: >:? ::: N N 0 : ::::: v .. 0 :;: D:::: >::::: o o o 0 0 >:::: O O 0 00 D O 00 n (D m N co N N N O ”" N Ni:i :: O - N Ni i i i:• N 0 0) O O V Q) N : :;: N N N ■ N_. » : - N >:::» N N N N N : > :::: : N N N ::: ::r N N N ::: >:: N y O :: O O O O O N :: `: N N N o 0 ::: O o _.,0 : :>: >:: O ,.. 0 :: >: O O O 0 O 0 .... O : O O O O O O > : : : : O O O O O :::<::::: (D O O > O O CO : ::: :: ::: CO CO O � / �E�° c° v.k �-, E0 co / a Z. 7 ° r c / mk 2 l''' d c © E o ° = b 2 ƒ J » tu c c (D co 3 f C E g ƒ \ 2 § @ m $ 2 m - 0 2 \ § q CD - 0 I, o -4 \ 3 \ k co o — a. 0 0. « @ 3 o D CD ƒ g 0 O ■ g F. CD CD co 3 0 Cr a iv @ m 'Si,' o \ \\ k g cD cn 2 a CO Es CD / / 0) CA § § - \ § El. 0. /§ — — (0 t (1 �• cn @ ■ ■ 2 2 ■ k Cr CD CD CD - CD CI ƒ ƒ ƒ cD CD Z $ % % % k � k k k « a _ Zr) -, « � = k / 0 3 ° 3 - ) ( E ƒ 7 k k * \ ) ] ] ] . « § N -, § « h / g 2 — § 2 a 7 g § — 3 CD " —1. X X X X X rn § w& w a) a.0 w \ a w w m / / // 0 0 - \ k) kk « OD CO CO § 2 = o Z Z Z 3 - 3 ƒ� 2 3 / - 3 - c 3 2 c 2 - 0 z a z 2 —m ss. . 5 E c5 -< -< -< 0 / '' 0 CD-1 =0 (0 _ /CD- /ƒ -I = t y 2 m 2© CD to m Z -0 co Z E E Z -0 E Z -0g 2 2 f a • a . a — . a . CITY OF ATLANTIC BENCH BOARD / COMMITTEE NIEMBER APPLICATION FOItM FEB 0 7 2008 Please check (ti) beside each Board or Committee that you are applying: to serve on: (A summary of each boardicommittee is available on page 2 of this form.) OIFICL Ot! .! Hi_ ; CLLRK / Code Enforcement Board / Community Development Board Pension Board of Trustees / Tree Conservation Board / Cultural Arts and Recreation Advisory Committee Board Member Review Committee APPLICANT'S NAME: To/k OcA v {tee ADDRESS: U 36 /1 /Z/ 5 (U S S . DAYTIME PHONE: yam-, - b q_ ?7 EVENING PHONE: -S f' E -MAIL ADDRESS: / G/vii vrl c1 Q 1■6'4 : kw^ FAX: it/ /,4 Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board/committee applying for. j cAve 1,,Jor kfc/ /A //e Ca/►1/"1 �f'c�� It•Chr) c-c,►c'i /e Iii ci 12 /c/ / c, r 4e /G 5-/ ? yCa lrs 1 c�.� c urren.I a te. (/* (-16 v cc i cs.� 07 Lfc. c /rt� Q d ve% vr►r,► "gr A AC. kt.v r t a J ;5 ry 0 1 \ Q AlePf' Or �C c,.�� cLes /vet ' wGA, S jai) it /6C C A es-te t 'kJ cA r. . l 4'4.1 dC G rU�� �-� c. �o 4/o0 { peo to 4.7 . / ' J f y dkv(Z k f Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons for wishing to be appointed to this board/committee. y / / // ecoi j /1d r 41 f�c,d cP „tr,�tt:. „ /7 //1 /4/4: t c ,e! r / /Ace -th t 1�ov -k t c />'il t 7/a ,ir► c4e �y se /g Q u r % 7 ck4 y seriAc P /`r° u.is c c.7` 1 e . Please return completed form to Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 1 CITY OF ATLANTIC BEACH BOARD / COMMITTEE MEMBER APPLICATION FORM Please check (V) beside each Board or Committee that you are applying to serve on: (A summary of each board/committee is available on page 2 of this form.) X Code Enforcement Board Community Development Board -._- Pension Board of Trustees 1 Trc..v Conservation Board Cultural Arts and Recreation Advisory Committee APPLICANT'S NAME: Nitc.H0LAS ADDRESS: 5 (721 Sr . DAYTIME PHONE: c lC i A - 24c EVENING PHONE: E-MAII. ADDRESS: nacc\c&ro e vtcrivvvat • CD •16 FAX: C) 43L-l Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board/committee applying for. 1 believe 1 have the knowledge and experience base to assist in many issues relating to either the Code En iiircement Board or the Community Development Board. First. I am a Board Certified Emergency Medicine physician. trained here in Jacksonville. As such. I will be comfortable relating to issues of the Florida State Health Code. My camaraderie with many of the current leaders in the medical community may also benefit our efforts here in Atlantic Beach. Additionally. I was the founder (and CEO) of a small real estate investment and development company in Myrtle Beach. SC. From this experience I have gained a modest appreciation and understanding of housing and building codes. zoning issues. and the like. Finally. I have been chairperson of several committees in large hospitals, giving me experience in the challenges of leadership and successful navigation of complex issues involving diverse groups of people. I would be happy to elaborate on the details of these experiences arid how the may allow me to effectively serve the community of Atlantic Beach. Please provide a brief explanation of your interest or any special qualifications you have in this field and our reasons for wishing to be appointed to this board/committee. - — My interest in serving on one of these committees stems from my appreciation of the Atlantic Beach community and a desire to be involved in that (my) community. For me, long-term commitment to a place. or a job, or a hospital. is born from involvement. In that way. I become a part of it's present and it's future. rvly special qualifications include: (1) my medical background, providing technical, scientific, and practical knowledge: (2) my familiarity with hard work. long hours, and commitment; (3) my ability to work with all walks of people. from CEO's to laborers. smoothly; (4) my understanding of business. finance. and commerce obtained from my family and developed in my "non-medical" endeavors: (5) my flexible schedule that affords me many days (adoring the "work week" to help complete the work of the Board. meet with contacts. etc. I feel that I have a lot to offer either of these Boards and to the leaders of our community. I wish. truly, to participate in the work of keeping Atlantic Beach such a great place to live. Thank you r teasc return compieteu 101111a, Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach. FL 32233 January 31. 2005 Donna 1.. Bussey Cite Clerk 800 Seminole Rd. Atlantic Beach. Fl. 32233 Re: Board Member Application ls. Busscy. lkilo. 1 hope this letter finds you doing welt. 1 have enclosed a completed application for Board membership in Atlantic Beach. 1 hake also enclosed a copy of my Curriculum Vitae tRcsnrno fi)r turther details ifneede.d. If you have any questions at alt. please don't hesitate to contact me at any of the numbers listed below. 1 look forward to hearing from you. Respect fully . - ? Nicholas R. Dodaro. M[). FACIP 373 Twelfth St. Atlantic Beach. FL 32233 904 -249 -4349 (home) 843- 260 -4750 (cell) ndodarydhotmail.com Chairperson: Pharmacy and Therapeutics Committer I Mc! -eat -- 2004}. Chairperson: Design and implementation of new written ED chart (McLeod -- '003i. Director: Scheduling Committee (Shands Jacksonville - 19991. Director Lecture Information Services (Tulane Lnisersity 1495) - Participation: Slemher: Physician Leadership Committee for the lmcrcency Dept (Mcl.end). Member: Chest Pain Center Development & Implementation Team IMcLeod). Member Chest Pain Ohsersation Center Comm ittee1McLoodi Member: Hospital Vision and Mission Statement Deselopment Comm tALLeodl. \lemur: Hospital Computerized Provider Order Entry Committee lerli 1`31/2005 12- 03 -'07 12:03 FROM- Medical Life Inc. *909 -854 -7912 T -331 P002/003 F -676 Nicholas R. Dodaro, MD, FACEP 373 Twelfth St.. Atlantic Beach, FL 32233 homy 9042494349 cell: 9042534293 enaaii: adedao.cmciatcreiau.com Professional Positions August 2007 — present Chief Medical Officer Crucial Care Jacksonville, FL December 2006 -- present Owner / Co Founder Crucial Care (Medical Life, Inc.) Jacksonvilk, FL December 2006 — present Lab Director Crucial Care Jacksonville, FL December 2004 — present Physician, Emergency Department Emergency Resources Group (ERG) Baptist Hospital System Jacksonville, FL Staff Emergency Medicine Physician December 2004 — present Clinical Teaching Physician (Emergency Dept.) University of Florida Shends Jacksonville Health Science Center Jacksonville, a Staff Emergency Medicine Physician December 2004 — Dec. 2006 Physician, Emergency Department The Schumacher Group Putnam County Medical Center Palatka, FL Staff Emergency Medicine Physician July 2001 — December 2004 Physician, Emergency Department McLeod Regional Medical Center Florence, SC Staff Emergency Medicine Physician Certifications Diplomat American Board of Emergency Medicine Fellow American College of Emergency Physicians Education Leadership 2007 - present Leadership Develop Program Work Systems Associates Hal Resnick, PhD, MBA Residency 1998 — 2001 Emergency Medicine Iof? 1 2/3/2007 12- 03 -'07 12:03 FROM - Medical Life Inc •904- 854 -7912 T -331 P003/003 F -676 University of Florida HSC, Jacksonville Internship 1997 - 1998 internal Medicine Oeorge town University, Washington, D.C. Medical School 1993 - 1997 Tulane University New Orleans, LA Doctorate of Medicine (M.D.) Undergraduate 1989 - 1993 Tulane University New Orleans, LA BS Environmental Biology Leadership Pounder: Crucial Care President: Qualified Emergency Group, PA Secretary: Medical Life Inc. Chairman: Physician Recruitment (ERG) 2005.2007 Chairman: Pharmacy and Therapeutics Committee (McLeod) 2003- 2004. Chairman: Design and implementation of new written ED chart (McLeod). Par k4.vk m: Member: Volunteer Physician for American Red Cross Disaster Services Team (Jacksonville, FL 2006 - present). Manbet: Physician Leadership Committee for the Emergency Dept (McLeod). Member: Chest Pain Center Development & Implementation Team (McLeod). Member: Chest Pain Observation Center Committee (McLeod) Member. Hospital Vision and Mission Statement Development Conunitwe (McLeod). Member: Hospital Computerized Provider Order Entry Committee (McLeod). Professional &gmMhuttars American Collage of Emergency Physicians.. American Medial Association. Florida College of Emergency Physicians. Persosai Date of Birth January 20 1971 Status Married to Canty Dodaro Children Ian (4 y.o,) Oia (2 y.o.) Hobbies Wine. Computer Technology. Travel. Art. Rs vrencv Available upon request 1 oft 12/3/2007 12-03 -'07 12:03 FROM- Medical Life Inc. .904- 854-7912 T -331 P001/003 F -676 IIIII CRUCIAL CARE TNI1 ENCY NROICINC DOCTORS 11048 -9 BAYMEADOWS RD JACKSONVILLE, FL 32256 PHONE 904 -854 -7911 FAX 904 -854 -7912 TO: Cit of Atlantic Beach FROM: Nicholas R Dodaro ATTN: Nancy FAX #: 904- 247 -5846 PHONE#: PAGES: 3 Including Cover MESSAGE: If you have received this fax in error, we apologize and please notify sender. I CITY OF ATLANTIC BEACH t BOARD / COMMITTEE MEMBER APPLICATION FORM 1 , 1 ; ,, , , Please check (v') beside each Board or Committee that you are applying to serve on: NOV 1 1 2901 (A summary of each board/committee is available on page 2 of this form.) _' Code Enforcement Board 1 Community Development Board Pension Board of Trustees Tree Conservation Board Cultural Arts and Recreation Advisory Committee i Board Member Review Committee APPLICANT'S NAME: .G(1 • E) DLO re_ ADDRESS: t 7 F A'AltilV 6 DAYTIME PHONE: 9 c f . • 21--6, - 11 ' ONING PHONE: log- 33. 743 E -MAIL ADDRESS: i iiie o y -:o e G6Y ; FAX: 'Pt- 2-1 - }33S2__ Please explain any employment experience, board/committee experience, and /or community volunteer experience relative to 6,,c board/committee �� for. - G ' ' 2 , t7 5 GOwVV.i44ec- ' r - 6411 OF k54711 'h vi l(e 2oc 3 - 2V05 , eanyA WV.ii44' r' - i U 4). - 1}n ki t - 41i fi 'vevel �-ii . Zo o2 - 2-e0s I f'- Ewa w1Pi� - • v - - - G - ZOO Z- b re fG� , + _5 . C4c4rd w - - 5r 5C eF J A ¥;l(e / t% f0 p - (Q . ✓A- ►1 '-- c7'e(44i4._ —n e✓'i €j ze x _- •c) 3 7. IX/- .us, Lid- /i$J t y • A - ` Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons for wishing to be appointed to this board/committee. / _ 4441 4 t r * e2t1 9 LCc i,,ctg e-- 7��;►'- lecf - G 7 5 5 €d' Wet( u & _ (vt. fit - A la/ ku ✓balA de ; 0-04 ill ' • - O - - 150e5. / 11 A-ve pe sv 4 re rt, )-i s A,,,, d t/a. -j 7 n r e tad 4 % s,-cd w1 -111 C✓b fi orb - 4.-r ci--s r .,4 Llvev/ rela✓1t�t.q vr4 des/ h 96 Gad. 1 � `fi�. . 0 1 , y 1 r i - t - P t (.1- 4 £ - t0 5 r!v' deis- ..cctiz ; ' 4 -/-r �l eAl *P5 d. � ,✓f x 67 TSStAeS b)'t�t/ &: re- - Me 6 P13. Please return completed form to Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 1 CITY OF ATLANTIC BEACH BOARD / COMMITTEE MEMBER APPLICATION FORM Please check ( '1) beside each Board or Committee that you are applying to serve on: (A summary of each board/committee is available on page 2 of this form.) O Code Enforcement Board liet ommunity Development Board ❑ Pension Board of Trustees ❑ Tree Conservation Board ❑ Cultural Arts and Recreation Advisory Committee APPLICANT'S NAME: ) 4 Y (. L . I ��r� Z y' ADDRESS: r4 $! •..1 ,tj<�c -C"" 1 Art- Aq Cij �ZZ�3 DAYTIME PHONE: 1 , EVENING PHONE: ---- E -MAIL ADDRESS: Chi di 9j Q/ i FAX: Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board /committee applying for. Si{N .ts'C0 Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons for wishing to be appointed to this board/committee. / I-.V Ceuiva -n/T /-'r77 -/ THE c!7 1.1 42V /, s/ & /t S �✓Y =.tJ!` it�vd yr ji,� �-!TF) /A) no ` °S[D s ttir�.c �- / /y.�.Ir- - -- . �� l • i L. it - G ../ f f7 h*f LL//7 f� Affvef litG19f A-r cd,u77C - 7-0r wJ) .04,14 42,00 Al .9� 14,'J CH Q Cbpi -Z 7T/ /A/e 7M -r r c44) 4:04-0y ve�a JMb4!4,.J2 isv , ye tic AvEsx5 Dec /0/AJ r r AGO #R Crry Zvi r 1.vn)j( /r. c,L . / b Ci A. Please return completed form to Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 1 CITY OF ATLANTIC BEACH BOARD / COMMITTEE MEMBER APPLICATION FWI Please check (v) beside each Board or Committee that you are applying to serve on: NOV 1 2 2007 (A summary of each board/committee is available on page 2 of this form.) C)1E1(l!?1 �kE (LIPS. Code Enforcement Board Community Development Board 1 Pension Board of Trustees C! Tree Conservation Board Cultural Arts and Recreation Advisory Committee L! Board Member Review Committee APPLICANT'S NAME: 'A ADDRESS: t b a 1t�7OL� t� DAYTIME PHONE: 4(2 EVENING PHONE: E - MAIL ADDRESS: {A 'aeir.. �( ��,��, �p � — Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board/committee applying for. t O �,2c,ta-1`r (N(�c \ R 0T- t.Ae -KA SI2.- mo t `' �T� Qr��� Z-.N.A Please provide a brief explanation of your interest or any special qualif cations you have in this field and your reasons for wishing to be appointed to this board/committee. M. co �C )1..cv END U3 \ ) t - e l ..A. � - 0 - 3 cl\ V\c2.-k), 1 ice_ Coo l • CA: c c.)r,2,c , — Please return completed form to Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 1