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City of Orono <br /> Information Disclosure Request ( !� <br /> Minnesota Government Data Practices Act \=� <br /> Completed by Requester <br /> Requester Name(Last First,MI): Cole, Marcus S Date of Request: 12/16/2 D13 <br /> Email:marcus . col e@lindj ensen.com Request Type: ❑ In-Person 0 Mail <br /> CIO Email 0 Fax <br /> Street Address:9 01 Marquette Avenue S. Phone Number. 612-74 6-01 0 5 <br /> City,State,Zip Code:Mirtneapolis,MN 55304 Signature:/ <br /> Note: MS§ 13.05,subd. 12,persons may not be required to identify themselves,state a reason for,or justify a request to gain <br /> access to public government data.A person may be asked to provide certain identifying or clarifying information for the sole <br /> purpose of facilitating access to the data. <br /> Description of the Information Requested: <br /> Building Permits and Inspection Records for the property <br /> located at 4550 Wolverton Place, Orono, MN 55359 for the years <br /> ____2-0-0"5-2Present . DO l I <br /> NOW + he y 11 p r i or +o ZDO 9 <br /> I h; - r• t 'nfoorrrmation s f and d and the city may charge fees to provide the information I have requested. <br /> /�.gnaTure <br /> 4.Completed by Department—Office Use Only <br /> Department: Processed By: <br /> Method of Response: 0 In-Person 0 Phone 0 Mail Information Classification: <br /> 0 Email 0 Fax 0 Public 0 Private 0 Non-Public <br /> 0 Confidential 0 Protected Non-Public <br /> Action: 0 Approved Requested by: <br /> 0 Approved in Part(Explain below) 0 Subject of Data <br /> ❑ Denied(Explain below) 0 Not Subject of Data <br /> Remarks or basis for denial,include statute section: Identity Verified for Private Information: <br /> ❑ Identification(DL,State ID,etc.) <br /> ❑ Compare Signature on File <br /> ❑ Personal Knowledge <br /> O Other <br /> Note: MS§ 13.03,subd.3,authorizes the city to charge fees to recover costs to provide copies of data,including costs <br /> associated with searching,compiling,copying,mailing or otherwise transmitting data. Prepayment is required prior to receiving <br /> copies of data. There is no charge for inspection of data or for separating not public data from public data. <br /> Copy charges: Method of Payment: <br /> ❑ (8 V x 11/14") X 0.25 0 Cash <br /> (#of pages) 0 Check <br /> ❑ (11x17") X 1.00 ❑ Visa <br /> (N of pages) 0 Master Card <br /> Q Employee Time($ /hr) X hrs <br /> (only charge if over 100 pages) <br /> ❑ Other Charges(attach explanation) Received by: <br /> Total Amount Due: $ Date: <br /> This request will be reviewed by staff and the requester will be provided an estimate of charges prior to copying. <br /> If mailed,return form to: City of Orono,P.O.Box 66,Crystal Bay,MN 55323 <br /> City of Orono,2750 Kelley Parkway, Orono, MN 55356 <br /> Phone: 952-249-4600 •Fax: 952-249-4616 • Website: wwwcl.orono.mn.us <br />