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I'etalu'ma, ~
C'ity of
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Instructions: Use this form to apply to serve on any of the City of Petaluma, Cali ~~~' s' B rd~~~
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Commissions, or Comm
write N/A in the space provided. When completed, please forward to the City Clerk's Office City of
Petaluma, 11 English Street, Petaluma, CA 94952. All applications are reviewed by the City Council.
.Name: -
HomeAdd~eas, City, Sfate and Zip:Cod:e:
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`Home Phone: (If.dppoihted, do~you,waritthis
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number to be av~aila~ble to the public?~
S ^ NO
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FAX:
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E-nAail: (If appointed, do, youwant this address to ~~
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' be available to the public?) l~.l YES
Are, you a registered voter,`in ;Petaluma ~ If so:,for how long?
YES ^ NO ~ i ~ v ~ S
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Board(s), Commission(s) or Committee(s:) of Interest tk~,
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*Note: To serve on the Senior Advisory Committee, you must be age 55 or above.
-- Have you~attend;e;d a rrieetin'g.of°this Have you served on, interviewed, or,applied~"for
'body? '.this bod,.y~previously?
YES ^ NO YES ^ NO
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resenf Employer: -
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Job Title: •
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' I Bodies/Elec#ive: Offices you have served Position/Office Held and
Previous Governrnenta
Dates: - . ~ ..
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Civic;or Charitable Or'gamzq#ion o which yovhave~>belon`ged;,`P..osition/Office~Held, and
_ Dafes::
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~c.Q,~Ge s o F I~.a-~ 1,~,~,+e~c~ ~c~-; v~.Q~ ~~1,~,~.aQ c<~~ v~ - R/o Co -
ll~hat Special Interests/Skills/Talenf's.wou;ld :youbring to this Board, Commission; or Committee?'
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.College, Professional; .Vocational Schoo{s Attended (:Major Subject,. Dates, Degree/Date):
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~Sp'eciaLAwards or Rec`ognitio_n Rec~eived~: ~ ~ ~' .
Please state reasd,ns~why you, want,~to;becorne a member:;of this Board, Commission nor
Committee, inc[uding,awhatapecific objectives you•would:be working toward as a member of
.this advisory body:.'
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1s ther;e any other information, that: you feel' would beuseful to> the City Council in ,reviewing
your gpp{icatio,n?
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re you associated with any Organisation/Emp oyment that might'be, deemed-a'.conflict of
interest in performing your duties,if appoinfed to this,positior?
YES ^ NO
;If yes, please state name of Organization/Employment: °° ~ u, ~ '
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'.C'ity policy directs,all appointed; advisory body members. not to:wote on ma#ters where there
exists<a pofential conflict of interest. Would you"be willingto;,abstain.f~om voting if such-a
confiict.arises?
YES ^ NO
``How~dd yo\u hear.ab,out~#his operng?
~i~` l C~Pa-~--~-
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Applicant's Sigriatur~, ~. Date'.
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Revised August 12, 2008 . ~~
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v~ar.~o rcfi rrn nmm~latarl ni iactinnnnira to tha C~ffi~a of tha City clerk 1 1 Fnnlich .CtrPet Petnlumn. CA 9d9.5~
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.Horne Phoiie: ~ ,: ~ ' -.. '. .; . `- .., Work Phone:;
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Please print or type your answers to the following questions and submit to the City Clerk's Office. You may
submit additional sheets, if necessary, to complete your answers.
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Have you°attended any of. fhe followrng meetings? ~ - .
Planning Commission Orientation Session r ~p1 rt-F-~~i rt.,i v~-fL YES ^ NO
2~ o ~ ~I - ~ 01 ~ l ~ a'1 1 o z o ~1
Planning Commission Meeting YES ^ NO
Date: ~ ~,~d ~ rG~-~ 61'1 `f'~ ~I G~-~ i'l~ W~.1V~ 5 ~l~oYl ~1 ~ c-Q-- ~/ ~ I a G~ ,
What. do you think qualifies.you toservAe ,ori the Planning Cormission?
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What do you see as the best solutions",.both-brig and short ferm, for. economic development'in Petaluma:?
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Imdgine' yourself as d;vis'rtor #o ,Pet~al'urna~"~'l at~'do~you se'e{physically; econom~cdlly~ "and environmentally "ds'
you walkaround'town?.
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The"Geri ial Plari (Plan) is the guiding docu ent andewision for the i y. How wou d-yo iriterpref the'. policies:
and,godls articulated in-the plan? How-.f~exible,,..would~you be'and would you feel comfortable not approving .
specific'lahd uses allowed in the Plan? '
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hy ;_;~ ~Nfh management system h'as been an''elemerit of he developmerif process in Petaluma since ,1972;
and an'Urban Growth Boundary was adopted:in 1998;to control the physical growth<of Petalumd. With these
t~.vo-major ~^'~cies in mind, aril given the pressufe: for ongoing growth during the next decade or so, what two
r_~r three poli_ ies and .programs would you promote to protect the._historic, cultural, and physical aspects of
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Petaluma? .. ,-
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How would you address cucr.ent and'futu,re floo;din_g:issues'for: taluma?
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How would you"address current and~future;traff~c-congestion'n Pe'talurna2 ... ~ ' `..
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.~~'hat infill f=~~li~;ies do you think should be_adop ed in light ~of the Urban GrowthBoundary passed by the voters?
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Signature _ , , . ,,,:.: `Date;.
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Revised June 1, 2005
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