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6.1. SR 11-13-2012 >I*Ekkl REQUEST FOR ACTION River TO ITEM NUMBER Mayor and City Council 6.1 AGENDA SECTION MEETING DATE PREPARED BY Worksession November 13,2012 Jessica Miller, Executive Secretary/Deputy City Clerk ITEM DESCRIPTION REVIEWED By Interview Planning Commission Applicant Tina Allard,City Clerk REVIEWED BY Cal Portner, City Administrator ACTION REQUESTED Interview Mike Keefe for consideration as a Planning Commissioner. If appointed,Mr. Keefe's term would expire February 28,2015. BACKGROUND/DISCUSSION There is one vacancy on the Planning Commission.The vacancy has been advertised per the Board and Commission Policy since January. Staff received one application from Mike Keefe. Mr. Keefe will be in attendance at the meeting. ATTACHMENTS • Application Action Motion by Second by Vote Follow Up PRIVERE0 8Y N:\Public Bodies\Boards\Council Memos\Planning Commission 11 13 12.docx IftJLATIJREI APPLICATION FOR APPOINTMENT TO CITY ADVISORY BOARD/COMMISSION RiverTerms beginning in March ° &WIT Thank.you for your interest in serving your community!Please indicate in order of preference on which of the following boards and commissions you are interested in serving with 1 indicating your first choice,2 your second choice,and 3 your third choice. Energy City Commission 3 Parks and Recreation Commission a Heritage Preservation Commission 0 Planning Commission I\ Ice Arena Commission S Utilities Commission All terms are three years and begin on the first day of March.See the specific board and commission description for additional information. APPLICANT INFORMATION Name: M' C City of of Residence: E es- Occupation: Sch\Q !QC'O\C.(* N V. Employer. IJJhee.le.c k{ethwa('e! Statement of Interest:Please state briefly why you are interested in serving on this board/commission for which ou are submitting this application. ll {X o dnie iZ.-SAcd tr e.t.a 0..∎ {�C� (At\ C1/4C\1�v e_ t A(.06 e thA Co rorqh-Nt/1-1. • Education/Professional Experience:Describe your educational and professional experience or skills that quillify you to serve on this board/commission Edveq or1 i' "n inn a9ewtcr�-f utlfh prdle551"Qtal exper&enCe. n consirucf tan /,1ana9 mre,i/ Relevant Personal/Professional Experience:Please describe your professional,civic, or comettwi ty participation,which may e elevant in serving on this board/ ommissio /! PraTeS3I'cnc ttj 4r+ior i 1� A. tea& base u3QrI ( tQ deg' ac\cA dWd op k3uikaltv35. • Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involved in preparing for meetings,and do you feel you have the time available to be an active participant? Yes ❑ No Comments: StC\Ce 141o0iCNSko E < s)42. T coo r yeasts evr3o L i hone. �StCt\ it Ncrt 4ceri en pos44G1 pcdl ng jC1 ��+✓ cnMD&uON OUJ ciaak.t have, '6 cue voi-� ii-:�$� y eke-� Conflict of Interest is defined as the participation in any activity,recommended action,or decision from which the individual has or could have the potential to receive personal gain,whether it be direct or indirect. (See attached"Conflict of Interest'Ordinance) In accordance with this definition,do you have any legal or equitable interest in any business, however organized,which could be construed as a conflict of interest?❑Yes kNo If yes,pro,'de details on a separate piece of paper. VO Applicant Signa e Date Questions may be directed to the Administration Department at 763.635.1000. This application will be kept on file for one year; after that time a new application must be — ---___-- --------__—_ —_ OFFICE USE ONLY The Applicant is: ANew Applicant ❑ Applying for Reappointment Council Action: ❑ Not Appointed ❑ Appointed to: Date Appointed: Term Expires: