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waive any and all claims under the Minnesota Government Data Practices Act, or any other <br />applicable state and federal law, that in any way related to the dissemination to the <br />-M i- te Am <br />public of information contained in this application that would be classified as private <br />under such laws. I understand that I may contact the responsible authority for the City of <br />Roseville if I have any, questions regarding the public or private nature of the <br />information provided.: Yes <br />I understand that the City will not publish my phone or fax numbers or email address <br />without my authorization and do hereby allow the City to publish (check all that apply) <br />Home telephone numbler, Home email address <br />Daytime Phone: <br />Evening Phone: <br />Cell Phone.: I <br />Home Phone (if different): 651 29-7 0229 <br />Work, Phone (if different): <br />Home Pax: <br />Work Fax.: <br />Home Email.- mrf3elstad@aol.com <br />Work Email: <br />student Application: No <br />If yes, please list your grade: <br />May we clontact you us in your work email or fax?: Yes <br />I have read and understand the statements on this form, and 1 hereby swear or af f irm that <br />the statements on this form are true. : Yes <br />Additional Information,. <br />Form submitted on: '7/17/2008 1:513:29 PM <br />Submitted from, IP Address: <br />Form Address: http://www.c"Ityofrosev'llle.com/foirms,,asp?FID=237 <br />N <br />