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06i12/92 11:30 THE CITY OF ORONO 612-473—?35? 008 <br /> �I'T`Y of t��i�N'�► <br /> Post Off�oe Box es•Cryerel �ay,Minaeeota t�9E3•Muotdl�l Q�cas <br /> - OR the North Shore of Lake Minnetor�ka <br /> DATA PRN�CY �DVI6QR�' <br /> . ,.. . <br /> Zii aCCOrBana• with M.S. �.3.04, Subd. 2, "Rights o� �ubjeota of <br /> dt�ta", we wou�.� like to info�rm you that yaur requs�t �Qr a permit or <br /> licena• f xom �h• City af orano ar any o� 3ts dep�rtmeenta m�►y �r�quizg <br /> you ta Eurnisri osrtie3n psivAta o� confidential informatioa. <br /> Yau ar• ndtif3ed tha�a <br /> 1. The iaf o�mdt�.on you turz�ieh wf�.i be used to de�ermin� yonr <br /> quali�i.cation fc�r the permit or Zic�n�e requoated. <br /> 2. Xau may r�luse ta aupp�y dat�, but rifusa�. may requfre that <br /> �be Ci�y deny �h• pormit or �ia�n�e. <br /> 3. The in�ormat�.on may be :b�re+d with other loca3�, s�ate or <br /> ��doral ag�ncies �o tho extsnt neassffir,ry tc� proce�cc the paxmit ar <br /> license. <br /> 4. If your raquested perm3� or Yiaense raquire$ Coun�i.I aatson <br /> �O �lpprove� aome intormat�on may beaom� pubXxu. <br /> 5. You have certain rights under M.S. 13.04 to r�vi�w privr,td <br /> dat� on yoursel�. <br /> 6. Xour �uZZ r►ame is requi.red to proc��� th�i� appliC�t�on ar <br /> permit. <br /> J ��s� � ���5 , � Mt. <br /> ---��-��� -�o� �v s s..�� - P�o,�-r- <br /> First ---M dd1.e Last �Mh��G.6�.v� <br /> �b � �--f�K�S +�� , F'Pt-�i'��.�..W. 't'rY' � S�-�T� �'z.Z-S <br /> Adc2res� <br /> Yv�i t�cy,�-S-o cv KA. �1�+^t�t _ �i.S'3,`�_� <br /> City State Z p <br /> �1 �- o.sy <br /> r• � ��rn r— <br /> Phone <br /> = understand my rights �aa stated abov�. <br /> �J t�.rt S�ty ��`^�S , �.�� <br /> y��� �� <br /> Signature <br /> At1li.ntNG d�ZONtNG w 473•7357 • AUM1N1S1'RATIQN&FINANCP.-�73�7358 + PU8L1C WQFtKS-473•7359 <br /> ASSESSING <br />