HomeMy WebLinkAboutrequests for property info ORONO ADMINISTRATSVS OFFICES
Ir7F'ORMATION DISCI,OSURE REQIIEST
I�iINNESOTA Ga DATA PRACTIC�S ACT
REQIIESTER NO�E- .
A, Request Frequency - Private Data on individua?s. After you
have been supplied the data and u£foresixfmonthsethereafter
data need not be disclosed tO yending or additional data -on
unless a dispute or action is p
you has been collected.
g, you may be required to pay actual costs in making,
certifying and/or compiling the copies of information
requested.
Date of Request: �- - � ��"-9
Requester Name: �
� ( O City:
Address: "T
Z ip- ��
gome Phone: g 3 � � � �� _ Business: ��" � ^ � 7� �
Description of Information Requested:
�
---__
Re�uester' s Signature: �
gELOW INFORMATION TO BE FII,I�ED IN BY DEPARTMLNT ONLY
Handled By:
Department:
In erson Mail Phone
Re�uest Type: P
ge�uested By:
Subjec� of Data Not Subject of Data
Information Requested is Classified:
?ublic Private
Confidential
Nan-�ublic =rotected Non-Public
ge�uest is: Approved Denied Approved in Part
gem,arks/Comments-
. ��.
Authorzzed Signature: ..
i` .�`'''• - $
Fees: X Total Due
No. of Pages Rate per Page ..
ORONO ADMINISTRATNE OFFSCES
INFORMATION DSSCLOSIIRE RZ'S2�ST
I4INNESOTA Ga DATA PR�CTICES ACT
' gF:QIIEST�R 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 pendinq or additional data -on
you has been collectec.
g, You may be requirec to pay actual costs in making,
certif ying and/or compiling the copies o� information
requested. � �
Date of Request: C���w'� `'�'��'��•� � `C���
Requester Name: �t�t �v�������1 ���%�0 61
r i� ����,� city: ��I I-�1�'l�'�1�%��'_�
Ac�.dS2$$: � `� r� �
zip: ���-�� ��1 "�����
Ham.e Phone x
���7_-G�?�� � ���Q � Business= ���
Description of Information Requeste3:
-� '����� �f��YI,tU
' �� ��;�� �'titi ��h u�� ���;'����?1 ti��1 ti '� "� i.
� /n,��. („�i ,��1 � �/�� �/���,�
Requester'. s Signature: (,
BEI�OW INFO�TION TO BE FII�.LED IN BY DEPART�.'NT ONI'Y
I�C 7 Handled By:
Department= —
Request Type= � In Pe=son
Mai1. Phone
gequested By= _
Sub j ec� of Data � Not Sub j ect of Data
Information Requ
ested is Classified: l� �ublic _Private
Confidential Non-�ublic =rotected Non-Public
v A�oroved Denied P_pproved in_Part
gequest is: _
Remarks/Ca�ments:
Authorized Signatnre:
_ $
Fees:� eS X Rate per Page Total Due
No. of Pag