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ti,�7m � <br /> �,;'�'�, �` <br /> '"i°,.�.� <br /> >„�,,r A, <br /> � ,:;;: <br /> ��..;:Y... <br /> �� � <br /> CITY of O�iONO �� <br /> . Minnewta SG1xt�Mnnidpal Oalw ,"Y' <br /> Past O�ce 8mc 66 C►Yetal BaY. SG1 I <br /> � .. <br /> 5:, On the North Shore oj Lake MinnetonJca `� <br /> x,. <br /> f;�`�r��- • - • • �Tc p "�: <br /> ���;� ii� . . . r��nl� DOTVI�C�Y iA1J7�Y�fZX :.' <br /> �4 y � " . ' - « , <br /> �'� ,,> �, In accordance with M.Shat'lour request for abpermit or license `,� <br /> .��';+=,would .like to inform you t of its departments may require you to <br /> • �'<from'the City of Orono or anY <br /> � k:furnish ceztain Private or confidential information. <br /> , . <br /> �'� ^� �'� yo+1 are notified that: <br /> :���� � � <br /> a <br /> :s. �, <br /> f j�}� 1� �hication foritheypermitnor licensebrequested,determine your <br /> �� qualif ; <br /> � � _ ' 1 data, but refusal may require that <br /> . �'�, ,. • 2. �You may rethe permit or license. �' <br /> the City deny i� <br /> � ` "�- ;.' � ermit or � <br /> ��.�.�: 3. ,�;'The-information may be shared with othrocess the ptate or :� <br /> .� ,�;.�. - y�� ''�. <br /> .��� fedeial agencies to the extent necessary to p <br /> �,�j��C"Bsise.` '°'; <br /> �`���, 4 ^:If" your r�ested permit or license requires Councii action <br /> become gublic. >..• <br /> , :��"�tc :approve. some information maY �.K <br /> w '' ':� <br /> •y`��j 5;��.i Yourhave certain rights under .4.5. 15.165 to review private <br /> �,�� " �tdatn oa yourself. � <br /> ��r«i � .� ,� <br /> ��#4�� n �'= ��` `"' - <br /> .r���6 . 7tcnr fnll name, e��ate of birth are required to proces a: <br /> �� �iB ,appl3cation or p ' <br /> ; � } "�. <br /> � <br /> .,�..�:�s ~� `� ,�—.�. <br /> ,�� � . �P <br /> �� . , . �.ast� • . .;� <br /> �,� �First , Middle <br /> :� <br /> •; ^ -,r -�c.. ;�; <br /> ,"�`, . ,t��,. \ O <br /> ���r 4' <br /> G�-� �idZ688 � SS'�o� ..� <br /> � <br /> < <br /> ,�-•' Zip <br /> ., . State <br /> ',�",�3, ����W J.��, . . . • <br /> �w � <br /> ��. „q � ,,, t�. ,. . ., . . a'"s <br /> `�����'�'�i�� ''.4. " )� , - - -- �'',� <br /> �i f�,y a. <br /> ,,}phone � � �• :,�. <br /> � '' <br /> ,,z,, , '�£��k'�'`���'� above. <br /> � �Y 'tznderstand�mY ri4hts as stated ,� <br /> ��'�t��`�x�, 'X °" � <br /> � 1 <br /> ��`���-�� a s ' � � Nsp �;��� <br /> f � <br /> `�a��,,�� '"�,�� ' `; -� <br /> a�s. $ tfll�lttlte + ` `''� <br /> �'` *„�� ,�a�,�P�.� e : „ " ,. " ' _ ' • � rlJBL1C WOR1Cg_4�b7�39 : <�„� <br /> '�.':.. `k�.,z��'`""� ; `x� 'i'ION t FINANCE—473-7138 r� <br /> ` ADIt <br /> ��ON�NC. A71TYS7�. ! A II�f1STRA ` .,. <br /> J"" �4z..�I 4Yt k' . '.. � a { • <br /> ����� �� � + ^* , . <br /> A .�.3Ft 1' tRT* A S Mqe <br /> � {��y� ;r� .� r L .. . .�` f ����'f;'�'L%` <br /> � �'.i9`C�i3 4 ;� w�;C� 1 � .Y.r ��,R , T '.� �.. 1 C" `Y'�w4`�'Y�`t'}�*� <br /> ';y,,??.'y.�'E" .\kN k...-.i," �,.�e "9�r�uu rti. "� <br />