HomeMy WebLinkAboutHastings RZ
May 15, 2006
MERIDIAN PLANNING & ZONING MEETING
APPLICANT Monterey, LLC
RZ 06-003
May 18, 2006
ITEM NO.
8
REQUEST Public Hearing -- Rezone of 3.13 from R-4 (Low Density Residential) to L-O (Limited
Office) for Hastings - 2300 West Everest
AGENCY
COMMENTS
CITY CLERK:
CITY ENGINEER:
CITY PLANNING DIRECTOR:
CITY ATTORNEY
CITY POLICE DEPT:
CITY FIRE DEPT:
CITY BUILDING DEPT:
CITY WATER DEPT:
CITY SEWER DEPT:
CITY PARKS DEPT:
MERIDIAN SCHOOL DISTRICT:
SANITARY SERVICES:
ADA COUNTY HIGHWAY DISTRICT:
CENTRAL DISTRICT HEALTH:
NAMPA MERIDIAN IRRIGATION:
SETTLERS' IRRIGATION:
IDAHO POWER:
INTERMOUNTAIN GAS:
OTHER: See Attached Affidavit of Posting / See Attgched Email from Bill Carter
contacted:~.~'d. Date: 5'/I(P~ Phone: 3/G,I"-S-OdO
Emailed:jSrYtl-l6....I~J.eYj(/.lW.CD.Y) Staff Initials: ~
Materials presented at public meetings shall become property of the City of Meridian.
See Attached Staff Report
({ ce-omrnefld Appro vttP
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No comment
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18,2006
STAFF REPORT
TO:
FROM:
SUBJECT:
ctG""" Lr~~~
'\....,..;.f8. .Et~/_~.i ~ED
Caleb Hood, Current Planning Manager _~ . ?
. . ":.1~~!" ., lAAv, ,";~n06
Hastmgs Rezone -..i.,.!..:d!J."'!c, ~.:'1Jl!
. RZ-06-003 CetTY OF MERIDIAN
Rezone 00.13 acres from R-4 (Medium Low~Density k1Xct~~a~~)t~FFICE
(Limited Office District), by Monterey, LLC
Hearing Date: 5/18/2006
Planning & Zoning Commission
. V AC-06-006
Vacation of Public Utilities, Irrigation and Lot Drainage Easement on both
sides of the lot line common to Lots 46 and 47, Block 49, Lochsa Falls
Subdivision No. 12, by Monterey, LLC
1. SUMMARY DESCRIPTION OF APPLICANT'S REQUEST
The applicant, Monterey, LLC, has applied for a Rezone (RZ) of 3.13 acres from R-4 to L-O (Limited
Office). The applicant is requesting the subject property be rezoned so that the zoning of this property will
match the future land uses (this area was approved for office uses as part of the Lochsa Falls PUD in
2002). The applicant is also requesting that the existing public utilities, irrigation and lot drainage
easements on both sides ofthe lot lines common to Lots 46 and 47, Block 49, Lochsa Falls Subdivision
No. 12 be vacated. The applicant intends to construct a building across said lot lines. The site is
comprised of two recorded lots in Lochsa Falls Subdivision No. 12, which is located on the south side of
Chin den Boulevard and on the east side of Long Lake Way in Section 26, Township 4 North, Range 1
West. This site is currently vacant.
2. SUMMARY RECOMMENDATION
The subject applications were submitted to the Planning Department for concurrent review. According to
the UDC, the Planning & Zoning Commission does not need to make a recommendation to the Council
on the vacation application. However, because the subject applications are on the same property, staff has
combined the analysis into one report. The City Council is the final decision making body on the Rezone
and the Vacation applications. The Commission should make recommendation to the Council on the
rezone request only, RZ-06-003. Staff recommends approval of RZ-06-003 and V AC-06-006 as presented
in the staff report for the hearing date of Mav 18, 2006 based on the Findings of Fact as listed in Exhibit
C. Staff has included all comments and recommended actions in the attached Exhibit A. NOTE: Because
this is only a rezone application, and no new development is being proposed, there are no conditions of
approval.
3. PROPOSED MOTIONS
Recommend Approval
I move to recommend approval to the City Council of File Number RZ-06-003 as presented in the
staff report for the hearing date of May 18, 2006, and the with the following changes to the staff
report: (add any proposed modifications).
Recommend Denial
I move to recommend denial to the City Council of File Number RZ-06-003 as presented in the
staff report for the hearing date of May 18, 2006, for the following reasons: (you must state
specific reasons for denial. They should address how the applicant might re-do the application to
Hastings Rezone - RZ-06-003
PAGE I
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18, 2006
gain your recommendation for approval).
Continue
I move to continue the public hearing for File Nwnber RZ-06-003 to (date certain) for the
following reason(s): (insert reason).
4. APPLICATION AND PROPERTY FACTS
a. Site Address/Location:
2300 W. Everest Lane; South side of Chin den Boulevard, east of Long Lake Way in
Section 26, Township 4 North, Range 1 West.
b. Owner/Applicant:
Monterey, LLC
10221 W. Emerald Street, Ste. 100
Boise,ID 83704
c. Representative: Gene Smith, Engineering Northwest
d. Present Zoning: R-4 (Medium Low-Density Residential)
e. Present Comprehensive Plan Designation: Mixed Use - Community
f. Description of Applicant's Request: The applicant is requesting approval to rezone 3.13 acres
of property currently zoned R-4 to L-O. The subject property was previously approved for
office uses as part of the Lochsa Falls Planned Unit Development and the 20% land use
exception. The applicant is proposing to rezone the subject property so that zoning will match
the future office uses on this site. Subsequent to the rezone being approved, the applicant
intends to construct eight single-story office buildings on this site. One of those office
buildings is planned to be located on the lot lines between Lots 46 and 47, Block 49, Lochsa
Falls Subdivision No. 12. There is a platted utility, drainage and irrigation easement on both
sides ofthe lot line common to Lots 46 and 47 that is also proposed to be vacated concurrent
to the rezone request.
5. PROCESS FACTS
a. The subj ect application will in fact constitute a rezone as determined by City Ordinance.
By reason of the provisions ofUDC 11-5B-3, a public hearing is required before the City
Council on this matter.
b. Newspaper notifications published on: May 151 and May 15th, 2006
c. Radius notices mailed to properties within 300 feet on: April 21 st, 2006
d. Applicant posted notice on site by: May 8th, 2006
6. LAND USE
a. Existing Land Use(s): Vacant.
b. Description of Character of Surrounding Area: The area along this portion of Everest Lane
(private lane) is developing with office uses. Residential uses to the south and east ofthe site
are rapidly being constructed.
c. Adjacent Land Use and Zoning
1. North: Vacant, zoned RUT in Ada County
Hastings Rezone - RZ-06-003
PAGE 2
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18,2006
2. East: Vacant, zoned R-4 (future office), Lochsa Falls Subdivision.
3. South: Residential, zoned R-4, Lochsa Falls Subdivision
4. West: Future School site in Silver Leaf Subdivision, zoned R-4
d. History of Previous Actions: In 2002 a 354 acre 870 lot subdivision and annexation request
for Lochsa Falls Subdivision was approved by the City. A Planned Development Site
Specific condition of approval requires all future uses within the office phases of this
development to obtain CUP approval. Earlier this year, the Commission approved CUP-06-
008, a detailed CUP request for two office buildings on this site.
e. Existing Constraints and Opportunities
1. Public Works
Location of sewer: Lochsa Falls Subdivision. Everest Lane
Location of water: Lochsa Falls Subdivision. Everest Lane
Issues or concerns: None.
2. Vegetation: Existing landscaping along Long Lake Way and Chinden Boulevard
3. Flood plain: NA
4. Canals/Ditches Irrigation: None.
5. Hazards: None.
6. Proposed Zoning: L.O
8. Size of Property: 3.13 acres
h. Proposed and Required Non-Residential Setbacks: per the L-O zone
L-O Standard
Front
Side
20 feet
10 feet
20 feet
35 feet
Rear
Max. Building Height
Min. Lot Size
None
Min. Street Frontage None
1. Summary of Proposed Streets and/or Access (private, public, common drive, etc.): The access
to the site will be from existing curb cuts on Everest Lane. No access to Long Lake Way or
Chinden Boulevard should be allowed to this site.
7. COMMENTS MEETING
On April 28, 2006 Planning Staff held an agency comments meeting. The agencies and departments
present include: Meridian Fire Department, Meridian Police Department, Meridian Parks Department,
Meridian Public Works Department, and the Sanitary Services Company. No significant comments were
received from any agencies or departments. Staff has included all comments and recommended actions in
the attached Exhibit A. Because this is only a rezone application, there are no conditions of approval.
8. COMPREHENSIVE PLAN POLICIES AND GOALS
The Comprehensive Plan Future Land Use Map designates the property as "Mixed Use - CommWlity",
Hastings Rezone - RZ-06-003
PAGE 3
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18,2006
and it is currently zoned R-4. In Chapter VII of the Comprehensive Plan, this designation is defined in
part as an area that is situated in highly visible or transitioning parts of the City where innovative and
flexible design opportunities are encouraged. The MU-C has an upper limit on the square footage of non-
residential uses and is intended to allow a focused range of uses in close proximity of residential uses.
Staff recommends that the Commission and Council rely on any verbal or written testimony that may be
provided at the public hearing when determining the most appropriate zone for this property.
Staff finds the following Goals, Objectives, and Action items contained in the 2002 Comprehensive Plan
to be applicable to this application (staff analysis is in italics below policy):
· "Require all commercial businesses to install and maintain landscaping." (Chapter V, Goal III,
Objective D, Action item 5)
The applicant will be required to construct landscaping which complies with the Unified
Development Code, when the future office buildings are constructed.
· "Permit new . . .commercial development only where urban services can be reasonably provided at
the time of final approval and development is contiguous to the City." (Chapter IV, Goal I, Objective
A, Action item 6)
The subject site can be serviced by the City of Meridian's sanitary sewer and water systems.
Staffjinds that the proposal is harmonious with and in accordance with the Comprehensive Plan.
9. ZONING ORDINANCE
a. Zoning Schedule of Use Control: UDC 11-2B-2lists office as a permitted uses in the L-O zone.
The Planned Development allowed for office uses in the R-4 zone as of the 2002 approval
under the Meridian City Code.
b. Purpose Statement of Zone: The purpose of the Commercial Districts is to provide for the
retail and service needs of the community in accord with the Meridian Comprehensive Plan.
Four Districts are designated which differ in the size and scale of commercial structures
accommodated in the district, the scale and mix of allowed commercial uses, and the location
of the district in proximity to streets and highways.
10. ANALYSIS
a. Analysis of Facts Leading to Staff Recommendation
REZONE ANALYSIS: The applicant is requesting a rezone of this property, primarily because
City staff requested that they rezone to clean-up the property. The applicant is currently entitled
to office uses on this site, subject to Conditional Use Permit approval. Staff recommends that this
property be zoned to L-O to reflect the future land uses.
Based on the policies and goals contained in the Comprehensive Plan and the general compliance
of the proposed zoning with the UDC, staff believes that the rezoning of this site to L-O is in the
best interest of the City. Please see Exhibit C for detailed analysis of facts and findings.
The rezone legal description submitted with the application (prepared on March 15, 2006 by
James R. Washburn, PLS) shows the property within the existing corporate boundary of the City
of Meridian.
Hastings Rezone - RZ-06-003
PAGE 4
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18.2006
All future re-development of the subject property shall be constructed in accordance with City
of Meridian ordinances in effect at the time of development, and the Development Agreement
in effect for this site. All future uses shall not involve uses, activities, processes, materials,
equipment and conditions of operation that will be detrimental to any persons, property or the
general welfare by reason of excessive production of traffic, noise, smoke, fumes, glare or
odors.
V ACA TION ANALYSIS
The applicant has provided notarized consent to vacate from all of the major utilities including:
Idaho Power Company, Qwest, Intermountain Gas, Cable One and Settlers' Irrigation District.
The Meridian Public Works Department also consents to the requested vacation of the public
utilities, drainage and irrigation easement along both sides of the lot line common to Lots 46
and 47, Block 49, Lochsa Falls Subdivision No. 12. NOTE: There are no required findings for
a vacation application.
b. Staff Recommendation: Staff recommends approval of RZ-06-003 and V AC-06-006 as
presented in the staff report for the hearing date of May 18, 2006 based on the Findings of
Fact as listed in Exhibit C. Staff has included all comments and recommended actions in the
attached Exhibit A (because this is only a rezone application, there are no conditions of approval.)
11. EXHffiITS
A. Agency and Department Comments
1. Planning Department
2. Public Works Department
B. Legal Description
C. Required Findings from Zoning Ordinance
D. Easement to be Vacated
Hastings Rezone - RZ-06-003
PAGE 5
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18,2006
A. Agency and Department Comments
1. PLANNING DEPARTMENT
1.1 The legal description prepared by James R. Washburn, PLS, dated March 15, 2006 and submitted
with the application is accurate and meets the requirements of the City of Meridian and State Tax
Commission.
1.2 All future uses on this site should comply with the provisions of the Unified Development Code
in effect at the time of submittal.
1.3 Staff recommends that sidewalk be constructed on the north side of Everest Lane, as none
currently exists.
2. PUBLIC WORKS DEPARTMENT
2.1 This property currently has sewer and water mains installed along its frontage. Public Works
has no concerns with the rezone or vacation applications.
Exhibit A
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18, 2006
R Legal Description
Engineering North West) UC
423 N. AnccikJr Platz, Suire 180 Boise, Wabo 83704
(208) 316-5000 - Fa... (101l) 376.5556
Project No. 05-058-01
Date: March 15,2006
LOCHSA FALLS SUBDIVISION NO. 12
LOTS 46 AND 47, BLOCK 49
IU:ZONE DESCRIPTION
A parclll ofland being Lots 46 and 47, Block 49 ofLochsa Falls Subdivision No 12, lIS
same is soown.cn thll Plat thereofrecoroedin Hook92ofPIats at Page t0958 of Ada County
Records, located in the NW 1/4 orlbe NE 1/4 ofSeclion 26, T, 4 N.; R. I W., B.M., Meridian,
Ada County, Idaho. more particularly descn"bed as folloWll:
Commencing at \.he section comer common toSClCtions 23, 24, 25 and 26 of said
T. 4N., R. 1 W.;
Thence Nortb 89"38'20~ Weill, 2630.00 fccl on the section line common to said Srn;tions
23 and 26 to the 1/4 section COmer common to said Sections 23 and 26;
Tbem:.e rovcrsingdircclion, Souib 89"38'20" East, 199.79 feet;
"fbCl1<<\ leaVing said section line South 00"21'40" West, 105.00 feet to the northwest
COtner of 1.0147, Block 49 of said Lochsa Falls Subdivision No. 12, said point being the REAL
POINT OF BEGINNING; ,
Thence South 89"38'20" East, 440.00 feet on the northerly lot line of said Lots 47 and 46
to the notth6l'ly lot comer common to Lob 4S B1ld 46, Block 49 of said Subdivision;
Thence SQuth 00"21'40" West, 310.13 feet on the lot line COIIllJ1OO to said Lots 4S
and 46 to the southerly lot COIncr common to said Lots 45 and,46;
Thence North 89"38'20" West, 440.00 feet on the southerly lot line of said Lotll46 and
47 to the lIl)uthwest comer of said Lot 47;
Thence North 00"21 '40" But. 310.13 fectOD the westerly lot line of said Lot 4710 the
real point of beginning. Said plli'cel contains 3.l3 lICl'I'llI more or less.
PREPARED BY:
, EngiDeerlDg NorthWest, LLC
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James R. Wasbbul'l1i.Pl~J"!r.v;:, llS.I'T
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Exhibit B
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18.2006
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CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE OF MAY 18,2006
C. Required Findings from Zoning Ordinance
1. Rezone Findings:
Upon recommendation from the Commission, the Council shall make a full investigation
and shall, at the public hearing, review the application. In order to grant an annexation
and/or rezone, the Council shall make the following findings:
1. The map amendment complies with the applicable provisions of the comprehensive
plan;
The applicant is proposing to zone the subject property to L-O, Staff finds that the
proposed zoning map amendment complies with the applicable provisions of the
comprehensive plan, Please see Comprehensive Plan Policies and Goals, Section 8, of the
Staff Report.
2. The map amendment complies with the regulations outlined for the proposed
district, specifically the purpose statement;
Staff fmds that professional and personal services (offices) are permitted within the
requested zoning district of L-O, Staff fmds that the site is large enough to contain the
required parking and landscaping,
3. The map amendment shall not be materially detrimental to the public health, safety,
and welfare;
Staff finds that the proposed zoning amendment will not be detrimental to the public
health, safety, or welfare. Staff recommends that the Commission and Council rely on
any oral or written testimony that may be provided when determining this finding.
4. The map amendment shall not result in an adverse impact upon the delivery of
services by any political subdivision providing public services within the City
including, but not limited to, school districts; and,
Staff finds that the proposed zoning amendment will not result in any adverse impact
upon the delivery of services by any political subdivision providing services to this site,
Exhibit C
CITY OF MERIDIAN PLANNING DEPARTMENT STAFF REPORT FOR THE HEARING DATE Of MAY 18. 2006
D. Easement to be Vacated
!-_._.~- LOOHSA FALLS SUBDIVISION NO. '12 '
LOTS 46 & 47, BLOCK 49
PUBLIC UTILITIES EASEMENT VACA TjON
.-'"'---.~.........
SCALE: 1-'" 100'
5 89'38'20" E 220.00'
. Ii -= BLOCK
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N 89'38'20" W 220.00'
W. E~EST LANE
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N 890.38'20" W 220.00'
(PRIVAlE ROAD)
Exhibit D
/
'. ,,:.(~l: - ,~;~~-!
~r;dllizJf'\, TRANSMITTALS TO AGENCIES FOR COMMENTS ON
IDAHO ~/ DEVELOPMENT PROJECTS WITH THE CITY OF MERIDIAN
~ )y
~();""""I'!'Tnr;;\s[JI'eYAL1--'" 'P~o insure that your comments and recommendations will be considered by
lW8~ the Meridian Planning and Zoning Commission please submit your
comments and recommendations to Meridian City Hall
MAYOR
Tammy de Weerd
CITY COUNCIL MEMBERS
Keith Bird
Joseph W. Borton
Charles M. Rountree
Shaun Wardle
Attn: Will Berg, City Clerk, by: May 11, 2006
ransmittal Date: April 19, 2006 File No.: RZ 06-003
.~,Y'l, n'JI~ate: May 18, 2006
.,,;~ . 4'1 t for a Rezone of 3.13 acres from R-4 (Low Density
esiden i Limited Office for Hastin s
CITY DEPARTMENTS
City Attorney/HR
703 Main Street
898-5506 (City Attorney)
898-5503 (HR)
Fax 884-8723
2300 West Everest Lane
Fire
540 E. Franklin Road
888-1234 / fax 895-0390
David Zaremba (no FP)
David Mae (no FP)
Wendy Newton-Huckabay (No FP)
Michael Rohm (No FP)
Keith Borup (No FP)
Tammy de Weerd, Mayor
Charlie Rountree, CIC
Christine Donnell, CIC
Keith Bird, CIC
Shaun Wardle, CIC
_ Water Department
-L Sewer Department
Sanitary ServiceS(No VAR, VAC, FP)
= Building Department I Rich Greene
Fire Department
Police Department
= City Attorney
_ City Engineer
City Planner
Parks Department
Parks & Recreation
] 1 W. Bower Street
888-3579 / fax 898-5501
Planning
660 E. Watertower Lane
Suite 202
884-5533 / fax 888-6844
Police
1401 E. Watertower Lane
888-6678/ fax 846-7366
Public Works
660 E. Watertower Lane
Suite 200
898-5500/ fax 895-9551
- Building
660 E. Watertower Lane
Suite 150
887-2211 / fax 887-1297
- Wastewater
3401 N. Ten Mile Road
888-2i91 / fax 884-0744
Your Concise Remarks:
- Water
2235 N.w. 8th Street
888-5242/ fax 884-1159
Meridian School District (No FP)
Meridian Post Office(FPIPP only)
_ Ada County Highway District
_ Ada County Development Services
Central District Health
_ Nampa Meridian Irrig. District
Settlers Irrig. District
-Idaho Power CO, (FP,PP,CUP)
Owest (FP/PP only)
Intermountain Gas (FP/PP only)
Bureau of Reclamation (FP/PP only)
Idaho Transportation Dept. (No FP)
Ada County Ass, Land Records
- Meridian Development Corp.
Historical Preservation Comm,
RECEIVED
APR 2 4 2006
CITY HALL 33 EAST IDAHO AVENUE MERIDIAN, IDAHO 83642 (208) 888-4433
CITY CLERK - FAX 888-4218 FINANCE & UTILITY BILLING - FAX 887-4813 MAYOR'S OFFfCE - FAX 884-8119
Printed on recycled paper
Page I of 1
Sharon Smith
From: Bill Carter [bill@hosac.com]
Sent: Monday, May 15, 200610:48 AM
To: C. Caleb Hood; Tara Green; Sharon Smith
Cc: gsmith@engnw.com; 'Bob Hosac'; 'Nate Hosac'
Subject: Staff Report in connection with RZw06-003 and VAC-06-006
Vl.4 EMAll,,_ ONt '(
May 15, 2006
TO: Caleb Hood (hoodc@meridiancitY,9J9)
Tara Green (greent@m13xIgIanc:ity.org)
Sharon Smith (smiths@m~flgi~!J}city.org)
FROM: Bill Carter, Member Monterey, LLC
Subject: RZ-06.003 - Rezone of 3.13 acres from R-4 (Medium Low-Density Residential) to L-Q
(Limited Office District), by Monterey, LLC; VAC-06-006 - Vacation of Public Utilities, Irrigation and Lot
Drainage Easement on both sides of the lot line common to Lots 46 and 47, Block 49, Lochsa Falls
Subdivision No. 12, by Monterey, LLC.
cc: Gene Smith, Engineering Northwest
This is to advise that Monterey, LLC (the applicant in connection with the above referenced rezone and
vacation) has reviewed the Staff Report from Mr. Hood to the Planning and Zoning Commission and
agrees with its contents.
Further, representatives of Monterey, LLC will attend the hearing in connection with the above
referenced applications on May 18, 200 beginning at 7:00 pm.
Thank you for your assistance.
Bill Carter
Monterey, LLC
10221 W. Emerald
Suite 100
Boise, 1083704
208-322-5410 (Office)
208-869-3665 (Cell)
208-322-3337 (Fax)
bill@hosac;._Gom
5/15/2006
AFFIDAVIT OF POSTING
RECEIVED
MAY 0 8 2006
CITY OF MERIDIAN
CITY CLERK OFFICE
STATE OF IDAHO
)
) ~
)
.COUN1Y OF ADA
I J Mike Amnld
(name)
Premier Sign~ Inc, 2100 E F~irviAW Avenue, Suite 7 . 85$~0380
(address) (phone)
Meridian
(city)
Idaho
(state)
I being first duly sworn upon
oath, depose and say:
I personally posted the subject property with the hearing notice sign 10 days prior to the public
hearing for the RRqIJAAti.,g a RRzoninu of 3 13 ai:.... fmm R...4 (low-dAnsitv :residential) to L.
, 0 (IimiMd offieA) zone for Hastings' ,
Dated this 5th. day of
M::.y , 2006
~~
( (Sig sture)
SUBSCRIBED AND SWORN to 9Jtfore me the day and year first above written.
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f iJ r;p ,.,.;} ~ "\ Residing at ~ -e./7 LCI'C~
i ...~ .....:' E My Commission Expires: 7-2)j, {j 7
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. Master\affid-posting
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CITY OF MERIDIAN
PUBLIC HEARING
SIGN-UP SHEET
DATE
May 18, 2006
ITEM #
PROJECT NUMBER
PROJECT NAME
RZ 06..003
8
Hastings
NAME (PLEASE PRINT)
FOR AGAINST NEUTRAL