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Rosevi3le, MN - O�cial Website <br />Powered by CivicPfus � Copyright <br />2 of 2 <br />http://w ww.c ityofrosevi ] l e.com�fonns.aspx?F1i�237 <br />I understand that all information provided in this applicalion, except my telephone number, tax nurr�er and <br />e€r€ail address, r€iay be distributed by the Cify to the public including, but noi limited to, being posted on the <br />City of Roseville website. I agree to waive any and all claims under the Minneso#a Governrnent Data <br />Practices Act, or any other applicable state and federal law, that in any way related to the dissemination fo <br />fhe public of informat€on contair€ed ir� this appGcation that would he classified as private under such laws. I <br />understand that 1 may contect the responsible authariiy for the City af Roseville if I have any questinas <br />regarding the pubflc or private nature of the informafion provided." <br />r Yes <br />I understand that the Ciiy will noi pub[ish my phone or Pax numbers or email address without my <br />authorization and do hereby sllow the C€ty to publish (check all that apply). <br />2/24/2010 11;16 AM <br />Page 24 of 28 <br />