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the dissemination to the 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 Roseville if I have any <br /> questions regarding the public or private nature of the information provided.: Yes <br /> Occasionally City staff gets requests from the media or from the public for ways to contact Commission <br /> members. The CoMMission roster is periodicaly made available. Tease indicate which information the City <br /> may release to someone who requests it or that may be included on the Commission raster. Under IN Statute <br /> 12.60 1. subd. 3(b), either a telephone or electronic mail address (or both) where you can be reached must be <br /> made available to the public. Tease indicate at least one phone number or one email address to be available to <br /> the public, and fill in the corresponding information in the below.: Cell Phone Number <br /> Home Phone <br /> Work Phone <br /> Cell Phone: 612-867-0915 <br /> Preferred Email Address: 3yMejzroffjLDedinareWjy.com <br /> I have read and understand the statements on this form, and I hereby swear or affirm that the statements on this <br /> form are true. : Yes <br /> Additional Information: <br /> Form submitted on: 12/6/20112:48:18 P <br /> Submitted from IP Address: <br /> Deferrer Page: No Referrer-Direct Link <br /> Form Address: hqp-://www.cllygfrosevl*Ile.com/Forms.as-px'?FID=237 <br />