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u�der such laws. I understand that T may contact the zesponsible authority far the CiGy of Roseville �f I have any questions re�ar�ing the public or private r,atur ��" �" � information provided.: Yes � ,.. I undErstand �hat the C?�y will nat publish my phone or fax nurr�ers o� ernail address wi�houc my authorizat-ion and do hereby a�low the City to publish (cneck all that apply}.: Home telephone numbe�,kYOrk telephane number,Other t.elephane number �aytiime Telephone: 612-335-1471 Evening Telephone: 65�-698-5963 Home Te3ephone (if different}: Wor� Te�ephone {if different): Hpme Fax: Work Fax: - --- ---. Home Email: �rlork Email: F�iay we contact yau usanq your work emai� or fax?: Yes T have read ancl understand the statements on this form, ana I hereby sw�ar ar affirm that the statements on this form are true. : Yes Additional Infoxrnataon: Forrn subm�tted on: 9/10/20D9 6:29:09 PM Submitted from IP A.dd.re�s: F'orm Address: http://www.ci.rosevil].e.mn,us/forms.aspx?FIp-25�. Con�iaentiality Statement: The dacuments accompanying this transmission contain eonfideritial informataon that is le�ally privileged. This in�orma�aan is in�ended on?y for the use nf the individua�s or �ai�ities Zisted above. If yau are not the intended recipient, you are hereby notz��ed that any disclosure, copying, distribution, or action taken in rEliance on th� cantents of these documents is stract].y prohibited. I€ you have rECeived chis information in error, please notify the sender immedaately and arrange far tl�e return or destruction of these documents. z