Laserfiche WebLink
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 notified that: <br />1. The: information you furnish will be used to determine <br />your qualification for the permit or license requested. <br />2. You 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 otter local, state <br />or federal agencies to the extent necessary to process <br />the permit or license. <br />q. If your requested permit or license regiLes 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 applicucion or permit. <br />Qao <br />is Idr— <br />to of birtFJ3oe—snot apply to buildinc.'gerieral permits) <br />n _ 11�: <br />I u erstand my ti as stated above. <br />x — <br />