8B, Appointment of Terry Maurer as Public Works Director

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�:n�plo��ent of Relatives List any relatives currentiy employed by the C�t� of Arden Hilis Name Person�.l Re�erences (1�1ot former e�ployees or relatives) �c,�� C� c�,� � _ � r� � v�; -�� 1� �1 �l ��e�.-� � G r�,�t� ��# � �� ��Y�� ',�' l �1��'�Y3 C� �-� �� ! � �e�� _ �� Y � � � �� V � � Relationship 'i'o You C� � �� Ct� l�n�b� a ��'r� �,-�� .�� - �� ��r�. �}�� -� �� 2 �� � �i ocx� r�c� � � �.� � �. � i �C � 1 v��Y'; �'%� � `�� 3 �� �J' �'�t°.Y � t> �'� �. �Ur� 13�C� l-��c� �v�a.� it� � l �. � i � . � � 5��.�5�� �'ennesseen Warning,�ata Practices �Totice to All Applic�.�ts ��-��t�1�-3�O�Z I �..�/ � f �� w ` � � � � V � � i�� ' � �� �e Niinnesota Government Data Practice� Act requires t�at you be informed of the pur�oses and intended uses of the information you provided to t�e City of Arden �Iilis during the application p�ocess or during err�ployment. Any information about yourself that you provide wi�� be used to identify you as an applicant and to assess your qua�ifica�ions for employtneni with the City. if �ou wish to be co�sidered for employmen�, you are required to �rovide �e information requested in the Application for Employmen�. If you refuse to supp�y inform�tion requested by the Ci�y, it may mean your applica�io� will not be considered. You are hereby advised that, under Minnesota �aw, t�e fo�lowing infor�nation given by an applicant is considered to be up blic : veteran status, relevar�t t�si s�ores, ranlc on c�ur �ligi�le lis�; job hisiory; educa��on and ��aining; work availability. As an app�icant, your name is considered riva#e until you are certified as eligib�e for appointm�n� to a position or w�en ap�licants are cor�sidered by the appointing authority to �e �inalists fflr a position with t�e City of Arden Hilis. '`��na�ist" rr�eans an individ�ai who is selecied to be interviewed b� the appoin�ing au��iority �rior to seiection. � The data. concerning you, which is placed in your appiication folder or in yo�r personnel fiie and vvi�ic�i is no� listed as public, is �rivat�. Th�s �rivate date w�i� be shared w�th you ar�d those n�embers of the Ci�y staff who need it to process the application, update your personnel record, evaluate your work �e�forma�ce and if you are handicapped, provide the r�ecessary accom.moda�tions. It r�ay also be sha�ed with the followin�: persons au�horized to have access to the informatiot� under State or Fed�ral law; persons authorized by Court Orde� to have access to ihe in�or�nati4n; and persons to w�om you consent in writi�g to have access to the informa�ion. With t�e excep�io� of racial and ethnic data, �he data you give us about yourseif is needed to identify you and to assist determining your sui�a,bility �or t.�e po�it�on for vvhich you are app�ying. Racial and eth�ic data re used i� summary %rrn by t�e Ciiy's Aff rmative Aciion �'rog�an� tc� mon�tor protected class e�nployn�ent and to mee� Federal, Sta.te, and Local reporting requirements. Furnishing racial and ethr�ic daia about yourself, as wel� �,s your social securiiy numt�er, is voluntary. � certify that a.nsvvers herein are tru� and corr�p�ete to the best o�my know�edge. � aut�orize inves�igation o� ali statements contained i� th�s Application �or Employment as may be necessary in ar�iving zt an err�p�oym�nt decis�on. i un�lersta�d �hat t�is appiication is not, and is �flt intended, to be a contra�t for e�nployment. in �he vent of �mploy�nent, I understand t�at false or mis�eading informatio� given in my application, �r inte�-view(s), may result in discharge. � understand also, that I arn �equ�red to abide by all rules and r�gulations of the City. i certify t�a� I have r�ad �he "Notice tfl Ap�lication" regarding the Mi�nesota Data �'ract�ces Ace {MN Statuies 1301-1390}, and I understand my rights as a subj ect of date. Ap�iicant Signature: Date: � � City of Arden !* 1245 Wes# Highvvay 96, Ar�le� �ills, 1�1� 5� � 12 *�65 �} 634 -5 � 2�