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. • <br /> � �_. <br /> � <br /> CITY of ORONO <br /> Post O�ce Box 66•Crystal Bay,Minnesota 55323•Municipal Officea <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 supp].y 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 license requires Council action <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review priva�� <br /> data on yourself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> � ��, �rtY L�Z ���� ��v�� <br /> First Middle Last <br /> ��o c� C� � � I� U�`' � c� <br /> Address <br /> ��.�(� �.t��� II'�t�a� 553 s-� <br /> City State Zip <br /> _ �`13. � S 7�1 <br /> Phone <br /> , unde sta m rights as stated above. <br /> i <br /> i tur <br /> BUI G&ZONING— 73 357 • ADMINISTRATION 8c FlNANCE—473-7358 • PUBL[C WORKS—473-7359 <br /> ASSESSING - <br />