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CITY of ORONO <br />MmddpalOak:e,; <br />Pua Offlca Box" <br />Crysw Bay,~~ <br />DATA PRIVACY ADVISORY <br />In accordance with M.S. 13.04, Subd. 2, "Righr.s of subjects of data", we would like to <br />inform you that your requesc for a permit or license from the City of Orono or any of its <br />departments may require you to furnish cenain private or conti.demial infonnatjon. <br />You are notified that: <br />1. <br />.., ... <br />3. <br />4. <br />5. <br />6. <br />The infonnation you furnish will be used to determine your qualification for the <br />permit or license requested. <br />You may refuse ro supply data, but refusal may require that the City deny the permit <br />or license. <br />The infonnation may be shared with other local, stale or federal agencies to the extent <br />necessary to process the permit or license. <br />If your requested pennir or licens~ requires Council action to approve, .c:;ome <br />information may become public. <br />You have certain rights under M.S. 13.04 (sc:c following page) to review private dara <br />on yourself. <br />Your full name is required to process this application or permit. <br />G D Benson ary . <br />First Middle Last <br />Kraus-Anderson Construction Company, Midwest Division <br />8625 Rendova Street NE <br />Address <br />Circle Pines <br />City <br />I understand my rights as stated above. <br />~ <br />MN <br />State <br />55014 <br />Zip <br />612-786-7711 <br />Phone