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I understana that al� informatian p�ovided in this appl�cation, exce�t <br />my telephone number, fax number and email a��ress, may be distribu�ed <br />by the City to the publ�c including, buC not limited to, being posted <br />on tne City of Rosevi3�e website. i agree to waive. any and all claims <br />under tne Minnesota Government Data Practic�s Act, or �ny other . <br />applicable stiate and �ederal law, tr;at in any way related to Che <br />disseminataon to �he public of information contained in this <br />a�plication Ghat would be c�assified as private under such �aws. z <br />unaerstand that I may contact the. responsible authority for the City of <br />Rasevi�le if I have any questions reoardang tne nublic cx private <br />nature of the information provided.; Yes <br />I unde�stand that the City will not publish my phone or fax numbers or <br />ernail addr�ss without my au�harization and do hereby a�low the Caty to <br />publish icheck al� that apply}.: work telephone number,work emasl <br />aadress <br />DaytimE Telephane: 551-373-3457 <br />Evening T�lephone: <br />Home Telephcne (if different): <br />work TeZephone iif different): <br />Home Fax: <br />work �ax: <br />Home Email: <br />Work Email: julieoverbye@edinarealty,com <br />May we cantac� you us�ng your wark email or fax?: res <br />z have rea� and �nderstand the statements on this form, an� I hereby <br />sw�ar or affirm that the statements an this form are true. : Yes <br />Pdditional Tnformation: <br />Form submitted on: 9/9/2009 7:41:01 PN <br />5ubmitted from TP Address: � <br />Fo�m Aadress: http://www.ci.ro�evi�le.mn_us/farms.aspx?FIb�251 <br />