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CITE" ©f ORONO <br /> M <br /> Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices <br /> On the North Shore of Lake Minnetonka <br /> DATA pRNACY ADVISORY <br /> Subd. 2, "Rights of subjects of <br /> 'You that your request for a permit or <br /> In <br /> nwe wouldnlike1to i f orm3y0 require <br /> data" , of Orono or any of its departments may <br /> license from the City private or confidential in <br /> you to furnish certain p <br /> 1 <br /> you are notified that: <br /> 1, The information you furnish will be used to determine your <br /> qualification for the permit or license requested• <br /> 1 data, but refusal may require that <br /> Z. You may refuse to supply <br /> the City deny the permit or license. <br /> be shared with other local , state or <br /> 3 . The information may to process the permit or <br /> federal agencies to the extent necessary <br /> license. <br /> a, If your recuested permit or license requ <br /> to approver res Council actor. <br /> some information may become public <br /> J <br /> ain rights under M.S. 13. 04 to review private <br /> You have cert <br /> data on yourself. <br /> 6 . Your full name is required to process <br /> this app l; cation or <br /> permit. <br /> first <br /> Middle La <br /> dares V� g <br /> Cit State Zip <br /> 4poZn3e�� <br /> I understand my rights as stated above. <br /> i nature <br /> BUILDING&ZONING—47343S7 • ADMINISTRATION&FINANCE—473-7358 <br /> • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />