Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
41/16/O7 U9:58 FAX 6515583250 <br />�4'�a� � p��cr +ri�r �f t'�e �ol� <br />f �� �-� � � �� <br />�� � � � �� <br />tr� <br />�„� � _.��+�. .�, <br />VIKING SPRINKLER <br />�� <br />('.�m�ne�: �'�a�r� ���r �rt�F�rr�r�yaa w�a,�1r,Y� <br />�002 <br />�rce'� <br />� . ����._ ,.,.� <br />�LF I+ 4++• '_ <br />�Sf 44Vfi7YLL�I � <br />r� Y°4+,�� rs r�ew��r �? �e �,�aerhr}� �+e �e�. r+�c a�}r ��o a� r�r ���yQmr <br />w�ri �iax l�re: C�[+t�cr'� d� ���r,� <br />i _ _ 14l�� ��!''A�_��1'} �� ��.r�iJ� �s �.,I ��, ��M�9 -- <br />.. ,i� . ��� � I� - �� l����� . .... ...._- .. r _.. ._ �... . - <br />�`en�e�� i4'� ng -�+y � or �1 the i�fasmution that you az� a� to p�de is �L3� �d �rq � ef� ]a�- �s �ith�` p�v�� or <br />�I��?�. �a�� �!a!x is �Lae�9iin�l�f ��l��lr Ci�CI be �i�u lv Eh� �Ei�ifoE d� bC �lfse� !o $bC �abje�# d�lDkC �. <br />�r�ti�� �b#a � i,�'�e�t a�c g�lly t�,ea. c� ����� �� d�p rn sub�ca a�� ck <br />The C�.� �f lh.q �e.�� � s tx�il�ting the ini'nrmatia� to d�e qn�ifc�.tions to s�rv� dn a Citizen �{�v�- Ci�m€missio�#. <br />You �re nr�t Ie�� r�� �a pr�svide this i�f'�rmat�o�. �owever, i�'� do not supply t� �i'or�t�ts�, you �ua� a�ds sexve Qi <br />a Citizen �� �"�urrd�vr� <br />Other p�t�s or en��es aut�ariz� by law to rece�ve tYns � are City� ��1 �tae�nirexs, �, rresid�ts of �� <br />and irtter�s�d orhers. <br />I un�erst�d � a11 �� �� ��is app�ir�ic�n, except my telephone rn�rnb� fax number and <br />anaal. address, may b e�'i�l by fi�e City to the public including, but not �n,i�. to, b�i�g posted on the <br />City of �ras��lle w�bs��, I� to ��� a�y and all claims undertlze��sot�.G�v�;��rt��. <br />�C��e� Act, or ar� other �p}�li�ab� state and federal law, ���[ in any wayr�,T� to the dissemination b� <br />��iic of �or�ata�n �vrd�o�� in this applicationthat would be da�sifi� as private under such laws. I <br />understand that I may cor� t%e r�s�flr�s�l� a��t�r �'or tl�e �ity afitas�vyli� �I �.v� auy qv�ti+ata� <br />r'�;krr�n� �hr ���3�� ur �,e-i��� r,a�r� �#"ri,re �t��a �u�+rid�d_ <br />I understand �t i�he ��1� will not publish my phone or �t n�,T� or e�naa� address vvitl�o�.� my authorization <br />and do h�e�y allow the City to publish (checl� � th� a�ly) . <br />� home telephone number � �t'lctelephone�mber <br />home fax a? � er ..�L�var� �'� number <br />�home �m�l address �work � address <br />other telephone number <br />�� � � � �,��.� <br />5' af' A��it � �t� a��'+�pli�c�tio� <br />,�dw�ar� o►�ra,v <br />