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! <br /> � <br /> CITY of ORONO <br /> Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal OfSces <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 sub]'e��t or <br /> data", we would like to inform you that your request for a p <br /> license from the City of � ate orrconf dent ale nformationmay require <br /> you to furnish certain pri <br /> You are notified that: <br /> l. The inf orfo 1 they�ermit or Ii ensebrequested. determine your <br /> qualification P <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 shared with oth��r esscthe permit or <br /> federal agencies to the extent necessary to p <br /> 3.icense. <br /> 4. If your requested pe�itmar be ome public.res Councii act�or. <br /> to approve, some information y <br /> 5. You have certain rights under M.S. 13.04 to review private <br /> data on yourself. <br /> 6. Your full name is required to proc�ss this appl.ication or <br /> permit. <br /> �a l;,� o <br /> � C �ad �� � `�i <br /> `' L`� Last '� <br /> First Middle <br /> ��D C� �. � • `� <br /> (�r <br /> Address <br /> �� rc � SS� <br /> City State Z1p <br /> � 7�- 9 �� . <br /> Phone <br /> I understand my rights as stated above. <br /> 7 <br /> /�i�-. <br /> S ' re � <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />