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11.04 - Park Commission Appointment
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05-01-2012 Council Meeting
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11.04 - Park Commission Appointment
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� <br />(1) residential address; and <br />(2) either a telephone number or electronic mail address where the appointee can <br />be reached, or both at the request of the appointee. <br />(c) Notwithstanding paragraph (b), any electronic mail address or telephone <br />number provided by a public body for use by an appointee shall be public. An appointee <br />may use an electronic mail address or telephone number provided by the public body as <br />the designated electronic mail address or telephone number at which the appointee can be <br />reached. <br />City of <br />Pe uot <br />q <br />Lakes.-= <br />DATA RELEASE FORM <br />In accordance with the Minnesota Government Data Practices Act, the City of Pequot <br />� Lakes is required to receive your consent before releasing any information about you that <br />is classified as private data. Private data is information that is not available to the public. <br />� <br />If appointed to an Advisory Commission or elected as a City Official, I authorize the <br />City of Pequot Lakes to disclose the following information. You must choose at least <br />one phone number or e-mail address to be made public. <br />Number <br />Name <br />Home Telephone Number <br />Home Address <br />E-mail address <br />Work Telephone <br />Cell Phone <br />' /�!-� �cr �D/I �CA ��v <br />� - <br />�/1�-,�6�'� ��' �7 <br />5L1.�1 Si�lP;.1,� s�1d <br />, <br />I'.�tii,�-� 1.�-�S <br />� <br />r,%�.��37 p �,�s%nk. � <br />
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