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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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PR—Sim�be�ck <br />I understand that inform�ation provideed in this application ray be distributed <br />by the city to the public including, but not lim�iteed to, being posted on the <br />City of Roseville we�bsite . I agree to waive any and all claims under the <br />Minnesota Dove rnm�e�nt Data Practices Act, or any oche r applicable state and <br />federal law, that in any way related to the dissem�ination to the public of <br />inform�ation 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 questions regarding 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 cal 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.: Home Phone <br />Num�ber,Pre�fe�rre�d Em�ail Address <br />Home Phone : 651-488-6047 <br />work Phone : <br />Cell Phone: <br />Preferred Em�ail Address: gsim�beckl@,gm�ail 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: 2/25/2011 10:37':52 AM <br />@ � I, <br />
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