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I understand f.k� all information provided in this application, except my tele�t�ane ntur�be�s, fax number and <br />�annaai� address, may be distributed by the City to the p�h�c including, but not li.r�it'ed to, being posted on the <br />City of�asevz�.� vu��bsite. I agree to waive any and all claims under the Minnesota Government Data <br />Prac�c.�:s Ac� or any other applicable state and federal law, that in any way related to the c�isseminat�az� to the <br />public of ��c►r�at�on contained in this application ttz�t would be classified as private under such laws. I <br />understand that I may contact the responsible authority for the City of Roseville i.�` � have any c�uestions <br />�egarding the public or private nature of the information provided. <br />� wzder5�arz� that the City �i.�. not publish my phone or fax numbers or email address without my authorization <br />and do herebyallowthe City to publish (check all that apply). <br />home telephone number w o r k telephone number other telephone number <br />home fax number work fax number <br />home �mai.�. address work at�azl address � <br />� _ ���' � �� � <br />�;i of Ap�li Date of Application <br />Application 061129 <br />E:'d G�a��-���-�s� ua�t�lx�� ���=co �.0 fir +��� <br />