Laserfiche WebLink
. <br /> , ' , <br /> � <br /> �f-, ,,� , <br /> -��*��: �:}� <br /> ����� ;�: <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 /> Iicense 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 wil.I 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 license. <br /> 3. The information may be shared with other Iocal, state or <br /> federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or 3.icense requires Council action <br /> to approve, some information may become pub].ic. <br /> 5. You have certain rights under M.S. 13.04 to review privatc <br /> data on yourself. <br /> 6. Your full name is required to process this applicatian or <br /> permit. <br /> �� �� <br /> ?`"-+o f�' � ��A�'!��+{-'�-� <br /> First Middle Last <br /> �� ,��.�,�s���,� ,�^�i.�--- <br /> Address <br /> � �.�4 /�.�G'��� �.r`�'��/ <br /> ity State Zip <br /> ��jf��i�� <br /> Phone <br /> I understand my rights as stated above. <br /> � <br /> Si ature <br /> BUILDI'YG&ZO[VING-473-7357 • ADMIN[STRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359 <br /> ASSESSING <br />