Laserfiche WebLink
ev__ <br /> st'- ORONO <br /> -____ = _.-�. : CITY <br /> _4_.:,1„:_4z.... -,_:.:'.� Crystal Bay, Minnesota 55323•Municipal Offices <br /> Post Office Box 66• <br /> --.•-;--::'=--:'''..01F..''"- :'-'; . <br /> �" =Qr~ On the North Shore of Lake Minnetonka -_"- DATA PRNACY ADEITSORY <br /> 2, "Rights of subjects of <br /> with M.S. 13.04 , Subd. permit or <br /> license from the City of Orono or any <br /> In accordance you thatrequire <br /> data" , we would like to inform y your request for a p of its departments may <br /> you to furnish certain private or confidential information. <br /> You are notified that: <br /> you furnish will be used to determine your" <br /> 1. The information • � or license requested- <br /> cualif i cati on for <br /> the p =- <br /> emit <br /> 2. You may refuse to supply data, <br /> but refusal may require that <br /> den the permit or license. <br /> the City Y with other o,- local , state or <br /> federal agencies to the extent necessary to process <br /> be sharede,-mit or <br /> 3 . The information may the p <br /> license. action <br /> license requy-"eS Council <br /> 4. If your requested permit or ublic- <br /> �nformation may become p <br /> to approve, some y <br /> You have certain rights under M.S. 13.04 to review private <br /> 5 <br /> data on yourself. <br /> this app licat.on or <br /> 6 . <br /> Your full name is required to proceo ss <br /> permit. <br /> ------ , J ON OISI <br /> He oil I., Last <br /> First <br /> Middle <br /> 3C0 /6.0 ' 0A <br /> Add ess <br /> L ' trj U I L <br /> Zip <br /> City State <br /> phone <br /> I understand my rights as stated above. <br /> If . <br /> Sig ature • <br /> • ADMINISTRATION&FINANCE-473-7358 <br /> • PUBLIC WORKS -473-7359 <br /> BUILDING&ZONING-473-7357 <br /> ASSESSING <br />