City of Fortuna
APPLICATION FOR APPOINTMENT TO
CITY BOARD/COMMISSION
LIFOR
Name of Board or Commission: _ City of Fortung Planning Commission Applicant Name: Sance Jay Blakely
Home Address: Fortuna, Ct-95510
Mailing Address (if different): _
Home Phone: Business/Cell Phone:
Email Address
Education: Some college - trade School
Length of Time in the Fortuna Area: 30+ years
Present Employer: Retired
Job Title:
Organizations in which you are currently involved:
Reason for wanting to serve on this board/commission: Serve the Community Expertise you bring to this board/commission: Byear on cityof(vescent City Flarming Two Denotte GrandJuries
Reference:
Kathleen mewhorter
talblately 01/09/2023
ignatur Date
This application will be kept on file for six months
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