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•A <br />'\v • <br />i <br />I nr I <br />IrOHaNgJ <br />CITYof OROIVO <br />Post Offios Box 66«Cryatai Bay. Minasaou 55323 •Moaidpal <br />On tne North Short of Lake Minnetonka <br />DATA PRIVACT ADVISORY <br />In aceordane* with M.S. 13.04, Sabd. 2, "Rights of subjects of <br />data*, we would like to inform you that your request for a permit or <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 information you furnish will be used to determine your <br />ijujiXification 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 license. <br />3. The information may be shared with other local, state or <br />f«d«ral agencies to the extent necessary to process the permit or <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 />Firs <br />tJc <br />Last <br />IV. 77'^ <br />Mdress <br />City' State Zip <br />Phone <br />rights as stated above. <br />\JP <br />•UaOINC a ZONING - 473«73S7 <br />ASSISSfNG <br />AOMINimAnON a finance - 473.73SS PUEUC twOEKS • 473*73Sf