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� <br /> �„ � . <br /> _aa <br /> �� a�,�^� � , <br /> � A � r� <br /> ; �F� ; � � �ITY of ORONO <br /> ..��% 'ixc�'r,,�t���"z"`y+' ;'v <br /> ;r.c"�"-t v.� <br /> ,� «-R.��Ytt <br /> y�i ��';S: ;� <br /> .ry�r�� '�,jn� � ...y <br /> '� �� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices <br /> ���; <;� <br /> � ��' � Ji On the North Shore of Lake Minnetonka <br /> s - � � s <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects of <br /> data", we would like to inform you that your request for a permit or <br /> license f rom the City o r�ate or onf dential ei f rmationmay require <br /> you to furnish certain p <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your <br /> qualification for the permit or Iicense requested. <br /> 2. You may refuse to supply data, but refusal may require that <br /> the City deny the permit or Iicense. <br /> 3. The information may be snared with oth�ocesscthe permit or <br /> federal. agencies to the extent necessary to p <br /> license. <br /> 4. If your requested permit or be ome e b�ic.�es Councii ac��or. <br /> to approve, some information may P <br /> �. You have certain rights under M.S. 13.04 to review private <br /> data on yourself. <br /> 6 . Your full name is required �o proc�ss this application or <br /> permit. <br /> �%G� ` <br /> � � � f� ' �'�' � !'� -� <br /> First Middle a <br /> 3L � �� �� ><�� C,�-� /� <br /> Address _ <br /> ;�;� ��:« <br /> �-_ l��� S � :.��/ <br /> City State Zip <br /> �/ �/- i / � -� <br /> Phone <br /> I understa,d my r ' ght,� as stated above. <br /> n j <br /> G �� c <br /> i' , <br /> �Z, � <br /> Signatu <br /> BUILDING&ZONING—473-7357 <br /> • ADMINISTRATION&FINANCE—473•7358 • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />