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� . <br /> : �. - ��[��' o� ����"O <br /> post O�ce Box 60•Crystal Bay. I+'fin��ota 5a323•Mun.icipal Offices <br /> r1� <br /> � On the North Shore of Lake 1�irznetonka - <br /> � - �� s <br /> D�� P�ACy ADVISORY <br /> Subd. "Rights of subjects of <br /> S. 13.04r 2' r <br /> Tn accordance with i"i- �. our request for a P reQuire <br /> data" , We would like to inf orm Y°u `h of its depart:nents may <br /> license from the City or �=ono or any � � n=o��`ion. <br /> Y <br /> ou to furnish certain private or conf-dent_al <br /> v e notified that- <br /> ou ar to Qetermine your <br /> rnish wiZl be used <br /> �=ormation you fu_ eQuested. <br /> l. � cense r <br /> cualification tor the pe'-"�=-� or L <br /> 2. You may refuse to SllDDI.y data, <br /> but re=usz� may recruire that <br /> deny the pe='��� ar license. <br /> tne City local , s�a�e or <br /> ,�}Z Q`nor <br /> may be snared W= �- the pe=�it oi <br /> 3 . The inTorTnation �o proc�ss <br /> federal agencies to the extent necessarY <br /> =icense. . ; ac��o% <br /> y r iicense recu�,-=s Counc_s <br /> d. ;i yau� requestec Pe';n t o <br /> `� aporove, some in:o�a�=On may <br /> become puD�-�- <br /> rtain rights unde= M.S. 13. Oa to rev�eW pr-vG`e <br /> �, You have ce_ <br /> data on yourselr• �. � � ca�.-on or <br /> 6 . Your full name is r'�'cu=red to P <br /> rccess �:_s �DDZ- <br /> Pe�it. <br /> �— �� � l�. <br /> i �as� <br /> Middle <br /> :irst <br /> Z�Z.O � Gt.a-c o <br /> nddress `�� , �.53°1 � <br /> �� State Zip <br /> City <br /> .7 <br /> Phone <br /> I unders�and rig <br /> hts s stated above. <br />:� <br /> i� / . . • . <br /> I= g i.g t��� <br />�� / <br /> ' • PUBLIC wORKS -473-7359 <br /> BUILD[YG&ZO`�ING-473J357 <br /> • pDML*fISTRATION&FIN.�CE-'�73-7358 <br /> pS5ES5ING <br />