Loading...
HomeMy WebLinkAboutRe: requests for property info ,- ��S . � �s �� ���� J C� ORONO ADMI2iISZ'RAT2QE OFFSCES �F'ORMATION DISCLOSURE RE4,�ST . • - Ii�INESOTA Ga DATA PR�CTICES gCT • gEQUESTFR NOTE: • p�, geo2test Frequency - Private� Data oa individuals. ��e'-' ��o have been suppZied the aata and infor�ed of its neani.ng, uata need not be discZosed to 1'ending ar ada t on 1 edatat-on � � . .unless :'a dispute or ac�ion is •p . , . � � you .has� been. collected. . � � you may be required to 'pay�'zCtuzl cos�s in �akin?, B- zhe copies or inioraation certifyiag and/ar comailing requested. • Date af Request: �� ��_ �� Requester Name s �`�� - A.aaress= �- y�l �� �4-�_ �.A R��,� i�y= k� � Zip: `�� )�� � . ('`"pl -t��j2�' Business: H�,e Phoae: - / Description of Information Rec_rueste3:. �5 �3 � ��5 C �tio .� �2.S -F r`'t� ���`'�5 . � Req"aes�e�'� s Signature: BF,yOW INgORMATION TO BE FIT�LED IN BY DEPARZ'�HT OI�LY sanalea sy: D ep art�e.n"t= Mail. Phone gequest Type= In persan . — — gequested By= _Subjec:. o= Data Not Stw�ect of Datz =�ormat�.on Requested is Classified: �u'r�lic Private Non-?ublic =�=otected Noa-Public Confidential _ . � � ' Aonroved in Par� � ' Approved Denied _ -- ' gecruest is: _ — Re�arks/Camme�ts: � Aathon-zed Signature: • = S Pees:• X Total Due .. Ha. af Pages Rate per Page • • 4 . ��l< ���-�� . � . �� ORONO ADMSNIS�RATNE ��=�S ' =NFORMATION DISCZOSUKE RE4�ST . ..amr ���r"?+T('�,$ g.Cl • �F...SQ '� ���YSLYl Lt�1ra ��..��.��� , • g�QU'ESTI?R NO�E: . .. ��o_ A. gequest Frequency - Private Data on individuals. �' �-- t°ho have been supoZied the data and ouf fo esixfmonr.:c�se hereafter � data ue�d not be disclosed to y . .unless .`a dispute or ac:.ion is �pending or additional data -on yQu .has� been collected. � yQu may be reauired to pay ��actual cos�s in �aking, B. zhe copies o= in=°r�zt1°P certifying and/or compiling requested. • � % �� , Date of Request: - • / • , � �� , ester Name: � . Reqa ;� � ; ) � � � City: /�^%r�?jLc`.) Ac�fdress- ���� � � � Zip: ����1�� � . , -� � � - -�� C^��- L� )�- /� L'� Business: Hame Phone: / `� _/ i '�S �G'�C�/c.1� ,� Description of Information Re�a'ueste =. < �%� .` �� � ,�� ��(�' � �-- �.� ':5��`' � ' 'r-� �, - ! . � Retruester'. s Signature: BgyOW =NgORMATION TO BE FII�LE� IN BY DEPARZ'M'--�'NT ON�Y '�� L Handle3 By: D ep art��.e-nt= t� Mail. Phone gequest Z'ype� ' In persan . — — gequested By= _Subjec� oi Data ✓ Not Subject o= Data ,i �ui�lic Private Tnfor.m,ati.on Requested is Classified: -- Non-?ublic -rotecte� Non-PuD7-z� Con=idential �� Pa� Denied � P_nvroved _- gecraest is: � Agproved — � Re�arks/Co�.ents: ,, , � � , j � ;i // , ,,� �,. � � , Ant�iorized Sign.atnre: ,, � / _ $ Fees:• X Tota? Due ., No. of Pages Rate per Page ORONO ADMINISTRATIVE OFFICSS INFORMATION DISCLOSIIRE REQIIEST MINNESOTA GOVERNMENT DATA PRACTICES ACT REQIIESTER NOTE: A. Request Frequency - Private Data on individuals. After you have been supplied the data and informed of its meaning, the data need not be disclosed to you for six months thereafter unless a dispute or action is pending or additional data on you has been collected. B. You may be required to pay actual costs in making, certifying and/or compiling the copies of information requested. cf Date of Request: � � / � , Requester Name: Address: S��D =5 � � ��,f� City: "` 2i� ZlP: ;�/��fj�3i��� Home Phone: ��i �l- ��G�� Busines s: ���j�% �� � � Description of InfoYmation Requested: �� ' , � � � , i �- %.� ...� f C/ 1��� �' % ��� � < � Requester's ignature: BELOW INFORMATION TO BB FILLED IN BY DEPARTIKENT ONLY Department: (; 4 G� Handled By: -;'�,.,, ,_,��, Request Type: � In person Mail Phone Requested By: Subject of Data ��Not Subject of Data Information Requested is Classified: �`�' Public Private Confidential Non-Public Protected Non-Public Request is: ���' Approved Denied Approved in Part Remarks/Comments: r , Authorized Signature: �� , � ;��u�. Fees: x = $ No. of Pages Rate per Page Total Due � ORONO ADMINISTRATIVE OFFIC$S INFORMATION DISCLOSDRE REQIIEST MINNESOTA GOVERNMSNT DATA PRACTICES ACT REQDSSTER NOTS: A. Request Frequency - Private Data on individuals. After you have been supplied the data and informed of its meaning, the data need not be disclosed to you for six months thereafter unless a dispute or action is pending or additional data on you has been collected. B. You may be required to pay actual costs in making, certifying and/or compiling the copies of information requested. Date of Reqnest: % � ���� y/ Requester Name: � i Address: ��6� (o� i'�v�e. City: Zip: ��3j � Ho�e Phone: �/�� — �� �l�- Business: Description of Information Requested: Requester's Siqnature: �--- "7�� ^ BffiAW IPFORMATION TO 8$ FILLED IN BY D TIKSNT ONI�Y Department: Handled By: Request Type: In person Mail Phone Requested By: Subject of Data Not Subject of Data , Information Reqnested is Classified: Public Private Confidential Non-Public Protected Non-Public Reqnest is: Approned Denied Approved in Part Reaarks/Ca�ments: Authoriaed Signature: Fees: x = $ No. of Pages Rate per Page Total Due �