HomeMy WebLinkAboutCitizen Comment FormsREQUBST TO ADDRESS
CETV COMMISSION AT R.EGULAR
OR. SFtrC{AL ]WEETINGS
The Cif is required by state law to keep minutes oi City Cornrnission meetings. To properly identifi,
peisons who address the City Commission in tiose rcinutes, the City requefa that this foim be complete4l
arid provided to tle City Clerk, before the meeting begins.
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DA.NIA BEACH
sEA li Ulf tT LOYE it
DATE CF COMMISSION
PRILtT r-rlA[4E:
ADDR]]SS:
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PHOti E NO. (optiorrai):
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PLE.A.SE CEECK O C,R, BOTH CF'THE BO)ffiS EELOW:
FLEASE B E TiiE
t.i i _CITIZE'NCoMMENTS:
Comments by Darja Beach citizens or itrterested paiies tllat are not part of the regular p nted agenda may be made during each
CommissioD meeting curing the peliod s€t aside for "Citizen Con,Iments." A thirty (30) minute 'titizea comments" oeriod shatl
be designated o! the agenda for ciiiz.:ns_ and intercsted peruons to speak on malters not scheduled on that day's ageoda. Each
speaker shall be limited to -? nin'Jtes for his 9r h9r cgmments. Persorc desiring to speak during tho citizen commeniperioC shallinfom] the City Clelk iBnediately p|ior to lhe beginniag of ttre meeting of their intection tispeak if more thao iC ,p"uk"r,
express a desire to speaL the CoEmission shall detemine o1r a meeting by meetin-q basis whether to (a) exterd thb time allottedfcr citizen conments tc accommod3te ail speakers, or (b) whether to limit the num'er of speakers or amount of time per speaier.A speaker's time shall rloi be tralsferable to anothei speaker.
]ViATTER OF YOUR COMMENT:
n ('lG
,\iEl PUBLIC h:EARINGS _ ITEM # IO .2O]&S
PRINTED ON AGENDA)
PLEASE NOTE: IF -YOU WISIJ TO SPEAK ON AN ITEM TIr"A T PERTATNS To A zolrnic" ttrys oF MATTER (FOR EXAMPLE. A
SITE PL,4N, VARIANCE. SPECIAL EXCEPTION OR SIMILAR TYPE OF ITEM I<}JOWN AS A "QUASI.JUDICIAL" MATTER YCU4R' SUB]ECT TO BEING ASKED TO SWEAII OR AIFIRM TT{AT YOU wlLL BE TRIJTHFT]L AS TO YOUR COMMENTS OR
TESTII\,{CNY. YOU MAY AISO BE SIJBJECT TO QUESTICNS ASKED OF YOU BY AN APPLICANT OR AN APPLICA}iT S
REPRESENTATiVE OR ATTORNEY WHICH RELATE TO TT.IE ITEM
ANY PERSON WHO DECIDES TO APPEAI ,A.NY DEC1SICN I\,,'T{DE WrIH REGARD TO ANY MATTER CONSIDERED AT THIS
MEETING OR HEARING W1LL NEED A RECORD OF TIIE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TO ENST]RE
T!{AT A VERBATIM RECORD OF TIIE PROCEEDING IS MADE I{HICH RECoRD INCLTIDES TI{E TESTIMo}'IY AND EVIDENCE
UPON WHICH THE APPEAL IS iO BE BASED.
LOBBYIST REGISTRATION IS REQUIRED, PRIOR TO ENCAGING iN ,ANY LOBBYING ACTIVITIES, WHETIIER OR NCT
COMPENSATION IS PAID OR RECEI\GD IN CONNECTION WITH THOSE ACTfu-ITIES, EACH LOBBYIST SHALL FILE WTIH TI]E
CITY CLERX AN ANNUIi NXGISTRATION STATEMENT AND PAY AN ANNUAL TWO HIINDRED FIFTY DOLL,ARS ($25O,OO)
REG]STRATION FEE FOR EACIi PRINCIPAL OR EMPLOYER- REGISI'RATION TORMS ARE AVA]LAILE ON THE CITY WEBSITE:'{TWW.DANIABEACIiFL.COV (oRDSIANCE #2012{1 9. AMENDED Bl ORDINANCE i20t9-0t9)
\\FSl\Cle*\Cii, acrEm;ssio! Mcetings\Agenda\PuBuc SPEAKINC FORM.doc
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Public Speaker Commission Form
08/2412026 8:09 PM (EDT)
SEA IT. LIVE IT. LOVE IT.
The City is required by state law to keep minutes of City Commission meetings. To properly identify
persons who address the City Commission in those minutes, the City requests that this form be completed
and provided to the City Clerk, before the meeting begins.
Date of Commission Mosting: 0812512026
Name:Staci-lee Sherwood
Address 714 nw 44lh terrace. deerfield beach
Email photosbystacilee@yahoo. com
5615587221
. Public Hearings
Phone No. (Optional):
PLEASE CHECK ONE OR BOTH
OF THE BOXES BELOW:
Item # (AS PRINTED ON
AGENOA)
10. QUASI.JUDICIAL & PUBLIC HEARING ITEMS 1. RESOLUTION NO. 2026
PLEASE NOTE: lF YOU WSH TO SPEAK ON AN ITEM THAT PERTAINS TO A'ZONING" TYPE OF MATTER (FOR
EXAMPLE, A SITE PLAN, VARIANCE, SPECIAL EXCEPTION OR SIMILAR ryPE OF ITEM KNO\AA AS A'QUASI-
JUDICIAL" MATTER, YOU ARE SUBJECT TO EEING ASKED TO SWEAR OR AFFIRM THAT YOU WLL BE
TRUTHFULAS TO YOUR COMMENTS OR TESTIMONY YOU MAY ALSO BE SUBJECT TO QUESTIONS ASKED
OF YOU BY AN APPLICANT OR AN APPTICANT'S REPRESENTATIVE OR ATTORNEY WHICH RELATE TO THE
ITEM.
LOBBYIST REGISTRATION IS REQUIRED. PRIOR TO ENGAGING IN ANY LOBBYING ACTIVITIES. WHETHER
OR NOT COMPENSATION IS PAID OR RECEIVED IN CONNECTION WTH THOSE ACTIVITIES, EACH LOBBYIST
SHALL FILE WTH THE CIry CTERK AN ANNUAL REGISTRATION STATEMENTAND PAY AN ANNUAL TWO
HUNDRED FIFTY DOLLARS ($25O,OO) REGISTRATION FEE FOR EACH PRINCIPAL OR EMPLOYER.
REGISTRATION FORMS ARE AVAILABLE ON THE CITY VVEBSITE: VWW.DANIABEACHFL.GOV (ORDINANCE
#2012-019: AMENDED BY ORDINANCE #2019-019)
Ag enda Public Portal Link
DANIA tsEACH
REQUEST TO ADDRESS CITY COMMISSION AT REGULAR MEETINGS
Public Hearings
ANY PERSON WHO DECIDES TO APPEALANY DECISION MADE WTH REGARD TO ANY MATTER
CONSIDERED AT THIS MEETING OR HEARING WILL NEED A RECORD OF THE PROCEEDING, AND FOR SUCH
PURPOSE MAY NEED TO ENSURE THATA VERBATIM RECORD OF THE PROCEEDING IS MADE WHICH
RECORD INCLUDES THE TESTIMONYAND EVIDENCE UPON WHICH THE APPEAL IS TO BE BASED.
REQIJEST TG ADDRESS
CE'TY COMMISSION AT RE,GULAR
OR. SPtrCIAL 1VEEETINGS
DANIA BEACH
;EA I.', LiYE IT LO\€ IT,
The City is required by state iaw to keep mhutes of City Comrnission meetings. To proper.ly identifu
persons who address the City Commission in those miautes, the City requests that this fomr be coinpleted
and provided to the Cify Cler{<, before the meeting begins.
IIA-TE OF COMMISSION h,EETING:u
PRINTNAME:
ADDRESS:
\NE ( LE-
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IBOI'|E NO. (optionati:-1 5L+q \+\.,l *
PI-EASE CHEEK AI{EIQB }OTH OF THE BO)MS BELOW:
i) X CITZENCOMMENTS:
Comments by Dania Beach citizens or iqterested parties tlat are llot palt of tho regutar p nted agesda may be made dudrg each
Commissioa meeting durinB Lhe pe od set aside for "Citiz€n Comlcents." A tLi4y (30) minute "Citizeu Comments" peiiod shaii
be designalod on the agerda for citizens and htercsted pelsors to speak on Bartters not scheduled on that day's ageoda. Each
speaker shall be limited to -1 ruinuiis for his or her commelts. Pe$ofls dosidng to speak during the citizen comment perioC shall
irlfo|m the Ciry Clerk iflmediarEly plior to the begiadng ofthe meethg of their intention to speali. lf more {lan lC spoakers
er$ress a desirc to sp€alq the Coomission shall detsrmine on a nieeting by meeting basis whetber to (a) extend the time allotted
frrt citizer comments tc accoEno&ie all sp€ak€rs, or O) whether to limit the number ofspeake$ or amount of time per spoeiier.
l, speaker's time shall not be tra.Dsferable to alother speaker.
PLEASE BRIEFLY DESCR]BE TTIE SUBJECT T,IATTER OF YOUR COMMENT:
t850 lL0
2) X puBLrcHEARrNGs-rrEM# {U " \(AS Pzu}ITED GN AGE}{DA)
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PLEASE NOTE: If YOU WISH TO SPEAK ON AN 1TEM THAT
SIIE PL4,N. VARIANCE, SPECLA.L EXCEPTION OR SIM1LAR
ARE SUBJECT TO BEING .ASKED TO SWEAR OR ATF]RM
PERTAINS TO A "ZONING" T1?E OF MATTEA (FOR EXAMPLE. I.
TYPE OF ITEM IO]OWN AS A "QUASI-JUDIC]AL" MATTER YCU
T}IAT YOU WILL BE TRiJTHFUL AS TO YOiJR COMMENIS OF.TIMONI', YOU MAY AISO BE SiJBJECT TO QUESTIONS ASKXD OF YOU BY AN APPUCANT OR AN APPLICANT'S
REPRESENTATTT/E OR ATTORNEY WHICI{ REII.TE TO THE ITEM
ANY PERSON WHO DECIDES TO APPEAL .ANY DECISION I\,[{DE WI|H RECARD TO A}IY }vl,{TTER CONSIDERED AT THIS
MEE|INC OR HEARING \,,lLL NEED A RECORD OF THE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TO ENSURE
TIIAT A VERBATIM RECORD OF TIIE PROCEEDINC IS MADE \'}IICH RECORD INCLUDES TI]E T'STMONY AND EVIDENCE
UPON WHICI{ IHE APPEAL IS TO BE BASED,
LOBBY-IST REG]STRATION IS REQUIRED.
COMPENSAfiON IS PAID OR KECEIVED iN
PRIOR TO ENCAGING IN ANY LOBBYING ACIIVITIES, 'WHETIIER OR NCT
CONNECTION wTIl{ THOSE AC'ITVITIES, EACH LOBBYIST S]IALL FILE qryrH nG
CITY CLERK AN ANNU,'I REGISTRATION STATEMENT AND PAY AN ANNUAL TWO HLINDRED FIFTY DOLL,!.RS ($25O.Oi))
REGISTRATION FEE FOR EACH PRINCIPAL OR EMPLOYER- REGISTRATION IORMS ARE AVAILAELE ON THE CITY 'WEBSITE:
WW&.DANIABEACHFL.GOV. (ORDNANCE #2012-019: AtvfNDED BY ORDINANCE #2019{1
\\FSl\Ciert\Ci{, CcmmissioD Mc€tingsrA.genda\PuBllc SPEAKING FORM.doc
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R-EQUEST TO ADDRESS
CETV COMMISSION AT R.EGUI-AR.
CIR. SPtrCI.dT- 1WEETXNGS
DANIA tsEACi]
3EA I], LiYE IT. LOYE 11,
The City is required by state law to keep minutes of City Comrnissicn meetings. To properiy identi;i
peisons who address the City Cornmission in those mimrtes, the CiSr requests that this fomr tre completed
and pravided to the City Clerk, before the meeting begins.
DATE CF COMMISSION MEETING:
PRINTNAME:
ADDRESS CB f-rr
i'liONE NO" (optional):c
i) i--1 _cmzENCoMhrIENTS:
Cornments by Dada Beach citizens or intoresied parties thal are rct part ofthe rcgular printed ageada may be made duriag each
CorEnissio! meeting d'Jring fii period set aside for "Citizen Con,ments." A thifty (30) minuh 'Citizeq CoBmetrts" pericd shail
be designaled on th€ ageoda for citizens and ilt€rosted pelsons to spoak on matters not scheduled on that day's agcDda. Each
speaker shall be limited to 3 niqr'Jtes for his or hor commeqts. Persons desiring to speak during the citizen commert period. shall
ir,forar the City Clerk iEuredialely prior to the bBginEiDg of the meeting of iheir irtefltioD to speali lf more tha! IC speakers
express a desire to speaL the Coormission sha.ll determine oII a rieeting by meeting basis whetber to (a) ertood thb time ailotted
for citizen corxlnellb tc acconuoodale ail speakerq or @) whedrer to limit r.ile Ilumber of sp€ak-ers or aEount of time per spealter.
A spea.ker"s time shall trot be traosferablo to another speoker.
FLEASE BRIEFLY DESCRIBE THE SI.]BJECT ]VIATTER OF YOUR COMMENT:
,'1
PLEASE NOTE: IP YOU WEII TO SPEAK ON AN 1TEM TF.AT PERTAINS TO A ZONING'' T.I?E OF MATTER (FOR EXAT,,PLE, /.
SITE PL,AN, VARIANCE. SPECLq.L EXCEMON OR SIMILAR TYPE OF IIEM KNOWN AS A 'QUASI-JUDICIAL" MATTER YCU
AI{E SUiIJECT TO BEING AS(ED TO SWEAR OR AFFIRM THAT YOU WILL BE TR'TJTHFUL AS TO YOUR COMMENIS OP-
TESTIMONY. YOU MAY AISO BE SUBJECT TO QUESTICNS ASKED OF YOU BY AN APPLiCANT OR AN APPLICANT S
REPiESENIATiYE OR ATTORNEY WHICH RELATE IO THE ITEM.
ANY PERSON WHO DECIDES TO APPEAL ,ANY DECIS]ON MADE WTIH REGARD TO ANY MATTER CONSIDERED AT THIS
MEETING OR HEARING WILL NEED A RECORD OF T}IE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TO ENS1JRE
TI{AT A VERBATIM RECORD OF T}IE PROCEEDNG IS MADE \iIHICI] RECORD INCLUDES THE TESTMONY AND EVIDENCE
UPON WI{CH THE APPEAL IS TO BE BASED,
LOBB1IST REGISTRAT1ON IS REQUIRED. PNOR TO SNGAGING tN ANY LOBBYING ACTWITIES, WHETIiER OR NCT
COT4PENSATION IS PAID OR RECEI\5D IN CONNECT1ON WITH THOSE ACTIVITIES, EACi{ LOBBYIST SHALL FILE WITH THE
CITY CLERK,{N ANNU,AJ REC1STRATION STATEMENT A]\D PAY AN ANNUAL TWO HUNDRED FIT,TY MI-L.!.RS ($25O,CO)
REG1STRATION TEE FOR EACIi PRINCIPAL OR EI4DLOYER. RIGISTRATiON FORMS ARE A,VA]LABLE ON THE CITY Vr'BBSITE:
WWW.DANIABEACHFL.GOV. (OFDINANCE #2012-019r AMINDED BY ORDINANCE #2019-019
\\XSl\Ciedi\Cil. Ccmmission Meetings\A,genda\PlBl-lc SPEAKn\iC FORM.doc
FILEASE CEECE.IQNE OBEOTS OF TEIE BOIBS EELOW:
i}l puertc h:EARINGS -rrEM #-(AS rRINTED oNAGEIIDA)
REQ{JEST TO ADDRESS
CETV CCIMMISSION AT REGUI,AR.
OR. SPtrCIAL MEETINGS
DANIA BEACH
sEA II. LIVE 11, LOVE II
Tle City is required by state law to keep miEutes oi city comrnission meetings. To propei-ly identifi,
persons who address the City Commission in *.hose minutes, tlre City requests that this form be comirleted
and provid--.i to tle City Clerk, before the meetiag begins.
DA-TE CF COI"{MISSION II,{EETING:-L<20?L
PRINT }'{A},4E:
^
n!_rEECe (q
FHOIIE NC. (optional):I u- o OC./ ,/
FI,EASE CEI4CK OI{tr OR. BOTH OF T"E{E BO}MS BELOW:
1) !l_CITIZENCOMMENTS:
CotryIleits by Dada Beach citizeos or interesied palfjes that are rct part of the rcgular p nted agenda may be made dudlg each
Commission Be€ting durin8 the pe od sot asii.e for 'Citizen CoEments." A thify (30) minute 'Citizer Commerlts' pe od shail
be designatod on the agenda for ciiizens and interested persotrs to speak on matters rot scheduled on that day's agioda- Each
spqker shali be limited to -i niinutes for his or her corEmetrts. Persoos dcsiring to speak dudng the cittn corumeni pcriod shall
irrfomr dre City Clerk immedistely pior to the begiriri[g of the mceting of their irtention to speali. if more thar iC speu.t"rs
exprcss a desire to speali, tle CoEnission shall deterEine on a nieeting by Beeting basis whether to (a) ei1fld thb time ailotted
for citizsl ca.iments tc acconmodate ail speak6s, or (b) whethq to limit the numb€r of speakers or amour,t of time per speaier.
,4, speaker's tirTre sliail not be traosfetable to anothei speaker.
PLEASE BRIEFLY DESCR]BE THE SIJBJECT L'I,dTTER OF YOUR COMMENT:
dr-\ \650
,\PTJBLICMARINGS_IEM# i d (AS PRD{TED ONAGENDA)
PLEASE NOTE: lF 'YOU WISH TO SPEAK ON AN ITEI\,f T!{AT
SITE PL,4N. VARLqNCE. SPECIAL EXCEPTION OR SIMILAR
4,RE SLTi]]ECT TO BEING ASKED TO SWEAR OR AFRRM
PERTAINS TO A ZONING" TI?E OF MATTEP, (FOR EXAMPLE A
TrPE OF ITEM KNOWN AS A 'QUASI-JUDICIAL' I\4{TTER- yCU
TIIAT YOU w]LL BE TRUT TUL AS 10 YOTJR COMMENTS OR
TESTiMONY. YOU MAY ALSO BE Si,EJECT TO QUESTICNS ASKED OF YOU BY AN A-PPUCANI OR AN APFLICANT S
REFRESENIATiYE OR ATTORNEY WHICH RELATE TO THE IIEM.
AI\Y PERSON WHO DECIDES TO APPEAI ,A.NY DECISION NIq,DE i!TN] RECARD TO ANY MATTER CONSIDERED AT THIS
MEETING OR HEARING W1LL NEED A RECORD OT THE PROCEEDING, AND FOR SUCH PURPOSB MAY NEED TO ENSURE
T}IAT A VERBATIM RECORD OF THE PROCEEDING IS MADE WHICI{ RECORD INCL1IDES THE TESTMONY AND EVTDENCE
UPON WHICH THE APPEAL IS TO BE BASED.
LOBBYIST REGISTRATION IS REQUIRED. PRIOR TO ENGAGING IN ANY LOBBYING ACTIVITIES. WHETHER OR NOT
COMPENSATION IS PAID OR T(ECEIVED IN CONNECTION \\ITH THOSE ACTIVITIES, EACH LOBBYST SI{ALL mE WTTH TTE
CITY CLERK,{N ANNU,AI RECISTRATION STATEMEN'T AND PAY AN ANNUAi., TWO HUNDRED FIITY MI-LARS ($25O,CO)
REG]STRATION }EE FOR EACIi PRINCIPAI OR EMPLOYER., REGISTRATiON FORMS ARE AVAILABLE ON THE CITY WEBSITE:
iTWW.DANIABEACIiFL.COV. (ORDINANCE #2012{19: AMENDED BY ORDINANCE *2019419
\\FSl\Ciert\Ci!, Ccmnissior Mcetirgs\Agenda\PLiBllc SPETKINC FORM.doc
REQUEST TO ADDRESS
CITY COMMISSION AT REGI]LAR
OR. SPECIAL MEETINGS
DANIA BEA(H
sEA II. UIE lT, LOVE tI,
The City is required by state law to keep minutes of City Commission meetings. To properly identify
persons who address the City Commission in those minutes, the City requests that this form be compieted
and provided to the City Clerlq before the meeting begins.
DA^TE OF COMMISSI MEETING:b
PRINTNAME:
ADDRESS:N-I.J A
F_I-EASE CHECI{ ONE ORBOTH OF TEM BO}IES BELOW:
PLEASE BRIEFLY DESCR]BE THE SUBJECT il,iATTER OF YOUR COMMENT:
2oz:
PLIBLIC h:EARINGS - ITEM #(AS PRINTED ON AGENDA)
PLEASE NOTE: lF YOU WISH TO SPEAK ON AN ITEM Tt{AT PERTAINS TO A ZONING" T1?E OF MATTER (FOR EXAN,IPLE, A
"SITE PLAN, VARIANCE. SPECIAL EXCEPTION OR SIMILAR TTPE OF ITEM KNOWN AS A "QUASI-JUDICIAI" MATTER. YOU
AN.E SUBJECT TO BEING ASKED TO SWEAR OR AIFIRM THAT YOU WILL BE TRUTHFUL AS TO YOUR COMMENTS OR
TESTIMONY. YOU MAY ALSO BE S1JBJECT TO QUESTICNS ASKED OF YOU EY AN APPUCANT OR AN APPLICANT'S
RXPR.ESENTATiVE OR ATTORNEY WHICH RELATE TO T}tE ITEM
ANY PERSON WHO DECIDES TO APPEAL ANY DECISION MADE VTTII REGARD TO ANY MATTER CONSIDERED AT THIS
MEETING OR HEARING WILL NEED A RECORD OF THE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TO ENSURE
THAT A VERBATIM RECORD OF THE PROCEEDING IS MADE WHICH RECORD INCLTJDES THE TESTIMONY AND EVIDENCE
UPON WHICH THE APPEAL IS TO BE BASED.
LOBBYIST REGISTKA-TION IS REQUIRED. PRIOR TO ENGAGING lN At\Y LOBBYING ACTTVITIES, WHETIIER OR NOT
COMPENSATION IS PA]D OR RECEIVED IN CONNECTION WIIH THOSE ACTTVITIES, EACH LOBBYIST SHALL FILE 1ITTH THE
CITY CLERK AN ANNUr'J REGISTRATION STATEMENT AND PAY AN ANNUAi. TWO HTJNDRED FITTY DOLLARS ($25O,OO)
REGISTRATION FEE FOR EA.CTi PRINCIPAL OR EMPLOYER. RTGNTNATiON FORMS ARE AVAILABLE ON'iTIE CNY WEBSITE:\i W.DANIABEACHFL.COV. (ORDtrI-ANCE #2012-019; AMENDED BY ORDINANCE #2019.019
\\FS l\Clcrt\Cit , Conunissior Mcetings\F.gcnds\PuBLlc SPEAKn iG FORM.doc
PHONE NO. (optional):
i) n _CITIZEI.ICOMMENTS:
Cornms s by Danis Beach citrzqs or intcrested parties that are rlot part of the lrgular pdstcd agcnda may bc madc drniag each
Commissiotr meetilg during ths period set aside for "Citizen Coq8ents." A thfuty (30) ldautE 'Citizm Commeqfs" p6iod shall
be desiSnatcd on thc agcnda for ciiizcns and irtercstod psrsom to spe€k or matt€rs not schcdulcd on that day's ageld& Each
spe€k€r shall b€ liuited to 3 roin'Jtes fo! his or hcr commoots. Persoos dosiring to spcak during the citizcn commcnt perioC shall
irrform thc City Cl.rk immediatEly plior to the begimirg of tho mecting of their intentioo to speali. lf more thal lC sp€ake$
express a dasirc to spcalq thc Coomirsion shall dcterflrine oB a uceting by mc€tirg basis whethe[ to (a) eDdexrd thb time allotted
for citizen comments tc acconmodate all sp€akerq or O) whether to limit $e rumber ofsp€ak€$ or aaount of time p€I speaiier.
A, speaker's time sball lot be tralsfe.able to aoothcr sp€ak€r.
REQUEST TO ADDRESS
CITY COMMISSION AT REGT]LAR
OR. SPECIAL MEETINGS
DANIA tsEA(H
sEA IT. UVE N LOYE IT,
The Ciry is required by state law to keep minutes of cip commission meetings. To propei'ly identifu
persons w-ho address the City Commission in tlose minuteq the City requests that this form be completed
ald prcvided to the City ClerIq before the meeting begins.
all { .2ol-LDA.TE OF COMMISSION MEETING:
PRINTNAME:
ADDRESS:
tsbu: r,.)g a_<[dL *-\o,,-,n,--
zSzol
FIiONE NO. (optional):qs+-18o-9112 @
PIJASE CEECK ONE OR BOTE OF TEE BO)GS BELOW:
i) L-l _CITIZENCOMMENTS:
Commslts by Dania Beach citiz$s or ioterested panics &al arc Dot part oftho rcgular print€d sgrada may bc Dradc during €ach
Cornmissioa meetilg during tbe pc od set aside for "Citizsn Com.IIre s." A thirty (30) minute 'Citizrn Commorts' po.iorl shall
be designstcd on the agcnds for citizens and iutcrested pasons to spcsk oll mattors not schcdul€d on that day's ageoda- Each
speaker sbll be limited to 3 niButes for his or hq clmmeots. P.rsoos dcsiling to spcak during the citizen commeui pctioa snAt
inform the City Ctcrk immedi8tEly prior to thc begiruing of thc meeting of fteir intcntioB to speali. If more than iC sp"at ers
exprcss a desire to spcalq the CoEmission shall determine on a meeting by mo€ting basis whsther to (a) cxtcnd thb tiDe allotted
for citizen ccrnmeots tc accornmodatc ail spcskeE, or O) \ahether to limit r.ie ruInber of{rcakErs or amouot of time pcr spealier.
,4, speaker's tirne shall Dot be tralsfcrable to atrotho speaker.
PLEASE BRIEFLY DESCRIBE T}IE SUBJECT TVIATTER OF YOUR COMMENT:
-)4,u,Lrc h:EARTNGS - rrsrr.l *1812?r?s PRINTED ON AGENDA)
PLEASE NOTE: IF YOU W$Ii TO SPEAK ON AN trEM THAT PERTATNS ro A "zoNNG;i"ypE oF MATTEP. (FOR EXAI'"{PLE. A
SITE PL.AN, VARIANCE. SPECIAL EXCEPNON OR SIMILAR TYPE OF ITEM KNOWN AS A 'QUASI.JUDICIAL" MATTER YOU
AITE SUBJECT TO BENC ASKED TO SWEAR OR AFflRM T1{AT YOU WILL BE TRUTHFTJL AS TO YOUR COMMENTS ORTESTIMONY, YOU MAY AI^SO BE SIJBJECT TO QUESTIONS ASKED OF YOU BY AN APPUCANT OR AN APPLICANT S
REPR.ESENTAT;VE OR ATTORNEY WHICH REI-A,TE TO THE ITEM
ANY PERSON WHO DECIDES TO APPEAL ANY DECISION MADE V'Tru REGARD IO ANY MATTER CONSIDERED AT THIS
MEETII\:C OR HEARING \vlLL NEED A RECORD OF THE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TO ENSURE
TITAT A VERBATM RECORD OF THE PROCEEDING IS MADE WHISH RECOBD INCLUDES TIIE TESTIMONY AND EVIDENCE
UPON WHICH THE APPEAL IS TO BE BASED.
LOBBYIST REGISTRATION IS REQUIRED
COMPENSATION IS PA]D OR F.ECEIVED IN
PRIOR TO ENGAGING IN ,ANY LOBBYINC ACTIVITIES, WHETI{ER OR NOT
CONNECTION WITH TI.IOSE ACTIVITIES, EACH LOBBYIST SHALL F,ILE WTTH THE
CITY CLERK AN ANNUI'I REGISTRA'IION STATEMENT AND PAY AN ANNUAL TWO HUNDRED FIFTY DoLLlnS ($250.00)
REGISTRATION FEE FOR EACIi PRINCIPAI OR EMPLOYER. REGISTRATION FORMS ARE AVAILABLE ON THE CITY WEBSITE:
WWW.DANLABEACHFL.COV. (ORDINANCE#2012-01 9; AMENDED BY ORDINANCE #2019419)
\\FS l\Cicrt\Ci8 Commirsior M.€tings\Agada\PLJBUC SPEAKING FORM.doc
2.ol f-.L+-c
TTEQUEST TO ADDRESS
CITY COMMISSION AT REGULAR
OR. SPECIAL MEETINGS
DANIA BEACH
sEA Ii LIVE II LOVE II
The City is required by state law to keep minutes of City Comrnission meetings. To properly identifii
persons who address the City Commiss ion in those minutes" the City requests that this fomn be compieted
and provided to the City Clerk, before the begins.
}A,TE OF COMMISSION MEETING:7 20%
PRINTN
ADDR-ESS ffis{Sr,trz Au--'/r.o crL
PI,E.A.SE L_t!I\]E OF TTIE BO)'ES BELOW:
3
il
-CITIZEN
COMMENTS:
Cornmsnrs by Dania B€ach citizens or iotercsred partics that arc mt part ofthe rcgular pdnted agisda may be made during €ach
Corunissio! mceting during the period sst aside for *Citizcn Cornments." A thiny (30) EiIIut€ titizcn ionmcns" period shall
be designstod on tbe agcBda for ciiizerE aod hterested persoos to speak orl mattcrs oot schcduled on that day,s agenda- Each
sp€akcr shall bc limit€d to 3 minules for his or her commcots. Pqsoos dccidng to spcak during the citizen *r^-ip".ioc rtrrttir,fo r th€- city Clirk ismediEtely plior to the begiuiing of the mectiag of their intcntion to speak. If more than ic q"ut"o
express a dcsire to sPealq tbe Commissiorl shall determine on a meeting by meeting basis whsther to (a) extend thb tiore auotted
for citiz€n comurclrts tc acconmod3le all speakers, or @) whettrer to limit the number ofspeakrs or amount of time p€r speaiisr.
A speaker's time shall uot be tra.Dsferable to anothcr speakcr.
PLEASE ERIEFLY DESCRIBE TTIE SUBJECT IVIATTER OF YOUR COMMENT:
l'1 tr pueI,lc h:EARINGS-ITEM #_(AS eRINTED oNAGENDA)
PLEASE NOTE: IF YOU \\,ISH TO.FEA( ON AN ITEM THAT PERTaNS rO e'zON[.tc"I"E OF MATTEP, (FOR EXAMPLE I,SIIE PLAN, VARIANCE. SPECIAL EXCEPIION OR SIMILAR TYPE OF ITEM (}IOWN AS A 'QUASI-JUDICIAL" I\,{TTER YCU
A.R.E SUBJECT TO BEING ASKED TO SWEAR OR A.FFIRM T}IAT YOU WILL BE TRUTHFUL AS TO YOIJ'R COMMENTS ORTESTIMONY. YOU MAY AISO BE SIJBJECT TO QLTESTICNS ASKED OF YOU BY AN APPLICANT OR AN APPLICANT S
REPB.ESENTATTVE OR ATTOR},]EY WHICI]RELATE TO THE I'TEM
ANY PERSON WHO DECIDES TO APPEAL ,ANY DECIS]ON MADE WTTH RECARD TO ANY MATTER CONSIDERED AT THISMEETING OR HEARING l,r'lll NEED A RECORD OF THE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TO ENSURETHAT A VERBAflM RECORD OF THE PROCEEDING IS MADE 1{HICH RECORD INCLUDES T}tE TESTIMONY AND EVIDENCE
UPON W'HICH THE A.OPEAL IS TO BE BASED,
LOBB}'IST REGISTRATION IS REQUIRED.
COMPENSATION IS PA]D OR F,ECEIVED IN
CITY CLERK AN A},INU.AI REGISTRATION
REGISTRATION FEE FOR EAC}i PRINCIPAL
PRIOR TO ENGAGIN G IN ANY LOBBYING ACTIVTTIES, WHETI{ER OR NOT
CONNECTION \A'iTH THOSE ACIWITIES, EACH LOBBYIST SHALL FILE WIIH T'I{E
STATEMENT AN'D PAY AN ,ANNUAL TWO HUNDRED FtrTY DoLLIAS (3250-OO'}
ok EMpLoyER- REGrsrRATioN FoRMS ARE AvAILABLE oN tuE ctty wlgsrg,
WWW.DANIABEACHFL_COV. (OkDINANCE #2012-0t9 : AMENDSD BY ORDINANCE #2019{19)
\\FSl\Clc*\CiD, Cohmissiotr Mcerifgs\Agcnda\PlBuc SPEAKINC FORM.doc
PHONE NO. (optionai):
REQUEST TG ABDR.ESS
CEE'Y COMMISSTON AT' REGUI-,AR.
SR. SPECEAL MEtrTNNGS
DAN|A BEA(H
sEA rL LiVE lT. LOVE n
The Ciry is required by state iaw to keep misutes oi City Commission meetings. To properly irientifl
peisoirs who address the City Commissicn in those rniuutes, the City reques'rs that this form be conpieted
and provided to the Cify Clerk, before the meeting begins.
}A.TE CF CO},{MISSiON h4EETTNG:A 5 20_?b
PRINTNAIvIE: f)Nra q t4elt,'3
^tBI*AD}EESS:
ll-iol.rE NC- (cptionali:
PI-EASE CHECK OIrIE OR. EOTtr OF T'EE BOffiS EELOW:
it l:l CITIZEN COI\&{ENTS:
'-loirlments 9y 9alia Beach citizens oi interested parties &at are not part ofth€ regular pdnted agenda may be made during each
Ccrnfiissiodli-ieeting CLrriaE drr period s€t asiie loi "Citizen Commsrts.' A thirty (30) minute "Citizen Comments', peiicd shall
be designated on tlie agetrda for cldrens and intercsted persons to speat on Battels rot scheduled on th8t day's ageoda. Each
speaker shall be llnited to -? niiffrtes fot his or h€r commeots. Persons desring to speak durirg the citize!1 commeli perioC shallidon:: the Cil) Clerk i$nediately prior to the begilrriDg of the meeting of their intentios to speali. If more than iC speakers
express a desirc to speal! the CorBaiission shall detemine oI1 a meeting by meetilg basis hether to (a) exterd thb time a.ioned
fcr citizei coirlrtents tc acco*$odate ail speake$, or (b) whether to limit the number of speake$ or amount oftime per speaiier.l, spiaker's tiile shai! not be -aisfera'cle to anothei speaker_
FLEASE EPJSFI,Y DESCR]BE TIIE STIBJECT I\,IATTER OF YOUR COMMENT:
t-.i PUBLIC HEARINGS -ITEM #_(AS PRTNTED ONAGEI.{DA)
PLEASE NOTE: II YOU WISH Td SPEA( ON .AN ITEI\4 TP.AT PERTA]NS TO A .,zoNING" T13E OF MATTER (FOR ETAMPLE. /.,
SITE PL.AN. VARIANCE, SPEC1AL EXCEPT]ON OR SIMTLAR TYPE OF ITEM KNOWN AS A "QUASI.JTJDICIAL" MA'I"iER YCU}JlE SUBJECT TO BENC ASI{E!TO SVTGAR OR AIFIRM THAT YOU WILL BE TRUTIIFUL AS TO YOUR COMMENTS ORTESTIMjOI{Y, YOU MAY ALSO B E SIIB]ECT TO QUESTICNS ASKED OF YOU BY AN A?PLiCANT oR TiN APFLICANT SRIFRESENTATIVG OR,A.TTOR]{EY WHICH RELATE TO THE ITEM.
A\Y PERSON WHO DECIDES
MEETING OR HEARING WILL
TO APPEAI ,^.NY DECISION MADE WTIH REGARD TO ANY MATTER CONSIDERSD AT THIS
NEED A RECORD OF TTIE PROCEEDING, AND FOR SUCH PURPOSE MAY NEED TC ENSURETHAT ,4. VERBATM RECOR' OF THE PROCEEDING iS MADE 1;r'HICIJ RECORD INCLTIDES TT.IE TESTMONY AND EVTDENCE
UPON WHICi{ THE -AJ'PEAL iS TO BE BASED.
LOBB:'IST REGISTRATION iS P.EQUTR-ED,
COI\4PENSA?iON IS PAID oR F.ECEI\ID IN
FRIOR ?O R\IGAGING iN ,ANY LOBBYING ACTIVITIES. WHETTiER OR NOT
CONNECTION W1TH THOSE ACTIVITiES, EACH LOBB]'IST SF"ALL FILE WITI] THE
CITY CLERK All ANNU.Ai REGISTRATION STATEMENT AND PAY AN ANNUAL TWO HUI.IDRED FII'TY DOI-LIRS ($250.C0)
REG1STRATION FEE FOR 9ACIi ?RINCIPAI OR EMPLO1€R REGISTRA?iON SORMS ARE A,VAILASLE ON THE CIT-Y WBBSITE:
il^,{W.DANIABEACTiFL.GOV (oRDn ]ANCS #2012-01 9 : AMSIJDSD BY ORDX.,iAr\CE #20i9{19)
A. I <r.'1'et
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