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! f•_!1 ■.*121 � 11 :�� 4i it k. Y i �i�l yam [ r� ' Y ,I.L 1i IIWTI.7 hfi■�- to: M M C9t�(t1021 �� cL�r Men COMI netrt t (TM*& amyl w Me ;W ca-M-a jo Jl ar yrmr i�� e are +� You mgj also aa=A Aar r r 3yvx WMWbAe cal 0 MW*r.) I look forward to 65dffh6tS to the sound development of-tho City of Rosewfe. Tenneswa waraiag -Some or M M info>xtWon ffiff you are asked to de is dassifiod. by State law as p6mt+e m l PAvM dM k M& VWFERY to &= in is Vab�Unti= by �'i} — rage mkoa af datL CVJ0 Grub d M IS ft&rMWM the �y W MW bc� ;O-A- n iu ai1hi #fit p4%> bG ea me 9dW Oftbe dip. 7U cep tf R06twinv is wllcax�P, �1& in6r+ Wrr hn W G MMM ifxadffln io w as oa a Ci l= Adi+ry CowmiakuG YOU ara nat kgl* MquiRA 10 WUYide this iftiOUrA04r. Xos r u. ifyou W ax:R*PIY the iei%mim a Yip z1jW rw W'r?C an a CWMM i4 LV COM rrissim �dhr�p �r rx anommW bFIM to UM&M aft Wficadko am and RiffiiRl others. I w>dery d that all information provided in th6 applicationr awtV my telephone members, fax number and email address, may be distributed by the City to the public including, but not limited to, being posted oA the v ofReseville website. I wee to waive any and all claims mdse the.%fawcsam Cioverament a a PrAtu s Act, or any od-fir aThcable state caul federal law, that in anyway related to tho disseminationtb the public of information conWwed m this aMhcation, tba wc4d be classilled as private under such laws. I =dwmnif that I mV coydact the nnponffTe autho6ty fQr the City of RoxvWq if have any questions regarding the public or private nature of the information provided I understand IR the City w i I I mt publish my phone cr &x nuTioers or email address without my authorization and do hereby allow the City to publish (check all mat apply). ___hare telephone number wotic telephone Wmber home fax mnnbe r —,,3c fax number X home email address work mW1 ad& of d= A*&ffKM4MJ UP other telephone number Dato of Appk2MUD 9/6 'd PLO 'ON 09MUS9 SA31SAS a3AM031 W tDZI or