HomeMy WebLinkAboutRequest for Data/Park Fee Payment ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOSURE PRACTICES REQUEST
ACT
MINNESOTA GOVERNMENT
REQ17ESTER NOTE:
A. Request Frequency - Private Data on individuals. After the
have been nasupplied isclosed to youhe data and f foresixfits monthsethereafter
data need not b
unless -a dispute or action is pending or additional data -on
you .has- been collected.
You may be required to 'pay actual costs in making,
B. . the copies of information
certifying and/or compiling
requested.
Date of Request:
Requester Name: J/
Address:
.� S City:
. Zip: �jCJ�(,�o
Business:
c�S1 /(o yS- (0330
Home Phone:
Description of Information Requested:.
Requester's Signature:
BELOW INFORMATION
.14 IDLED IN BY DEPARTMENT ONLY
6�r) Handled. By.
Department:
Mail Phone
Request Type: _�ln Person — —
Requested By: _Subject of Data
cL Nvt Subject of Data
ub Ii c Private
_,_
T—nfoffiation Requested is Classified: _�P
protected Non-Public
Confidential
Non-?ublic
Approved Denied Approved in Part
Request is: __ —
Remarks/Comments:
-------------------
Authorized Signature:
= S
Fees:- x Total Due
No. of Pages Rate per Page
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