RECEIVED
CITY CLERK'S OFFICE
JULY 6, 2021
BOARD OR COMMISSION APPLICATION FORM
DATE Jul45,2001
Check one: New API
ReAppr
NAME OF BOARD OR COMMISSION Labaic Preservation Commission OCCUPATION Education MAIL ADDRESS
PLACE OF EMPLOYMENT: Dakland Daces Scheds
Ie bistery ef tenmend a samdthing teet a venungarant bome. za greatplace, lumidito take as activerla in busesure as wish FRATERNAL AND/OR CIVIC ORGANIZATIONS:
Lalalone
Harand a vuna for Ectuataon
EDUCATION:
REFERENCES (Minimum 5- List Name, Address, Phone Number, and Email Addrese)
2. 3. Melody yee
4 Garatedall
To the beat of my knowladge the information provided is true and correct:
Senatura Slty5,2021
Deliver or hail to carden
Or Email ta: City [email protected]
450 Civic Center Plaza
Richmond, CA 94804