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2005_0912_Packet
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2005_0912_Packet
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5/12/2014 1:41:26 PM
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9/14/2009 10:04:28 AM
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Roseville City Council
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Council Agenda/Packets
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What is your view of tlie role of a member of the Housing & RedevelopmentAuthority? <br />Other Comments: (Include anyfurther infor�r�zatiora you would like the City Council to consider or <br />that yau feel is relevant to the appointmentyou are seelcing. Yon �2c�y also attach other materials you <br />would like the Council to consider.) <br />"�'en�essett Warning -�otne or all the infor�nation that you are aslced to provide is classified by State law as either private <br />or confidential. Private data is information that generally caianot be given to the public but can be given to the subject of <br />the data. Confidential data is information that generally cannot be given to either the public or the subject of ti�e 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 <br />0�1 a Citizen Advisory Connnission. <br />Other persons or entities authorized by law to receive this i�ifornlation are City Co�ncil �nen�bers, staff, residents of <br />Roseville, and interested others. <br />I understand that all information provided in this application, except my telephone nunibers, fax number <br />and e�xaail address, may be distributed by the City to the public including, but not limited to, being posted <br />on the City of Roseville website, I agree to waive any and all claims under tl�e Minnesota Government <br />Data Practices Act, or any other applicable state and federallaw, that in any way related to the <br />dissemination to the public of infonnatioi� contained in this application that would be classified as private <br />under such laws. I understand that 1 may contact the responsible authority for the City of Roseville if I <br />have any c��estio��s regarding the public or private nature of the infomiation provided. <br />I understand t11at the City will not publish my phone or fax numbers or e��aail address without my <br />authorization and do hereby allow the City to publish (check all that apply). <br />_home telephone number <br />enn.ail address <br />_ work telephone number <br />I understand that I may be invited to an interview by the City Council that may be audio or videotaped <br />Signature of Applicant <br />� �,�::�i c�x� <br />Date of Application <br />
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