Laserfiche WebLink
,i <br />DATA PRIVACY ADVISORY <br />In accordance with M.S. 15.165, "Rights of subjects of data", <br />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 <br />require you to furnish certain private or confidential inform- <br />ation. <br />You are notilied that: <br />1. The information you furnish will be used to Determine <br />your qualificacion for the permit or license requested. <br />2. Yo'j may refuse to supply data, but refusal may require <br />that the City deny the permit or license. <br />3. The information may be shared with other local, state <br />or federal agencies to the extent necessary to process <br />the permit or license. <br />4. If your requested permit or license reqires council <br />action to approve, some information may become public. <br />5. You have certaan rights under M.S. 15.165 to review <br />private data on yourself. <br />6. Your full name, and date of birth are required to process <br />this applicztion or permit. <br />y �A <br />First Mi a Last <br />Add rp ss <br />A <br />4 <br />to oe mot apply to building/general permits) <br />Phone <br />I und, %I rights as stated above. <br />q a.ur ,. <br />