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9.1. SR 02-18-2014 Elk Request for Action To Item Number Mayor and City Council 9.1 Agenda Section Meeting Date Prepared by Work Session February 18, 2014 Jessica Miller, Executive Secretary/Deputy City Clerk Item Description Reviewed by Commission Interviews Tina Allard, City Clerk Reviewed by Cal Portner, City Administrator Action Requested 1. Council to interview all applicants in attendance. 2. Appoint by motion, applicants to fill the open seats as outlined below. Terms should be valid March 1, 2014, until February 28, 2017, for all positions. Background/Discussion The City Council considers board and commission appointments in February for terms beginning in March. All applicants have been notified of the interviews and asked to arrive at 7:00 p.m. These positions have been advertised since December through various marketing tools. Positions not filled this evening will continue to be advertised. Below is a list of board/commission applicants: Energy City Commission—4 open seats (2) energy-related business representatives (1) landfill representative (1) Council/EDA representative Jim Hamann New applicant Landfill representative Jason Hoskins New applicant Choices: Utilities 1", ECC 2nd,Parks 3rd Leslie Sale New applicant (Choices: Planning 1", HPC 2nd,ECC 3rd) Chris Tanaka New applicant Choices: ECC 1", Utilities 2nd, Planning 3rd Matt West aard Requesting reappointment Council/EDA representative (John Setala and Ryan Setterholm did not seek reappointment as energy-related business representatives to the Energy City Commission.) POWERED By A IR Heritage Preservation Commission - 2 open seats Lance Lindberg Requesting reappointment Debra Mortensen Requesting reappointment Michael Schroeder New app licant Choices: Parks 1st, HPC 2nd Jill Larson-Vito New applicant Choices: Parks 1st, Planning 2nd, HPC 3rd Leslie Sale New applicant Choices: Planning 1st, HPC 2nd,ECC 3rd Ice Arena Commission - 3 open seats (1) ERYHA representative (1) at-large representative (1) Parks & Recreation Commission representative Brian Ballenger Requesting reappointment ERYHA representative Ryan Holmgren Requesting reappointment Parks & Recreation representative— check with Michael Thurs after PR mt Michael Larson New applicant At-large representative (Dale Martin did not request reappointment as the at-large representative to the Arena Commission.) Parks and Recreation Commission—2 open seats Jason Hoskins New applicant Choices: Utilities 1st, ECC 2nd,Parks 3rd Jill Larson-Vito New applicant Choices: Parks 1st, Planning 2nd, HPC 3rd Michael Niziolek Requesting reappointment James Nystrom Requesting reappointment Michael Schroeder New applicant (Choices: Parks 1st, HPC 2nd) Planning Commission—2 open seats Jill Larson-Vito New applicant Choices: Parks 1st, Planning 2nd, HPC 3rd Leslie Sale New applicant Choices: Planning 1st, HPC 2nd,ECC 3rd Chris Tanaka New applicant (Choices: ECC 1st, Utilities 2nd, Planning 3rd) (Dana Anderson and Chad Westberg did not seek reappointment to the Planning Commission.) Utilities Commission— 1 open seat Jason Hoskins New applicant Utilities 1st, ECC 2nd, Parks 3rd Allan Nadeau Re uestin reappointment Chris Tanaka New applicant Choices: ECC 1st, Utilities 2nd, Planning 3rd N:APublic Bodies\Agenda Packets\02-18-2014\Final\x9.1 sr commission interviews.docx Financial Impact None Attachments • Applications (in alphabetical order) • Sample Interview Questions (will be distributed to the Council at the meeting) N:APublic Bodies\Agenda Packets\02-18-2014\Final\x9.1 sr commission interviews.docx i APPLICATION "T TO CITY cat?0 VISORY BOARD/COM MISSION Terms beginning in arch tlWMi AAAW11 6.d'i3SfIaYiJQ 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 Parks and Recreation Commission ❑ Heritage Preservation Commission Planning Commission Ice Arena Commission 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: Brian Ballenger City of Residence: Elk River Occupation: Finance Manager Employer: Digi International Statement of Interest:Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. I feel that I have the background and passions to be a successful commission member, working as a conduit between the ice arena/city and the youth hockey association. I am very interested in helping all parties involved in providing a great opportunity for Elk River residents and businesses. Relevant Experience: Please describe your educational,professional, civic, or community participation,which may be relevant in serving on this board/commission. Relevant experience: 1 - ERYHA Board Member for a number of years, 2 - Coach / Educator from High School to Young Kids for multiple programs, 3 - Job (Finance Manager) Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involved in reparin for meetings,and do you feel you have the time available to be an active participant? es No Comments: I feel to be an effective commission member it is important that you not only attend meeting, which is a must, but you also spend the appropriate amount of time being prepared for those meetings. 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 anv business, however organized,which could be construed as a conflict of interest?aes ✓ No If yes,provide details on a sel2arate pigge of 12al2er. @,4ry Dl:cn=slOnedbybder @d11.wm d101.com 02/11/2014 brian.ballen er di i.ConI.DN:cn014.0.111 :23:05g 6'00' I D9ta;2014.02.11 10:23:05.06'00' Applicant Signature Date Questions may be directed to the Administration Department at 763.635.1000. OFFICE USE ONLY D New Applicant D Reappointment Council Meeting Date: D Appointed to: Term Expires: D Not Appointed i i Ct Brian; Yes go ahead and apply to stay on as our Arena Commission Representative. f Thanks, Lyfe Vowson i i APPLICATION FOR APPOINTMENT TO CITY c+ty;dr ADVISORY BOARDICOMMISSION 'Terms beginning in arch ' g g 7fi3:GlS,t'QUO ' 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 Parks and Recreation Commission Heritage Preservation Commission Planning Commission Ice Arena Commission 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. APPLIQ yT INFORMATION Name: dim Hamann City of Residence: Andover Occupation: District Manager Employer: Elk River Landfill (WM) Statement of Interest:Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. I would like the'opportunity to support, promote and assist in projects pertaining to alternative sources of energy. Have the ability to demonstrate how we at Elk River Landfill use Renewable Energy to produce electricity from MSW. Relevant Experience:Please describe your educational,professional,civic,or community participation,which may be relevant in serving on this board/commission. Studied: Business Management at Western Illinois University 9 years of experience as a Project Manager for a Mass Grading Contractor 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? es No Comments: Confllet 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 inditect. (See attached"Conflict of Interest"Ordinance) In accordance with this definition,do you have any legal or equitable interest in an business, however organized,which could be construed as a conflict of interest? es No If yes,provide details on a qeparat e piece of a er av�-- 1/24/2014 A c t Qnalure Date Questions may be directed to the Administration Department at 763.635.1000. OFFICE USE ONLY New Applicant 0 Reappointment Council Meeting Date: El Appointed to: Term Expires: ® Not Appointed i i APPLICATION EB 1 201 City of ADVISORY BOARD/COMMISSION E I k =... Ri,F6r Terms beginning in March �...no1':u6.-m °63.03,.1000 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 Heritage Preservation Commission Planning Commission Ice Arena Commission Utilities Commission All terms are three years and begin on the fist day of March. See the specific board and commission description for additional information. APPLICANT INFORMATION Name: 3Ahopi WciSr-wS City of Residence: E.LK Occupation: ELr'cTrL1cm. E N 414 Employer: UL-M119 E7j41rj 5 Statement of Interest:Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. -X /gym Ltac�t-srj( Fog AM (Weoiz-v 1a IYy i'D ?Uo� f NleAL- ® !�LeS,iuC-35 A tJ o Lr-Ao K I Q S v-%Lx S -rc, -me OF -ale v�ra ur,17r7 T�i�11 Relevant Experience: Please describe your educational,professional,civic, or community participation,which may be relevant in serving on this board/commission. YMA'r OAS C>VL-A. . �P saw 6 1 6 C 1 tar lc- PO%,4- — S�� S- -&"$,Aj&sy A-►o ar, r `.=vta Cn'/ LAS-1- q ytea-S. Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involved in reparin for meetings, and do you feel you have the time available to be an active participant? X es o Comments: WILE -� a AtfZ A—a -, v Foa- w-r xbr3 , :L 47 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 an business, however organized,which could be construed as a conflict of interest? es ao If yes,provide details on a se agate ice of a er. A plicant Signature Date Questions may be directed to the Administration Department at 763.635.1000. B _ d OFFICE USE ONLY L3 New Applicant D Reappointment Council Meeting Date: LJ Appointed to: Term Expires: Not Appointed Potential Conflict of Interest Statement for Jason Hoskins: My employer, Ulteig Engineers, is an employee-owned consulting services company. Ulteig provides design services in the Power, Renewable Energy, Communications and Government Markets. The City of Elk River is a potential client of Ulteig. However,the City is not currently a client. Furthermore Ulteig has no immediate plans to pursue work with the City. Should I get selected to serve on an advisory commission, I would abstain from any discussion/decision that could potentially benefit Ulteig. My desire to be on the advisory commission is not to benefit my employer but only to support the City of Elk River. I feel that I have much to offer based on my knowledge, education and experience. APPLICATION FOR APPOINTMENT TO CITY City of ADVISORY BOARD/COMMISSION .�. y (.l Terms beginning in March 13Ufi5 jL<,,.lvr 753.635.1[700 Thank you for your interest in serving your community! Please mi dicate 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 _ Parks and Recreation Cormission Heritage Preservation Commission _ Planning Commission A Ice Arena Commission Utilities Commission _3l1 terms are three years and begin on the first day of March. See the specific board and comnussion description for additional information. APPLICANT INFORMATION Name: . /7llrr 1� ��:�t'Sc`' 1 City of Residence, �a Occupation: 15�.�-.. �J :.z ,�ti.:.�. Employer: �'C% Lim Statement of Interest: Please state briefly why you are interested in serving on the board/commission for which you are submitting this application, S kp,,- U-If Ll,. Relevant Experience:Please describe your educational, professional, civic, or community participation,which may be relevant in serving on this board/commission. r � _ J 7 �;:;o ice' �I�� .�-c-l � (�[ t•l it^�t'4•`a' t�t= � �' 't C':�( ._'.{� ��'l�``Y1�"'--ti.'LLl r Attendance: Are your aware of the importance of regular meeting attendance including the time commitment involved in reparing for meetings, and do you feel you have the time available to be an active participant? 'es ❑ No Comments: 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 a Y business, however organized,which could be construed as a conflict of interest? ❑ Yes ,1No If yes,provide details on a separate iy'ece of pager. App cant Signature Date Questions may be directed to the Administration Department at 763.635.1000, application This - . new . . must be filed. OFFICE USE ONLY ❑ New Applicant 0 Reappointment Council Meeting Date: '❑ Appointed to: Term Expires: IL- El Not Appointed APPLICATION I E T TO CITY City or ADVISORY BOARDICOM 7'eravi§ beginning in March 000,Y lx seeu Awkxv,l 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 sccond choice,and 3 your third choice. ElEnergy City Commission Parks and Recreation Commission F71 F;T1 Lo I Heritage Preservation Commission LAJ Planning Commission Ice Arena Commission 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 INFORMA'T'ION Name: Jill Larson-Vito City of Residence: Elk River Occupation: National Accounts Manager Employer: Summit Companies Statement of Interest: Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. I would like to be involved in the Parks & Recreation Commission (or other available commissions)to be more involved in my community. My children have participated in numerous activities through the Parks & Rec Dept, and I would value the opportunity to give back. Relevant Experience: Please describe your educational,professional,civic, or community participation,which may be relevant in serving on this board/commission. I work professionally in fire protection and have for the last 10 years. I also have a bachelor's degree in Psychology. I have experience in researching, reporting, and managing budgets. Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involvedUl"reparingy for meetings, and do you feel you have the time available to be an active participant? es No Comments: 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 anv business, however organized,which could be construed as a conflict of interest? es ✓ No If yes,provide details on a sel2arate pigice of paper. Jill Larson-Vito %W V4%1, � ° •�m,C.U5 1/28/14 Applicant Signature Date Questions may be directed to the Administration Department at 763.635.1000. OFFICE USE ONLY ® New Applicant ® Reappointment Council Meeting Date: ® Appointed to: Term Expires: Not Appointed APPLICATION 1 CITY 0 of ADVISORY BOARD/COMMISSION Terms beginning in March . I MS O.w ftrkway 763.6�,i.1tMX1 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 Parks and Recreation Commission .Heritage Preservation Commission Planning Commission Ice Arena Commission 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: L.Cat. '" ► €f1 ''" City of Residence: � t ; Occupation: E, I" �x Employer: �\ s 1��°✓� �° Statement of Interest:Please state briefly why you are interested in serving on the board/cornrnissio £or which oul are✓su fitting this application. ti 4 . (AJ i`�� a � .t t C 1 Relevant Experience: Please describe your educational,professional,civic,or community participation,which may be relevant in serving on this board/commission. �. � -'-'> N PC \r rA 01; S 0. 6\'r—c e) Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involve airepa for meetings, and do you feet you have the time available to be an active participant? o Comments: 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 anybusiness, however organized,which could be . ed as a conflict of interest? es o If yes,provid etails on a se piece o �Waax 'B,f� '9wrnr....nrwv+'..' .✓,�d ♦��, � .. {/,,�� Ap 'lican zgiia Date/ Questions may be directed to the Administration Department at 763.635.1000. OFFICE USE ONLY LJ New Applicant Reappointment Council Meeting Date: ❑ Appointed to: Term Expires: Not Appointed `✓ APPLICATION FOR REAPPOINTMENT TO CITY City of ADVISORY BOARD/COMMISSIO o Reappointment to: fl Wiz_ ��.. ese Uci-! t •� 0 7, yw, .q a,'c� 13065 Orono Pnk�vay.' , 763,6.35.1:000 ... APPLICANT INFORMATION r Name: t"c V En.a,CN City of Residence: 614' �'=o e,- occupation: /-us-{ 1'YIcz✓seas, ca— Employer: Ccn kei \ Sc!-- .s-Pr;1 k � Statement of Interest: Please state briefly why you are interested in continuing to serve on the board/commission for which you are seeking reappointment. \,i'e. r 0!\, .0 CJ !1 sV9,1 i .t.' .f\ 1 .S Ci l 1 •�°cl t f 1i o4 A- )P C ;..l.l� ��'C'/t^I� Yt 1 k", CG -1 0 1_ft r. :(.lie,. C ` .i� e C ✓✓+ aJ„ '. d�C, S Gv� L,� 12 U_C!/)t._i_.I .✓\ (5'111. A",L),?r -to Relevant Experience: Please describe your educational,professional, civic, or community participation,which may be relevant in serving on this board/commission. .:J ka ;c_ .S eC-\YCz0 � � s l�� C c� .� .�`,5��'L? � S, n��3 �t7r� ..°� � 17 (QL.,J.'hc,re. °l. /i !:a oc-) I an f J\ r e'\ Qr \i \i 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 LJ No Comments: Me e 4, S CA C e c;°U C o 0 19 e,>\ e c3 4- 0 r)-\ 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? 0 Yes EI No If yes,provide details on a separate Rjece of 12al2er. x ..21 Applicant Signature Date Applications will be kept on file for one year,after that time, a new application must beffled. OFFICE USE ONLY Council Meeting Date: El Reappointed Term Expires: Not Reappointed APPLICATION I T TO CITY City of ADVISORY BOARD/COMMISSIO El - - River Reappointment to: LL 13.066 0iono P"kway 763.63$;1000 APPLICANT INFORMATION A Name: //l e�P, �b- ),!Lz City of Residence: i Occupation:_Jo tee.. s Employer: Statement of Interest: Please state briefly why you are interested in continuing to serve on the board/commission for which you are seeking reappointment. Relevant Experience: Please describe your educational,professional, civic, or community participation,which may be relevant in serving on this board/commission. '�- 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 El No Comments: 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? Ll Yes ANo If yes,provide details on a separate iece of oaner. 'Z-- � Applicant Signature Date Applications will be kept on file for one year,after that time, a new application must be filed. OFFICE USE ONLY Council Meeting Date: El Reappointed Term Expires: Not Reappointed APPLICATION I T CITY City.of ADVISORY BOARD/COMMISSIO er Reappointment to: ark e" 13.065 Orono.Parkway 763,635,1000 APPLICANT INFORMATIO N "R- Name � I , City of Residence: C �✓° r Occupation: C2--le-clt(? r— Employer: b b 7 �`5 Statement of Interest: Please state briefly why you are interested in continuing to serve on the board/commission for which y�gu are seeking reappointment. VQ, r�?[h ca co ft cu �C ' t!> ca �.0'PC3 EY(„0cr48'�^sa� �y,r� rt8+nt a"�l'._4�t°Ea c�o'i6«�� J W�`,J��.6"�i ran•_ \@l��'..d'� e:�. trJc.5:3.� �1�C°- .'� 9 eel a/'�.`y� ."�!J&+i`e� �d/1. �y'' .3;°° •�c:.7 �i1�G��i � ��../' ?,C3 :'b•1�.-S� Gx?llC 1f�6t�Jli`'`'L-?'. CRd9G' pL .�� C"i �`rn�� ti� 6� Cre?car -i�w'stz« r ��1y Relevant Experience: Please describe your educational,professional, civic, or community participation,which may bi�relevant in serving on this board/co . e ssio� a4\vAkke, VU2 r �, a e4- a t'3f°®re� 1-0 re eE""PtU @dt ruLVIN�V'IA'I.�7 v v�c� C��.w,!4. col�lEc�.'_-��r``✓l..C,�l.�ti `��c?�c�t�:l°��'c:�. . ��i.f rra,,c`a 'p � . �i.L 'a� `:•�. e�.� attendance:Are your awe of the unortance of reguar me ng attenc�aicludinhe time commitment involved in preparing for meetings, and do you feel you have time available to be an active participant? '-Yes El No Comments: 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? El Yes 0 No If yes,provide details on a. arate iece of a er. Applicant Signature Date Applications will be kept on file for one year,after that time, a new application must be filed. OFFICE USE ONLY Council Meeting Date: El Reappointed Term Expires: EJ Not Reappointed APPLICATION F City of ADVISORY BOARD/COM MISSION o n Reappointment to: 13065 Orono Parkway. 763.63$,1000 APPLICANT INFORMATIO N Name: -,f A tv?z-`� ��' "° � �� (�' City of Residence: C.p:' LK Occupation: E" gLeE� ZE" Employer: 1--(912.41 Statement of Interest:I have been a life long user and supporter of parks and trails and a participant in recreation programs in Elk River. I believe that a lot of progress has been made in the last several years with the addition of Bailey Pointt and the.possibility of adding the Houlton Property to the Park system. Recreation opportunities should improve with the addition of a lighted field Oak Knoll park. I also have adopted Ridgewood East Park. I feel have the background, training and experience to continue on the Park and Rec Commission. Background Experience: I graduated from ERRS, and the U of MN. Most of my working career was at Cretex in ER where I was a civil engineer. I was a long time member of the ER Fire Dept.,ERFD Relief Association and a former member of the Sherburne Co. Fair Board. Recently I have been a trtentor to graduating senior Civil engineering students working on their Cap Stone projects at the U of MN. Many of the Cap Stone projects have been related to and were of great value to the functions of the ER park system, Last summer I helped an Eagle Scout build a pedestrian bridge in Woodland Trails Park. commitment involved in preparing for meetings,and do you feel you have the time available to be 4 an active participant? Yes D No Comments: 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? El Yes El No IAyes,provide deta�s on a se arate-piece of paoer. lz.9 Applicant Signature Date i Applications will be kept on file for one year,after that time,a new application must be filed. OFFICE USE ONLY Council Meeting Date: El Reappointed Term Expires: El Not Reappointed L APPLICATION 6 City cf ADVISORY BOARD/COMMISSION El a .. Terms beginning in March . 13065 Omm,Pael—ay 76 3,635.1(100 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 Parks and Recreation Commission Heritage Preservation Commission Planning Commission Ice Arena Commission 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: Leslie Sale City of Residence: Elk Giver Occupation: Owner Employer: TLC Remodeling Statement of Interest: Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. I live Elk River and I plan to stay here for many years to come and I would like to be a part of the city goverment. I would like to help grow, enhance, and improve the city by being a member of the commission. Relevant Experience: Please describe your educational,professional, civic, or community participation,which may be relevant in serving on this board/commission. am a small business owner of a remodeling company that is based in Elk River. I have an architectural drawing and construction technology background that I have used in the I remodeling industry for over 33 years. I just finished a two year term as secretary of the Board of Directors for the National Association of the Remodleing Industry (NARI) of Minnesota which I enjoyed and learned a great deal about a working board. Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involved in reparin for meetings,and do you feel you have the time available to be an active participant? es No Comments: Planning would be my first choice, then Heritage Perservation, then Energy i i I 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 accor4n e wi this definition,do you have any legal or equitable interest in an business, however org ni ed,which could be construed as a conflict of interest? es No If yes, rovi e etaijs on a separate iece of a r. 1/22/14 Applic n ign,t k/ Date Questions may be directed to the Administration Department at 763.635.1000. OFFICE USE ONLY New Applicant 13 Reappointment Council Meeting Date: Appointed to: Term Expires: Not Appointed : APPLICATION FOR APPOINTMENT TO CITY C y of ADVISORY BOARD/COMMISSIO Terms s e innin in March 1 ThiIYS t>r.:i..1':.r4ee ai 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 L I J Parks and Recreation Commission Heritage Preservation Commission Planning Commission Ice Arena Commission 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: 1k adV City of Residence: CA Occupation: Employer: 13o'o IdIle Statement of Interest:Please state briefly why you are interested in serving on the b/oard/commission/for which you are submitting this application. slave f�tA UG+��C1G!rr -d 0(, "LJ ie110011-,A^ i yt/-e, xvvh,dao rf �i/t� ht,'A:� ,u) �uSl+b"� pd,- f/'t dv�✓Clc/f �u /mot .wwv..:fi� �h dV.h•l Pv,� �U,I n ',i f - •11'e OV01,w'f '!vJ ever -e "q Relevant Experience: Please describe your educational,professional, civic, or community fparticipation,which may be relevant in serving on this board/commission. Ukert .T 4041h 11)'� or- &A 0 4, LcalQ99 dasse4 ho Z u„Je.3 ad 40 o- v,`11 ; fl(wk -the Attendance:Are your aware of the importance of regular meeting attendance including the time commitment involved in parin for meetings, and do you feel you have the time available to be an active participant? es No Comments: I 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 inditect. (See attached"Conflict of Interest" Ordinance) In accordance with this definition, do you have any legal or equitable interest in an business, however organized,which could be construed as a conflict of interest? es o If yes,provide details on a se agate pigce of 12al2er. Appli --ature Date Questions may be directed to the Administration Department at 763.635.1000. 4 1 OFFICE USE ONLY LJ New Applicant U Reappointment Council Meeting Date: ® Appointed to: Term Expires: Not Appointed i I APPLICATION PP INTMENT TO CI'T'Y City of ADVISORY BOARD/COMMISSIO Terms beginning in arch g � 13065 C l,i,mo Ru_k,i,q ?6:5,6:5:>.1 OW 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 1:1 Parks and Recreation Commission ❑ Heritage Preservation Commission 51 Planning Commission Ice Arena Commission El 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: / �� City of Residence: Occupation: Employer: 01 e-- Statement of Interest:Please state briefly why you are interested in serving on the board/commission for which you are submitting this application. �,�„.IX 10— ��s ��P�� 5��ss J� CC Relevant Experience:Please describe your educational,professional, civic, or community participation,which may be relevant in serving on this board/commission. -1 44'e--IJ 1; ` ��,rj J.>.u+1 b e �C:t.@�a°L � "r✓ �»�6.t �.C.��o®.�._ �-�dOf� / da'a+�� '',.... Attendance:Are�our aware of the importance of regular meeting attendance including the time commitment involved in reparin for meetings,and do you feel you have the time available to be an active participant?Wes No Comments: ,,,��"" f t Conflict of Intere§t 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? es No If yes,provide details on a separate 12icce of 12al2er. Ap cant Signature Date I Questions may be directed to the Administration Department at 763.635.1000. . ee • • - ce e • e • • • e - e OFFICE USE ONLY U New Applicant ® Reappointment Council Meeting Date: ® Appointed to: Term Expires: ® Not Appointed I