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GITYoTORONO <br />Municipal Offices <br />StnttlMrtss: <br />2750 Kelley ParUj/ <br />Orsno. KM 5S3S6 <br />Mailing IMrtti: <br />F.O. Bn €6 <br />Ciyitai Bay. 101 55323^C!5 <br />DATA PRIVACY An\7gnpY <br />iZ!LT * ^ • ’ C" ? P'""" fro ” >;« Citv of Orono or any of itsdepartment, may require you to furnish eenain private c: confidenUa: information. <br />You are notified that: <br />p^r©r llccwe rec-bc that the City deny the <br />LratirmTbe»^U.ic“''“^ ” “ <br />Sa"on":^S" "*"“ ” •» -i- P"«>' <br />Your full name is required to process this appllcaticn cr permit. <br />Fire* Middle ' ------------------------------------------- <br />\JtC^ <br />Address • ——-------------------------- <br />^ift-u -JO_________ Ai, j T<7?fey ‘^"v ^rvi-TSio <br />Zi? Phone <br />1 uniSaicfMd my ^ <br />Signature <br />Its as stated above. <br />Tdcpbeoe(952)24M«0 • Faa (952) 24M<1«