Laserfiche WebLink
�� <br /> ` � ����' o� O���TO <br /> Post Office Box 66•CrYstal Bay,Minnesota 55323•Muaicipai Offices <br /> M � <br /> � On the North Share of Lake Minnetorcka - <br /> • ' • • <br /> DATA PRIVACY ��SORY <br /> � "Rights of subjects of <br /> Subd. 2� ermit or <br /> In accordance with M.S. 13•ou'that your request for a P uire <br /> data", we would 3.ike to inform Y of its departments may req <br /> licease from the City of Orono or any <br /> Y <br /> ou to furnish certain private or confidential information. <br /> You are notified that: <br /> The information you f urnish i ensebrequested, aetermine yaur <br /> 1• e-�-�nit or 1 <br /> qualification for the p uire that <br /> refuse to supply data, but refusal may req <br /> 2, You may the permit or license. <br /> the City deny <br /> be snared with other local, s�ate or <br /> 3. The information may <br /> rocess the permit or <br /> f ederal agencies to the extent necessary to p <br /> ?icense. <br /> a If our requested permit or Iicense r�eQUC res Councii a��=°r <br /> y become p <br /> to aporove, some information may <br /> - You have certain rights under M.S. 13.04 to review priva�e <br /> �. <br /> data on yourself. <br /> 6. <br /> Your full name is required to process this appZication or <br /> per,nit. �� <br /> 'n� �e � <br /> �vv' � �� Middle Last <br /> First <br /> � �� ��L � <br /> Address �� <br /> /l�///// `"��"' �`/� Z ip <br /> State <br /> Ci�y � <br /> � ��-- ��il . <br /> Phone <br /> I un rstand mY rights as stated abone• <br /> Signature <br /> . • PUBLIC WORiCS-473-7359 <br /> BUILD[NG&ZONING-4'13-�357 • ADMINISTRATION&FINANCE-473-7358 <br /> ASSESSIN G <br />