2012/12/18 Council Agenda Packet

EVERETT CITY COUNCIL • SPEAKERS REQUEST SH 1 ET • NOTE: PLEASE STATE YOUR NAME AND ADDRESS : ' ` : : IN PLEASE PRINT: • DATE: NAME: ADDRESS: 2 6 l t5 )c CITY/STATE: .z ' 64- • I wish to speak to the Everett City Council • under "Citizens Comments" or - "Audience Comments" regarding a topic that is not on the agenda. Briefly describe your topic below: I would like to comment on Agenda ite #CC6 . today's agenda. You will be given an opportunity to speak when that item is called. Each citizen is asked to limit comments to 3 minutes. The purpose of this practice is to allow all citizens a fair opportunity•to speak. If you wish to give a longer presentation, please contact the Council Office at (425) 257-8703, before you speak, either in writing, or by phone, so that other arrangements may be made to allow you the time you may need. Please return this form once • completed to the Council Administrator before the meeting begins. Project of Activity Title: \ k-kc Date: t 2 - ( ( Z Meeting/Activity Location: •• Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 Name(Please Pri Gender: A tiPPKale OFemale General Ethnic Identification Category (please check one) Caucasian ❑Hispanic American ❑American Indian/Alaskan Native ❑African American ❑Asian/Pacific Island ❑Other Color: ; National Origin: "CIVIL RIGHTS ACT OF 1964, TITLE VI STATEMENT TO THE PUBLIC: The City of Everett hereby gives public notice that it is policy of • the City to assure full compliance with Title VI of the Civil Rights Act of 1964, the Civil Rights Restoration Act of 1987, and related statutes and regulations in all its programs and activities. Persons wishing information regarding the City's Title VI compliance may call 425-257- 8703, Title VI Specialist for the City Council."