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i •. , <br /> . _ <br /> A, <br /> CITY of ORONO <br /> CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices <br /> OF <br /> ORONO On the North Shore of Lake Minnetonka <br /> DATA PRIVACY ADVISORY <br /> In accorJance with M.S. 13.04, Subd. 2, "Rights of subjects of <br /> data", we wou d like to inform you that your request for a permit or <br /> license from he City of Orono or any of its departments may require <br /> you to furnish certain private or confidential information. <br /> You are n.tified that: <br /> 1. The i formation you furnish will be used to determine your <br /> qualifica ion for the permit or license requested. <br /> 2. You m y refuse to supply data, but refusal may require that <br /> the City eny the permit or license. <br /> 3. The ' nformation may be shared with other local, state or <br /> federal a encies to the extent necessary to process the permit or <br /> license. <br /> 4. If yo r requested permit or license requires Council action <br /> to approv , some information may become public. <br /> 5. You h ve certain rights under M.S. 13.04 to review private <br /> data on y urself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> First / Middle Last <br /> 4/7 .5-37- /VIA T/".i4o/c r iJ,r <br /> Address <br /> City State Zip <br /> - a0 ‘7 <br /> Phone <br /> I understand my rights as stated above. <br /> 5g751h7t!_gottda.a.-------- <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING - <br />