Laserfiche WebLink
� f <br /> � <br /> '�r. . , <br /> x � e �` ���,. <br /> ��' y�1��Y CITY of ORONO <br /> Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices <br /> 0 � <br /> � - � � On the North Shore of Lake Minnetonka <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, S.ubd. 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 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 other local , s�ate or <br /> federal agencies to the extent necessary to process the permit or <br /> I.icense. <br /> 4. If your requested permit or Iicense requires Councii act�or. <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review priva�e <br /> data on yourself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> � __ �r��z--� <br /> - �-�.�' �� � '���.Q�' <br /> irst Middle � Last �� <br /> r�� �1�� <br /> Address <br /> k ,�"���� �'�,+�� ���c� I <br /> 1... - <br /> City State Zip <br /> ��-�-'1�.� <br /> Phone <br /> I unde tand my rights as stated above. <br /> ' gnatur . <br /> � - <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE —473-7358 • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />