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'�� s yo�z�- v�e�v ca�' �� rot� o��ks �o�u�ziss�a�a/�`oa��r��.i�eel"�`�sk �oree? To pxovide volunteer technical s�ppart and direction to the Ci�y Cau�acz� azad th� Publzc War�C� Depaxf�nent on recurrir�g �d ne�v iss�es that �ake a safe a��r� vzbr�t zr�z�er rir�g czty. I�lar� o� providing �npu�Es to pl�.n xevie�w, new and emerging techxa�alagies far safer roads (€�eicer alt�a.tives, pervio�zs pa�veznents), altez�-za�ives to stozzr� �a�er r�aziag�e�� (ra�wate�- garder�s and%ios�vales, pr��eeaiment vacu�m ax�d sf�eet s�we�ing) and educa�on on livable.cnmmun.it�es (a.Iternative t�a.��s�ar�afion chaice)- O��e� �om�aeaats: {Tiaclude any fur°th�r irzforma�ora you �voulcl lilce the City Couazcil to consider arr that you feel is Yelevctnt ta th.e appointrraerzt yau are seel�ing. You ma}, alsa attach otheY rnaterials �ou would like the Crauncil io cansider.� Te�nessen Warr�ing - Same or all tl�e informaYion that yau ate asked to provide is classi�ed l�y State �aw as either private or con�"zdenEiai. Private data is in�`oz�ation fi�at generally cannot be given ta the public but can be given to li�e subject o£ the data. Cn n£ideniial data is inf'ozmation that generalIy canaac�e be gi�ven to ezt�ser the pubTic or the subject of tlie data. �'he Ciry of Rosevil�� zs colZecting the informatzon io d�terrnine q��l'z�catzons to sezve on a Citize�� Advisory Cozi�.misszon. You are nat legally required to provide this infannation. However, if yo� cio nat supply ttze infoz�nation, yau may nat serve an a Citizen Advzsary Cozzurzission. Ot�er perso�as or entities authorzzed by law to receive thrs inforrnaLion are City Counczi mer.nbers, sfaff, zesidents of �Loseville a�d ir3terested a�laers. ��nderstand lhat a�l infozm,aiiaz� prov�ded �z� this ap�Izcatian, except rr�y teleph�n� z��rnbers, fax rn.�.nhez and e�ail addzess, may �e dist��uted by �e C�ty ta tlae pul�lic zncluding, but zaot lirzaited ta, �eir�g �os�ed on t��e Gity o£Raseville vrebsite, � a}ee fo waive any az7d a11 claims �u�.de�- the Minneso�a Govez�zez�t Data �'xac�.ces Act, or any ot�er a��licab�e sta�e arad �ed�raX �aw, t�at ir� any �ay relate,d �o the dissez�z�aizoz� t� ihe publi.c o£ ir�foz�ation confiaixzed in this ap�lication �hat wa�ld be classifi�d as �rf vate under s�zclx laws. � �ndezsfia�d thaf F inay con.tac� �ize responsable aut�ZO�ity far f�e Czt� of Ros�ville i�r I have any q�estions zegardzz�g �he pub�ic oz �r�vafe ��at�ure of the ixaforrnation provided. � uz�derst�d that the City wi�l nat p�btis� z�y p�oz�e or �ax z1�zx�bers or erriail adclress without rxay a�t�az�zation and da hereby aiZow t�e City tio publish (c�eck a�I t1�at applYj. I�zorne tele�hon� �-��ber ho�ze fax nuznbez- �Ipplicatio7i 061129 �X WOI�C fE��3��OS�� fxLt�ii�?C:� work fax number r��ork emai� addreSS of Ap�licarz� o�l�er �ele�hone numbex _12/29/0G Date of Application