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2011_0314_packet
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2011_0314_packet
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2/15/2012 1:34:33 PM
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12/19/2011 3:44:57 PM
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PL—PR—BoUl ton <br />inform�atiern contained in this application that would be classified as private <br />under such laws. I understand that I ray contact the responsible authority for <br />the City of Roseville if I have any que�stions re�garding the public or private <br />nature of the inform�ation provided.: Yes <br />occasionally city staff gets requests from the m�edia or from the public for <br />ways to contact Commission members . The Commission roster is periodi eat y made <br />available. Please indicate which inform�ation the city ray release to someone <br />who requests it or that ray be included on the Commission roster. Under MIN <br />statute §12.601. subd. 3,(b), e�ithe r a telephone or e�le�ctronic m�ail address (or <br />both) where you can be reached rust be made available to the public. Please <br />indicate at least one phone number or one em�ail address to be available to the <br />public, and fill in the corresponding inform�ation in the below.: Pre�fe�rre�d <br />Em�ail Address <br />Home Phone : <br />work Phone : <br />Cell Phone: <br />Preferred Em�ai 1 Address: cycl espeeder@,gm�ai 1 . com <br />I have read and uncle rstand the statements on this form , and I he re�by swear or <br />affirm that the statements on this form are true. : Yes <br />Additional Information: <br />Form subm�itted on: 211712011 11:08:58 AM <br />@ � 5 <br />
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