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Other Comments: (Include any filrther information you world ldce the City Council to consider or <br />that} feel is relevant to the appointment you are seeking io: - nzay also attach other materials <br />would like the Council to consider.) <br />My long experience in local government will make learning the Planning Commission <br />"ropes" easy. As a local government staff person, I have a deep understanding of the <br />role of local government staff and a genuine appreciation of what they do and the <br />environment in which they work. I will be able to develop good working relationships <br />with the city staff in short order. <br />Tennessen Warning - Some or all the information that you are asked to provide is classified by State law as either private or <br />confidential. Private data is information that generally cannot be given to the public but can be given to the subject of the data. <br />Confidential data is information that generally cannot be given to either the public or the subject of the data. <br />The City of Roseville is collecting the information to determine qualifications to serve on a Citizen Advisory Commission. <br />You are not legally required to provide this information. However, if you do not supply the information, you may not serve on <br />a Citizen Advisory Commission. <br />Other persons or entities authorized by law to receive this information are City Council inembers, staff, residents of Roseville <br />and interested others. <br />I understand that all informationprovided in this application, except my telephone numbers, fax number and <br />email address, may be distributed by the City to the public including, but not limited to, being posted on the <br />City of Roseville website. I agree to waive any and all claims under the Minnesota Government Data <br />Practices Act, or any other applicable state and federal law, that in any way related to the dissemination to the <br />public of information contained in this application that would be classified as private under such laws. I <br />understand that I may contact the responsible authority for the City of Roseville if I have any questions <br />regarding the public or private nature of the information provided, <br />I understand that the City will not publish my phone or fax numbers or email address without my authorization <br />and do hereby allow the City to publish (check all that apply). <br />—x-home telephone number -x—work telephone number o t h e r telephone number <br />_home fax number -y-work fax number <br />—home email address _work email address <br />t <br />Signature of e auk <br />0 �1 <br />Date of Application <br />