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Oct, 25. 2013 2.46 PM Xcel Energy Edina Construction [u o, 1663'//P. J,C1 <br />DAVII-EW <br />City of Mounds View <br />240'1 County Highway '10 <br />Mounds View, MN 55112 <br />763-717-4000 <br />App9aeafivn fcer Advisory drw3nttnisst®ns and �®mrnitt��s <br />Group(s) applied for: <br />Full Name (Please Pr <br />Work Phone: 95-)_—ffx�— Wz 3 <br />Address: <br />Years at this address: � 4 <br />E-mail Address: <br />Skills and Interests: <br />Work/Cali <br />Years you have lived in Mounds View: 5 6/ <br />Experlence and QualificatiON9 <br />EIpployrnent, Occupation or Other Relevant Experience: <br />Memberships, Accomplishments or Other Qualifications: <br />Please state your reason for wan)!,ng to 8 rvewith this group: <br />Date: /0 r� <br />(Your re poi se'to any di the above inquiries may be continued on the back of this form and you <br />ntay attac t other information that you would like fife City Council to consider.) <br />The Cify of Mounds Vlev, Is Cormni(led (O tha ppllcy that 70 p6r5005 shatl hate access (o ifs programs, <br />facilities and employment milloul regard for iaee, olhnk4y, sex, age or physical ahilltlas. <br />