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City Orono, MN ADA Grievance Form <br />Instructions: Please fill out this form completely and submit to: <br />City of Orono ADA Coordinator <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Or it can be e-mailed to: aedwards@ci.orono.mn.us <br />Complainant — person filing grievance: <br />Name <br />Home <br />City, State, Zip Code: <br />Cell: <br />Date <br />Address: <br />Work: Email: <br />Representing — person claiming an accessibility issue or alleging and ADA violation (if not the complainant): <br />Name: <br />Address: <br />Home: <br />Work: <br />City, State, Zip Code: <br />Cell: <br />Email: <br />Description and location of the alleged violation and the nature of a remedy sought. <br />If the complainant has filed the same complaint or grievance with the United States Department of Justice <br />(DOJ), another federal or state civil rights agency, a court, or others, the name of the agency or court <br />where the complainant filed it and the filing date. <br />Agency or Court: Contact Person: <br />Address: City, State, Zip Code: <br />Phone Number: Date Filed: <br />D.3 <br />