Laserfiche WebLink
� . a � <br /> i r <br /> :I <br /> � <br /> CITY of OR4N0 <br /> Post O�ce Box 66•Crystal Bay,Minnesota 55323•Municipai 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 3.ike 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 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 Iicense requires Council act�or. <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 �o process this application or <br /> permit. <br /> lo ec6oR,�l �eAnl /►'tA�►t� <br /> First Middl.e Last <br /> 30 6� �u rc�C � <br /> Address <br /> '��N O /rl r n,w :�?��S� <br /> City State Zip <br /> � �� ��{Z���� <br /> Phone <br /> I understand my rights as stated above. <br /> / / ► l� <br /> Signature � <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE — 473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />