Laserfiche WebLink
G 1 <br /> CITY of ORONO <br /> Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices <br /> • <br /> � - � � On the North Shore of Lake Minnetonka <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 from the City of Orono or any of its departments may require <br /> you to furnish certain private or confidential information. <br /> You are notified that: <br /> 1. The information you furnish wi3.1 be used to determine your <br /> qualification for the permit or license reguested. <br /> 2. You may refuse to supply data, but refusal may require that <br /> the City deny the permit or license. <br /> 3. The information may be shared with other iocal, state or <br /> federa.I agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or license requires Councii. action <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review prica�� <br /> data on yourself. <br /> 6. Yaur full name is required to process this application or <br /> permit. <br /> , � ��`;� -�l<:--,.._ � ��.����^� <br /> First Middle Last <br /> ��Cf�Cr �j�u'��G��'b� Uff .. <br /> Address <br /> �_/1 ,-�� � {,./L /��'�- �7� �� <br /> Cit' State Zip <br /> �� � � <br /> C.'-'�_; � <br /> Phone <br /> I understand my rigYrts as stated above. <br /> i <br /> �� , <br /> '�, �. <br /> � <br /> Signa � <br /> �,. <br /> ; , <br /> BUILDI:�G&ZONING—473-7357 • ADMINISTRATION Rc FIN.�'vCE—473-7358 • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />