Laserfiche WebLink
� <br /> CITY of ORONO <br /> Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices <br /> • <br /> � - � � On the North Shore o/Lake Minnetonka <br /> DATA PRNACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of <br /> data", we would Iike 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 Iicense requested. <br /> 2. You may refuse to supply data, but refusa]. may require that <br /> the City deny the permit or Iicense. <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 /> Iicense. <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 private <br /> data on yourself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> ���1 h Y � � �� ��� � <br /> First Middle Last <br /> J� �S� v� �6�,� K9�T0�✓ �o��,� <br /> Address <br /> l�'1 i rv/✓�i o�v Kl4 I�°i/1� �S 3�S' <br /> City State Zip <br /> `'T3r70��7Z <br /> Phone <br /> I understand my rights as stated above. <br /> atu <br /> BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473•7358 • PUBLIC WORKS-473-7359 <br /> ASSESSING <br />