Laserfiche WebLink
� - <br /> . ` <br /> CITY of ORONO <br /> Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Offices <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 ].icense 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 /> federa]. agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or Iicense requires Counci3. action <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 process this applicatian or <br /> permit. <br /> ��f�ichae..i Sag�,p►� �.t�.a^e�► a� <br /> First Middle Last <br /> `��.y � �V�c�-h ���. �r <br /> Address <br /> � t� ur� � �Y`!e �„�, ��`� �a� -- <br /> City State Zip <br /> ��Il '�"" V�� J � <br /> Phone <br /> I understand y ts as stated above. , <br /> Signature . <br /> BUILDING&ZOIYING—473-7357 • ADMINISTRATION 8c FINANCE—473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING - <br />