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ft::..,... <br />mi:^ <br />^i;'■ <br />CITY«f ORONO <br />Po.1 OIBo* Bo» U»Cry^ B«y. MiaiMWU 56323•Mankipal Officii <br />On Uut North Short of Lake Minnepinka <br />SSSi ; *pviafiM <br />In accordance vith request * or'a*pet«it or licensewould like to inform you ^hat your request * P ^^0 you to <br />You are notified that* <br />1 The information you furnish will be used to determine your <br />^sllfication 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 />1 The information may be shared ’’Sd.t or?;dera* agencies to the extent necessary to process the permit <br />. license. . - - • <br />4 If your requested permit or license retires Council action <br />to approve, some inforsition may become public. . <br />5. YOU have certain rights under M.S. 15.165 to revieu private <br />data on yourself. <br />6. Your full name, and date of birth are required to process <br />this application or permit. <br />• s«................ <br />City <br />. J^Li <br />tetf,iianm <br />r irt w <br />Phone <br />I understand my rights as stated above. <br />•k- ■ * *» • <br />- C - <br />- •* / <br />A’ftil <br />•ff <br />Ci'v>S <br />\^M <br />; : <br />iUiLDING A ZONING - 473-7357 <br />ASSESSING <br />ADMINISTRATION A FINANCE - 473-7358 rUSLIC WORKS - 473-73SS <br />'E- ■ <br />. .'; 'EE. <br />V ■:=r--S^ <br />■ <br />m <br />iilK'i <br />. '4 <br />n