Laserfiche WebLink
/o • o <br />r <br />w <br />• I <br />I CITY of ORONO <br />Municipal Offices <br />Street Mdreu: <br />2750 Kelley Parkway <br />Orono. MN 55356 <br />MaDlaf Addrets: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />DATA PRIVACY ADVISORY <br />In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to <br />inform you that your request for a permit or license from the City of Orono or any of its <br />departments may require 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 qualification for the <br />permit or license 'equested. <br />. « <br />2. You may refuse to supply data, but refusal may require that the City deny the <br />permit or license. <br />3. <br />4. <br />5. <br />The information may be shared with other local, slate or federal agencies to the <br />extent necessary to process the permit or license. <br />If your requested permit or license requires Council action to approve, some <br />information may become public. <br />You have certain rights under M.S. 13.04 (see following page) to review private <br />data on yourself. <br />6. Your full name is required to process this application or permit. <br />First Middle Last <br />Address ' <br />City <br />MM <br />State <br />Sr S3 11 <br />PhoneZip <br />1 understand my rights as stated above. <br />/Signature <br />Telephone (612) 249-4