AgendaItem2I-BMRC-7-28-05 Stambaugh, Charles v AGENDA ITEM#SB
APRIL 14.2003
SEB 0 .5 2003
CITY OF ATLANTIC BEACH
BOARD MEMBER INFORMATION SHEET
NAME OF BOARD PLANIVI r/ii _&/9/-;,12
NAME OF APPLICANT/MEMBER, ( .fr?t�i'L !' �I Mr)ljrl q i
ADDRESS • — (,'r"' E,1►/ V/7 •
DAYTIME PHONE /- 2 y1 7 EVENING PHONE 1-1/2, �}oP
E-MAIL ADDRESS - i irr 7t 1.44.2 4 ri-13). LClyt FAX# Z— '/' Y) Ai
PIM*provide a brief explanation of your interest in this field and your reasons for wishing to be appointed to this
board_
/Id i9 jz 1.2g-d1/ iAN 6t-11, nilp K L.-re / .0 ,-r
r424.1,-72," /I✓ cA/1}044- Y r i yd ti 3,/)7
Al ti r &g,„4e..3i ,
Please return completed form to
Maureen King, City Clerk. 800 Seminole Road. Atlantic Beach, FL 32233