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Application- Haynie, J CEB 1-27-18 Withdrew on 9-6-19161 ' CITY OF ATLANTIC EACH OARD / CO MITTEE ME BER APPLICATION FORM Please check (Ni) the box beside each Board or Committee that you are applying to serve on. If vou check more than one. please rank your interest in each board /committee by order of priority, (A summary of each board/committee is available on page 2 of this form) "." Code Enforcement Board Pension Board of Trustees Cultural Arts and Recreation Advisory Committee DATE: APPLICANT'S NAME: ADDRESS: Lc) 5"tt t DA.YTIME PHONE C6 EVENING PHONE: t, E-MAIL ADDRESS:Je.A‘,01LL 4..,..0...‘/frA, FAX: Community Development Board Board ember Review Committee Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board/committee applying for. (?: U Cculifc L 4: 6/1, (c.1 ei c',0 L,6,6i.)666.66„,L.60, t•I'lL(L.,c4. to ;VI tl\q, 666,66666i e646. 164 ti,66.,2166L52.1, 6e6 Cu 6 6' 7. 666,66::: 664,666L,Ur 7166,66666L... „:716c6,766_,,A6—U6:64; 66:6 el 'au 6 (IL:. tj: 66/ '66,,,,Lii6113.61L.:±l'u 5666u66i C? 1,,01 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. etit /1-0,4 i esicAL tr4-0,1 ,AL.tui„ 4.04111l 61.4H1i, Please return completed fonn to Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach„ FL 32233 PLEASE NOTE: Members of the Code Enforcement Board, Community Development toard and Pension Board of Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of interest" is provided on page MO of this application. This application ‘vill expire two (2) years after date of submittal. Code Enforcement Board (Also acts as the Nuisance Control Board) Meets in Commission Chambers, 800 Seminole Road, at 6:(X pm the second Tuesday of January, March. May', July. September and November. Theboard consists of seven members and one alternate who are appointed by the City Commission and Who. serve three-year terms, The Code Enforcement Board has the jurisdiction and authority, to hear and act on ,alleged violations of the following: O City of Atlantic Beach Code of Ordinances., • Building codes, as adopted by the City. • Standard Housing Code, as adopted by the City, • State of Florida Health Code, • Florida State Statutes, and • State, county, and local laws and ordinances whose intent is to promote the health, welfare„ and safety of the citizens of the City, The Code Enforcement Board has the authority to assign penalties as provided by Fla, Stat., Chapter 162. rn mi Meets in Commission Chambers, 800 Seminole Road, at 6Apm the third Tuesday of each ,month. The board consists of seven regular members and two alternates yvho are appointed by the City Commission and who serve. two-year terms. Applications for Va,riances. Uses -by -Exception and ,rezonings are considered by the Community Development Board, The board makes final decisions on Variances and forwards recommendations to the City Commission on Uses -by -Exception, rezonings and several other types of applications, The City Commission makes a .final decision on these requests, Pension Bo, rt of Tr tee Meets in City Hall, 8.00 Seminole Road, quarterly or as scheduled. The City has two pension boards, one for police employees and one for general employees. 'The boards are responsible for the general administration, ,management, and oversight of the operation of the retirement system, Each board consists of five members. Ittiri 1 Art a crc it n Adsi r Comni` e Meets in Adele Grage Cu,littral Center. 716 Ocean Boulevard at 6:00 pm on the lburth Tuesday of each month. This committee consists of nine members who are apl sinted by the City, Commission and who serve 2 -year terms„ The duties and responsibilities of the committee include: • Develop plans. promote and support programs and projects to bring the benefits of recreation to the citizens of Atlantic Beach, O Recommend a calendar of special events, • Evaluate and advise the City on the effectiveness of programs, O Evaluate and make recommendations on assignments or requests made by the City Commission or Cil) Manager, Manager, and Evaluate and make recommendations to the City commission on requests for City funding for special events,. art projects. and recreation programs, oard ember Review Co Meets in City Hall. 800 Seminole Road, at 5:00 p 1 usually on a Thursday (when needed). This committee consists of six (6) members, The committee reviews applications and makes recommendations for the appointment and reappoinnnent of members to the city's Boards and Committees, "CSN1FL1CT SF INTEREST" NOTICE: "Part III of Chapter 112. FlaStat., is the Code qf Ethics /or Public Qtricers and Employees This Code defines "conflict" or "conflict of interest" to mean a situation in which regard for a private interest tends to lead to disregard of a public duty or interest. Fia,Stat, §112.312(8)„ The intent of this Code, in pant, is that public office not be used for private gain. Ela..Stat, §112,311(1). A "conflict" or "conflict of interest" is something !hat would ,result in a special private gain to an usually a special financial benefit. An appointed member of a committee of the City of Atlantic Beach 1.1.i.11 ,most likely be subject to the provisions of the State Code of Ethics. Disclosure of any "conflict" or "conflict of interest" should be arcade as soon as possible in the appointment process. While it may: be difficult to anticipate conflicts or conflicts of interest that may arise during future committee meetings, which should be disclosed immediately by any committee member, those known or anticipated initially, including those which others might perceive as a conflict or conflict of interest, should be disclosed during the appointment process." 2