Laserfiche WebLink
r <br /> - � i <br /> � � <br /> CI7�Y of OR�N <br /> Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal 4ffices <br /> • <br /> � _ � � On the Nflrth 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 f rom 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 /> l. � The information you furnish will be used to 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 local, s�ate or <br /> federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or license requires Councii actior. <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review priva�e <br /> data on yourself. <br /> 6. Your full name is required to proc�ss this application or <br /> permit. <br /> ����,. �o.�\ �,,��.�.�� _ <br /> First Middle Last <br /> c`�.�\�. L. `�.��" S� <br /> Address <br /> �.— <br /> � <br /> City State Zip <br /> ����w��� <br /> Phone <br /> I understand my rights as stated above. <br /> � � � <br /> Signature • <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—�173-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />