Laserfiche WebLink
reu �� �� ��. ��_ , - - <br /> . DATA PRIVACY ADV150RY <br /> In accordance wfth M.S, 13,04, 5ubd. 2, "Rights of subjects of daia", we wauld like to inform you <br /> that your request for a permit or license from the Cliy of Orono or any of its departments may <br /> require you to furnish certain private or confidenti�l lnforrnation. <br /> You are notifled that: �. t. . <br /> 1. The information you furnish will be used to determine your qualification f4r the porrnit or <br /> license requested. <br /> - 2. Ypu may refuse to supply data, but refusal may requlre that the City deny the permit or <br /> license. <br /> 3. The information may be shared with other local, state or Pederal agencies to the extent <br /> necessary to process the permit or licens�. <br /> 4. If your requested permit or license requires Council action to aQprove, some information <br /> may become public, <br /> 5. You have certain rights under M.S. 13.04 {see follawing page) to �eview private data on <br /> yourself, <br /> � 6. Your Pull name is required to process this applicaiion or permit. <br /> �l-e.i�.v� }�uu,t�►� ��i7��-� <br /> First . Middle Last <br /> .�t 3 Z� G��- ���.c.� <br /> Add ss r�� �S b ��Z 3v�'�'"13�� <br /> City State Zip Phone • <br /> I understand my rights as stated above. <br /> V/ � <br />,-.� Sign ure • • <br /> _ •�:'�a <br /> .� �. :,=-�:�;,.a <br /> � � � �� ' <br /> f:;-,-�—�k ,�,,, �� l ,, �µ, , <br /> r � ^• �yil <br /> . '`4+ ..tr.., <br /> t����d",»7 +� , �:L.,4� �:-,:� . <br /> �� cs;;- ��' i"'�. f.,.� <br /> . Sa, f5E: ` 'c'�Y �.,.:� <br /> �(?��t:,:�� ,�� '�' t�::,.f� <br /> . '�� � �.i!i• C4. ._.:,::1 ....-,v. <br /> �� r� : . - <br />