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� <br /> � <br /> CITY of ORONO <br /> Post Office Box 66•Cryatal Bay,Minn�ota 55323•Municipal Offices <br /> • <br /> � - � � On the North Shore of Lake Minnetonka <br /> DATA PRNACY 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 /> license from the City of Orona 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 wiZl 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 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 Iicense requires Council action <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review pri�a�� <br /> data on yourself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> �� �-1 Y�►V�� ��I�'Y`�L�"�-- <br /> First � � Middle Last <br /> 2,� _' <br /> Address <br /> �,� ��� � <br /> lty State Zip <br /> ������f u�� <br /> Phone <br /> understa d m r'ghts as stated above. <br /> � <br /> t � <br /> ., <br /> BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359 <br /> ASSESSING • <br />