Laserfiche WebLink
CITYof ORONO <br /> Post Office Box R•Crystal Bay,Minnesota 55323•Municipal Offices <br /> • <br /> v On the North Shore of Lak Minnetonka <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of <br /> data", we would like to inform you that youl 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 license zequested. <br /> 2. You may refuse to supply data, but refusal may require that <br /> the City deny the permit or license. <br /> 3. The information may be shared wit other local, state or <br /> federal agencies to the extent necessary to process the permit or <br /> license. <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 /> First Middle Last <br /> 5 <br /> -7s- <br /> Address SAddress <br /> Y)--b1_/ <br /> r City State ZiEl <br /> Phone. <br /> I understand my rights as stated above. <br /> Signature <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473- 358 • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />