Laserfiche WebLink
. , <br /> �� x� <br /> w���`.��k:�. <br /> t CITY of ORONO <br /> ,� f�' <br /> .a,z m <br /> � Y`�F^'' <br /> t <br /> Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices <br /> • <br /> � - � � 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 /> l.icense 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 /> l. 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 Iicense. <br /> 3. The information may be shared with other local , s�ate or <br /> federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or Iicense requires Councii. actior. <br /> to approve, some information may become publ.ic. <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 /> , � <br /> �,, �_� ., �f �� � �� � ��� , - <br /> , �, <br /> First Middle Last <br /> `�� �G� -��� �� s-� ��.��-��►�, <br /> Address <br /> C `�t-ct� ,� G� S � 3� y <br /> City State Zip <br /> L��� � /,� �.� <br /> Phone <br /> I understand my rights as stated above. <br /> � � L� a <br /> J� � `�/� <br /> Signature <br /> BUILDING& ZONING-473-7357 • ADMI\ISTRATION&FINANCE - 473-7358 • PUBLIC WORKS -473-7359 <br /> ASSESSING <br />