HomeMy WebLinkAboutrequest for info ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOSURE REQUEST
MINNESOTA GOVERNMENT DATA PRACTICES ACT
REQUESTER 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 ending or additional edatat�on
er
unless a dispute or action is p
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 Request:
Requester Name: -J 0.1,--0.4
Address: o� �,\%/ �: tit,
City:
3S q(01?, (
Zip: ,�------------------.,�
44q, _ Business:
Home Phone: �
Description o/f� Information Requested:
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Requester' s Signature:
BELOW INFORMATION TO = LLED IN BY DEPARTMENT ONLY
Handled By:
Department:
person Type:
In Mail Phone
t
Subjecof Data Not Subject of Data
Requested By: '-
Information Requested is Classified: Public Private
Confidential Non-Public Protected Non-Public
PP
Request is:
Approved Denied Approved in Part
Remarks/Comments:
Authorized Signature:
Fees:. x Total Due
No. of Pages Rate per Page
40N�
General Information Sheet sf
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Date: I i.- Time: ❑ Counter ❑Called
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Property Information
Property Address:
City,Zip
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Zoning Classification: Map Attached: FIXYes ❑ No
I 5pide)
Contact Information
Name: (”
Home Phone: vI
Cell Phone: 1
Email:
Questions Handout(s)Given: ❑Yes ❑ No
❑ Animal Regulations(Type: ) ❑ Hardcover Regulations
❑ Building Permit (Type: ) ❑ Land Alterations(_Minor/_Major)
❑ Building Permit Status ❑ Rebuild Questions
❑ CUP Process ❑ Retaining Walls (_<4'/_>4')
❑ Decks ['Setbacks
E Demo or Teardown Process ❑Stairway to Lake
E Escrow Questions or Escrow Refund ❑ Subdivision Process
❑ Fence Regulations (_Lakeshore/_Non LS) ❑Variance Application Process
❑ Other/Additional
Other/Additional Questions & Staff's Notes/Response
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