Laserfiche WebLink
1 <br /> ���Y o� ORONO <br /> Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Officea <br /> • <br /> s _ � � On the North Shore of Lake Minnetonka <br /> DATA PRIVACY 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 Orono 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 will be used to determine your <br /> qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that <br /> the City deny the permit or license. <br /> 3. The information may be shared with other local, state or <br /> federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. If your requested permit or license requires CounciZ action <br /> to approve, some information may become public. <br /> 5. You have certain rights under M.S. 13.04 to review pri�a�e <br /> data on yourself. <br /> 6. Your full name is required to process this application or <br /> permit. <br /> �RIAiV/tt«/ �o r#� ��4ll.�J�/ <br /> First Middle Last - <br /> i�qb �Aa�� ��. <br /> Address <br /> 1'MN S'3 6 <br /> City State Zip <br /> �7t•3�3�1 <br /> Phone <br /> I understand my rights as stated above. <br /> • <br /> Signa re • <br /> BUILDING 8c ZONING—473-7357 • ADMINtSTRATION 8c FINANCE—473-7358 • PUBLIC WORKS—473-7359 <br /> ASSESSING <br />