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I understand that the City will not publish my phone or fax numbers or email address without my autharizaLion and do hereby allow th� City to publish {check all tha� apply).: �ome te�ephone nurr�er,Wark te�ep�one number,Qther telephane number,Home fax numher,wo�-k fax n.umber,HOme ema_1 address,Work email address Daytime Telephone: 651-484-9190 E�rening Telephone: 651-484-9190 Home Te].ephone (if different}: work Te�ephone (if different): Home rax: Work Fax: xome Email: kerrik�wesseldesign.�om Work Emazl: May we contac�. you using your work email ar fax?: Yes I have r�ad and understand �he statements on �his farm, and I hereby swear or affirm that the statements on this form are true. : Yes Addztion�I Information: Form submitted on: 8/20/2009 4:40:15 PI�7 Submitted frpm YP Address: Form Address: http://www.cityofreseville.com/�orrns.aspx?rID=251 Confidentia�ity Statement: The doc�ments accomp�nying this tr�nsmiss�on con��in conf�dential information that is legaily privileged. This infozmataon is intended only for the u.se of the i.ndividuals or entities iisted above. if you are not the intended recipient, ycsu are hereby r_ot�fied that any disclosure, copying, distribution, or action taken in reliance ari the contents of these documents is stYictly p�ohibited. Tf you have rece�ved this infarmation in error, please notify the sender immediately and arrange for the return or destruction of �hese documents.