Laserfiche WebLink
DATA PRIVACY ADVISORY <br /> In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd.2, "Tennessen warning",we <br /> would like to Inform you that your request for a permit or license from the City of Orono or any of its departments <br /> may require 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 qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. <br /> 3. The Information may be shared with other local,state or federal agencies to the extent necessary <br /> to process the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some Information may <br /> become public. <br /> 5. You have certain rights under Minnesota State Statute 13.04(see following page)to review private <br /> data on yourself. <br /> 6. Your full name is required to process this application or permit <br /> JAMES MICHAEL CLEARY <br /> First Middle Last <br /> 4109 NORTH SHORE DRIVE <br /> Address <br /> MOUND MN 55364 612-868-0748 <br /> City State Zip Phone jI unde nd my rights as stated above. <br /> Sig <br /> <<s 4 V13403ao r <br /> RECEIVED <br /> Variance Application—May 2016 <br /> Page 8 OCT 1 8 2016 <br /> 3880 CITY OF ORONO <br />