Laserfiche WebLink
I :7 ,--_,-.,:-:-: --.P.-: t.• -,....z::',. C ITT of <br /> . <br /> 1 - <br /> -_- ` :^ ' Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices <br /> - -°•O On the North Shore of Lake Minnetonka <br /> -- - DATA PRIVACY ADVISORY <br /> "Rights of subjects of <br /> In accordance with M.S. 13.04, Subd. 2, permit or <br /> we would like to inform you that your request for a p requior <br /> y <br /> licenseata", of Orono or any of its departments may <br /> from the City private or confidential information. <br /> you to furnish certain <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your <br /> cualification for the permit or license requested. <br /> • <br /> 1 data, but refusal may require that <br /> 2. You may refuse to Supp y <br /> the City deny the permit or license. <br /> be shared with other local , state or <br /> 3 . The information may the permit or <br /> federal agencies to the extent necessary to process <br /> license. <br /> 4. If your requested permit <br /> or licLnse requires Council action <br /> to approve, some information may become public. <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 process this application or <br /> permit. <br /> �0S P � n220 %- <br /> N Middle Last <br /> First <br /> 15-,Z Cr" i ' LE <br /> Address <br /> LK RM.) ft-. - III ` , S C- 3 '3 <br /> State Zip <br /> City <br /> () S0 — "1 "-1�7 ( l <br /> phone <br /> I understand my ight as stated above. <br /> I k .i ail <br />, ( . . <br /> Signatu ,ems 11 <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 <br /> • PUBLIC WORKS —473-7359 <br /> ASSESSING <br />