Laserfiche WebLink
. - . <br /> CITY of ORONO <br /> CITY Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices <br /> OF <br /> ORONO- On the North Shore of Lake 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 your 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 requested. <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 with other <br /> local ,astate he permit or <br /> federal agencies to the extent necessary to process <br /> r <br /> license. <br /> 4. If your requested permit or license requires Council action <br /> to approve, some information may become public. <br /> S. 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 /> //�� <br /> aur---kt,(1 4 ( .-RS i.--U Li6ru <br /> a ( � <br /> ` <br /> First Middle Last <br /> 1 --7C D_r 1, Rj c; y <br /> Addresse-P(, v\r\,z u„0-\ - <br /> A / ) C-S-Y q <br /> City State Zip <br /> 1177 3 -- 3 3 ? 7 <br /> Phone <br /> uflderst .d my rights - s = ' -d ove. <br /> (P--- <br /> Siw <br /> Sig ure - <br /> BUILDING& ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 <br /> • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />