Laserfiche WebLink
4 - <br /> CITY of ORONO <br /> Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices <br /> OF 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 /> or <br /> data", we would like to inform you that your request for a permit <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 informai�heyoe�i�or Iicenseill be used to requested, determine your <br /> qualification forP <br /> 2. You may refuse to supply data, but refusal may require that <br /> the City deny the permit or license. <br /> other <br /> al , state <br /> 3. The information to the extenthared necessaryhto process the r <br /> the permit or <br /> federal agencies <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 /> Et A- 1S� A l Som <br /> First <br /> Middle Last <br /> -7 O QJ 1 v D <br /> Address <br /> C-f-1 A VIA 1 <br /> City State Zip <br /> `33 CQ - S-4, 7 <br /> Phone <br /> I understand my rights as stated above. <br /> ,,u(1--/---e <br /> Signature <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 <br /> • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />