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���/� <br />City of Roseville . 2660 Civic Center Drive . Roseville MN 55113 <br />www.ci.roseville.mn.us . 651/490-2206 <br />Application for Citizen Advisory Commission <br />Please check commission applying fo1': <br />0 Ethics Commission <br />❑ Grass Lakes Water Management Organization <br />� Human Rights Commission <br />cl Park and Recreation Commission <br />❑ Planning Commission <br />❑ Police Civil Service Commission <br />❑ Community Task Force name) <br />Name• /I C,Cf�. �� �JC-Q/'r��'CGL <br />A d d r e s s:�D�� ��.P���L�`D'�� C.LN � <br />City/State/Zip: <br />ss�i <br />Telephone: (Home) ��� c� f7 ���J�' (Work) �� � �/�'� — ��0�% <br />Email: <br />Fax: <br />Civic and Volunteer Activities: (Past and Present) <br />�.� ' <br />� � �� � <br />� l �� � � <br />..��.� 9� �� ,l�.c�.eo �12�'�1�.lL <br />--- l/G�`�� _ ��1�-(�-'���yG%'�t'U�'i,.�'%i?��A_e�'�4 ��� �ch�C�% <br />� �.�� S � .� . 7 <br />���1-�'Q�r � ���� C� <br />