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From:
clrtOF SAN BERNARDI~ - REQUE5 FOR COUNCIL ACT:'JN
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~ C'\\ . /\-;., S'ubject:
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Mayor W. R. Holcomb
Dept:
Mayor's Office
Appointment: Herb Clemensen to the
Planning Commission as requested by
Mayor Holcomb.
Date: June 20, 1989
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Synopsis of Previous Council action:
Recommended motion:
That the appointment of Herb Clemensen to the Planning Commission, as requested
by Mayor Holcomb, be approved.
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Signature
Contact person: Mayor W. R. Ho 1 comb
Phone: 5051
Supporting data attached: Yes Ward:
FUNDING REQUIREMENTS: Amount: N/A
Source: (ACCT. NO.)
(ACCT. DESCRIPTION)
Finance:
Council Notes:
1S.0262
Agenda Item No,
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,!o.
OCITY OF SAN AAROINO
Application tor Consideration tor Appointment
to citizen Commission or Committee
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Personal Data
Name: /~'Kg.5J?r,C): 0LE".d/C#SCN
Home Address: -=162.5' c;fE/JdLI/Af:"~A ~r ~-~ q24"~4I'
Date of Birth: ~# /i)~/912. TelePhone{7/~) A;:(~-/...A ~~
Have resided in the City ot San Bernardino since .~~~r/~
Marital Status: ~"/~b Commun;.ty .\t!!liations: S:.R. l/. :R.K_
~s r A?.F..Hr~~ tf),c' : 7!?i)dR/J /:J,I!' J)/p~rhR.~'" ~/';~~~~~J~~
~.J>A?R,oS ~~.p.#IHi AfLP~R}) I~AHf/A/6 ~ .:?A.A//./V~'
Wii?' f!Cs/~ '/ tJ.F ~7. 7'72ti" /.c#~ y 'tJ,<} Y 4' E4.z:.e:r. A/~ft1..e
ww~cat",gYSlcZ/~ff AT .xtfi41l' 1979. ~&;V ~~ ~a'"~M:c..u .
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~st Emtllovment
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aAu~.s27"/L /'I'~<A,'r 7' yp, A.s'^~/;:' E-tH~/A~1J ~.p~/~~.
~6=iV o~ .d~.cc.- 'Y.f:!rJ ~Q.A:I.sr ('0" ;96'/.-/984.
urrent Em~~e.m; ~
Firm Name:. 7~0~.H~Nr~A/ifdL~i? Phone: B~q.f/.58:?(J
Address: ?4AJ ~ /~-<-V/AA//J ~~#.(. ~A/;g;>Al4 ~A" qL4~d
Please Indi
. ation For:
What Committe s/Commissions You Are Seeking Consider-
The information provided is factual to the best of my
stand that I will be required to sign a "Statement of
form as required by law, and that I will abide by all
nances of the City of San Bernardino and the State of
~~--...'r- ~
~ 19nature
Have you ever been convicted of a felony? Yes___ NO~
knowledge. r ~~de~-
Economic :nterestsN
the codes and o~di-
California.
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