Laserfiche WebLink
DATA PRIVACY ADVISORY <br />In accordance with MS 13 04, Subd .2, "Rights of subjects of data", we would like to inform you <br />that your request for a permit or license from the City of Orono or any of its departments may <br />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 permit or <br />license requested . <br />2. You may refuse to supply data, but refusal may require that the City deny the permit or <br />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 information <br />may become public .. <br />5. You have certain rights under M.S. 13 .. 04 (see following page) to review private data on <br />yourself . <br />6. Your full name is required to process this application or permit. <br />Roger D. <br />First Middle <br />1265 Bx ·acketts Point Road <br />Address <br />Wa zata <br />City <br />O'Shaughnessy <br />Last <br />55391 <br />Zip <br />~le."";:--, i(-~?.~ <br /><) ·. ·~ ¼.)"i ---.. <br />952-935-1722 <br />Phone <br />'{J)':, ._· ,., . ,. <br />~