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i, _; <br />·, ' <br />' <br />~-,·CITY of ORONO <br />Municipal Offices <br />Post Office Box 66 <br />Crystal Bay, Minnesota 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 requested. <br />2. You may refuse to supply data , but refusal may require that the City deny the permit <br />or license . <br />3 . The information may be shared with other local , state or federal agencies to the extent <br />necessary to process the permit or license . <br />4 . If your requested permit or license requires Council action to approve , some <br />information may become public. <br />5. You have certain rights under M.S. 13.04 (see following page) to review private data <br />on yourself. <br />6. Your full name is required to process this application or permit. <br />Eric <br />First <br />3490 <br />Address <br />Orono <br />City <br />James <br />Middle <br />Birch Lane <br />MN <br />I understand my rights as stated above. <br />~[~~ <br />55391 <br />State <br />-- <br />TELEPHONE -4n3'7J57 • FAX -473--0510 <br />Liljequist <br />Last <br />612/471-7255 <br />Zip Phone