Laserfiche WebLink
til.I w. � a <br /> � <br /> CITY of ORONO <br /> Post Office Box 66•Cryatal Bay,Minne�ota 55323•Municipal Officee <br /> • <br /> � - � � On the North Shore of Lake Minnetonka <br /> DATA PRIVACY 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 to determine your <br /> qualification for the permit or license requested. <br /> 2. You may refuse to supp3y data, but refusal may require that <br /> the City deny the permit or I.icense. <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 Iicense requires Council action <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review private <br /> data on yourself. � <br /> 6. Your fu11. name is required to process this application or <br /> permit. <br /> t <br /> � W S <br /> First Midd e L st <br /> �"7 �-�! <br /> �2�2.� �G --.`' �` <br /> Address <br /> (.�/�1'�� /���- �� � O <br /> City State Zip <br /> � - �.�.�- 2� 2� <br /> Phone <br /> I underst d my rights as stated above. <br /> Signature <br /> BUILDING 8c ZONING—473-7357 • ADMIlVISTRATION�FINANCE—473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />