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~u~ ~ ~. 2005 <br />• <br />CITY OF FALCON HEIGHTS <br />C O MMI S SIO N A PPL I CA T I O N <br />DATE: ~U.S"f' 2Cj , ZDOS' <br />NAME: <br />ADDRESS: <br />~'[pg <br />PHONE: (H) (oSl - (o~{''j-Q$Q(~, (~ <br />EMAIL ADDRESS: (MCt.I~gE,y~~,~ ( ~ V11S/"1 ~CO WI <br />HOW LONG AT ABOVE ADDRESS? ~ t~~ <br />IN WHAT CAPACITY DO YOU WISH TO SERVE? ~- -^n ~ SS i Mi»r ~, ~~ <br />f~l iG Ll~ 1 'i~ ~w.......~ c e- ?.ten <br />v ~ <br />REASON YOU WISH TO SERVE ON ABOVE: ~le IA.kS1' tA~ b~QS ~j2~pN,p SfN~(I¢J" <br />~ f ~-u~Q _ J <br />• ~ ~ <br />~ dL°G~.12~1~ <br />o'r- ab ~ li-f -r~s <br />PRIOR PUBLIC (OR RELATED) SERVICE: 1 ~ .. ;,~ ~%I'~w'QL <br />WV~ <br />~.~.lar' <br />OTHER RELEVANT BACKGRO (OR COMMENTS). UOI ~ ~n o r ~~? ~~ t~.~ <br />l <br />~CSSoria~-iQr,, <br />