Laserfiche WebLink
�' �- � <br /> � � C��'�.' o� ����"� <br /> ►�� . Post Office Box 66•Crystal Bay, Minaesota 5�323•Mun.icipal Offices <br /> g <br /> � - ,�j � •� <br /> On the North Shore of Lake Minneton a _ <br /> DATA PRNACY A��SORY <br /> °?�i_ I1t5 Oi subjects OL <br /> In accordance with M.S. 13.0� , Subd. 2� 5 ermit or <br /> we would like to inform you that your recruest for a P <br /> data" , o= Orono or any of its depart�ents may require <br /> I.�cense from the City <br /> you to s"urnish certain private or confidential inzormation. <br /> vou are notified that: <br /> 1, The iniormation you furnisn wi�l be used to dete="mine your <br /> cualif�cation for tZe pe*�n=-� or license reQuested- <br /> 2. You :�ay refuse to supply data, but refusal may require that <br /> Lhe er:nit or license. <br /> tne City deny �. P <br /> 3 . The information may be snared w'-th ot��=' local , S�a�� °r <br /> f ederal agencies to the extent necessary to proc�ss the pe'-�i� °i <br /> ?icense. , <br /> yo pe�nit or I.icense requ�res Councii ac��o% <br /> a, -i yaur reques�._�' <br /> - become public. <br /> to aporove, some insor.nation may <br /> You have certain rights unaer <br /> M.S. 13. Oa to review pr�v��e <br /> data on yourself. <br /> 6 . Your full name is required to proc�ss this application or <br /> pe*-mit. <br /> �,� �I �1 � ` ""�S�)lrl <br /> '�.J ' LaS� <br /> First Middle <br /> � �:�� f�' �r�c�C. J�'��c� <br /> Address �n `� .3 �, / <br /> L t.�/t��` t '\1`� `� <br /> City <br /> State ZiP <br /> ��� 2 — "�21� <br /> Phane <br /> I under an my ri ts as stated above. <br /> � �� - <br /> � �� �i�- <br /> Sign re <br /> BUILD[NG&ZONING-473-7357 • ADMiNISTRATION&FINANCE-;73-7358 <br /> • PUBLIC WORKS -4�3-�359 <br /> pSSESSI:(G <br />