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2004_0419_Packet
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2004_0419_Packet
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��� <br />� <br />_. <br />IJ-�—��—�3 15: �'� YOST 8 BRILL ft� �4 16�9 P.0+��5 <br />What is your view of the role of this Commissxon/Committ�e/Task Force? <br />See Attached. <br />Other Comments: (Includearay fin•ther r��trr�a�r�or� }�+� woul�llike r�- �'r+� Gn�rfTCi! to co�zsider or <br />that you�cci is relevan� to the uppni»tmc��t you r�r-t� seeking. You »ray also a�tach other rnrner���s wo� <br />,vould ��J� the Council to cnrac;der,j <br />See Attached. <br />'Cennessen Warning - Some or all the infonnation that you are sskcd to provide is classified by State law as oithcr private or <br />confidential. Private data is information that generally cannot be given to the public but can be given to the subject of ;F.ti data. <br />Confidcntial data is information that generally cannot bc givcn to either the public ar the subject of the data. <br />The City of Roseville is colltcting the infornlation to determine qualifications to scrvc on a Citize�i Adei.soiy Commission. <br />You arc not legally required tp provide this information. However, if you do not supply the information. you may not serve rn <br />a Citizen Advisory Commission. <br />Otk�er persons or entitics authorized by !aw to receive this I, i�4frn$'•I �n arc City Council members, staff, residents of Roscvillc <br />and intere>tzd Ochers. <br />I understand that a11 information provided in this application, except my telephone nnmbers, fax number and <br />emaiJ address, may be distributed by the City to the public including, but not limited to, being posted on the <br />City of Roseviile vvebsite. I agree to waive any arid all claims under the Miru�esota Government Data <br />Practices Act, or any other applicable state and federal law, that in ar�y way related to the dissemination to the <br />public of information contained in this application that would be classi�ed as private under such laws. I <br />understand that I may contact the responsible authority fur the City of Roseville if I have any questions <br />regarding the public or private nature of the information provided. <br />I understand that the City will not publish my phone or �aX numbers ar em�il dddrCss without my authorization <br />and do hereby allow the City to publish (check all that apply). <br />X home telephone number <br />�work telephone number <br />�email address <br />l u��erst��� t1ti�t I <br />Up�: 0'.V�t <br />� i�; ti� ��ed �� ar: in[�� ictiti� by the City Council that may be audio or videotaped. <br />- f -r <br />Signature ofApplicant <br />/!' - ��� <br />Date of Application <br />
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