Laserfiche WebLink
. � <br /> CITY of ORONO <br /> Post Office Box 66•Cryatal Bay,Minnesota 55323•Municipal Offices <br /> • <br /> � - � � On the North Shore of Lake Minnetonka <br /> DATA PRNACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of <br /> data", we would like to inform you that your request for a permit or <br /> license from the City of Orono or any of its departments may require <br /> you to furnish certain private or confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used �o determine your <br /> qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that <br /> the City deny the permit or license. <br /> 3. The information may be shared with other Iocal, state or <br /> federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or 3icense requires CounciZ action <br /> to approve, some information may become pub3ic. <br /> 5. You have certain rights under M.S. 13.04 to review pri�atL <br /> data on yourself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> �.�.o�.�� o L.�� N �s� <br /> First Middle Last <br /> �.3 O� �+�-�4I�'�w-oo b �o,o,.� <br /> Address <br /> l�n�'�z��r� r1�1. N �53a I <br /> City State Zip <br /> `-f� 1 —��0� <br /> Phone <br /> I understand my rights, as stated above. <br /> . , <br /> Sig ature <br /> BUILDiNG&ZONING—473•7357 • ADMINISTRATION 8c FINANCE—473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />