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• <br /> RECEIVED <br /> INDIAN RIVER COUNTY APPLICATION <br /> FOR COMMITTEE APPOINTMENT MAY Q 4 2015 <br /> Name: 'Ocij /7=/C� / Date: 2.--6----/S-- <br /> -�'1 BOARD OF COUNTY <br /> ! <br /> CON MISSION <br /> Full Name: PA"))6 e_ ia-. -1 C1.1-61/ Email Address: 17i4tJR L 7N6Z old,attx,v5 ,c'crrA <br /> Street Address (No P.O. Boxes): 7--415. 6 3 49' .. <br /> Home Phone: 6 7-- "No Work Phone: 14-2-`4/t Ss Cell Phone: V73 -24,51 <br /> How long have you been a resident of Indian River County? 3s 1j:hn� <br /> Are you a full or part time resident?Check one: Full TimeNi.Part Time ''ISTRIisUTION LIST <br /> L'mmissioners _. <br /> Administratorh� <br /> Please list current employer or business. If retired, please list any business expa nce..that-maybe ___1 <br /> rt <br /> applicable to the committee. Community Der.. ..,_.___.. <br /> f� E,u,r,y-5enrites <br /> /IK ,( k-+� `/� �r`7 ,,eneral Servires <br /> ;lumen Resources -- <br /> 6' -7--/‘ -1/0;.S40 ,01v <br /> 1 OMB <br /> P,,6lir weeks <br /> Recreation -- <br /> Please list any licenses you presently hold: iltiliiies Services ______ <br /> \ec "e <br /> Please list any organization of which you are currently a member: <br /> D..4r4 five"- 641,- Z -41 - /90v ,itik a.44/( / (,..e, -- r'Jo4Ln04 9 11- c /(Aiete /01"- <br /> /or <br /> 01 c.,/or c'iv,8 <br /> Please list any other committees or boards you currently sit on: <br /> vs D/; if),,Li,,../7 t A/ 'TO/An_d X19✓,r S7i17 6'Yn.n,h.ti, r- ez. c`-J its 7AMc Fc44.0 <br /> iii 7 k- <br /> Continued on next page <br /> 191 <br />