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CITE' of ORO NO <br />Nest tlffice Box 66e('rvsual Hay. Minnesota :634 i•Municipal Offices <br />On the North Shoe of Lake Minnetonka <br />CATA PPIVAC'i .ADVISORY <br />In accordance with t:.4. 15.165, "Rights of sub]ects of data", <br />we would like: to inform you that your request for a permit_ or <br />license frcn 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 notified that: <br />1. The information you Furnish will be used to determine <br />You- qualification for the per.��it or !:tense requested. <br />2. You may refuse to supply data, but refusal may require <br />that the City deny the permit or license. <br />;. ,he inform-- tion -4., be shared wit:; other local, state <br />or federal agencies to the ^x:.ent :ie.ess-iry to process <br />`_!]e ;:ermit or 1ic:ensa. <br />rtques ted '_:erm; t Or l:ct'n. -- : e i-cs i JunCll <br />_ic•n tc apr:ra•:e, son-I.L. :,-,formation ,J:ecoma public. <br />5, have tertian ri;ncs under M.S. 15.1b� t� review <br />ate data ci: yourself. <br />6. Ycur full nar'e, 3r,d rate of birth are required to prcc•2ss <br />this application or permit. <br />NARCO 131c'Haxu F'BAa 1!: — - — <br />First ._. st <br />Lim rr <br />A.1 reti <br />3-4-t)i1 <br />Cate ut birth (maces not apply to bui_ding/?eneral permits) <br />f> iK-4iflt+ - <br />Phune <br />I \Ur4l 'and .fty rinhts as sj,9Tec) above. <br />X <br />�f, /t1A1Vl. ♦' 1 11 • IW MKTRA nU% & MA\!! ♦7 V? 154 0 M BI lu ►►flak♦ 471 ; 3N <br />