HomeMy WebLinkAboutrequest for info ORONO ADMINISTRA�"NE OFFICES
INFORMATION DISCLOSIIRE REQIIEST
MINNESOTA GO DATA PRACTICES ACT
REQIIESTER NOTE: , .
p,, Request Frequency
- Private Data on individuals. After you
have been supplied the data anci informed of its meaning, the
data need nstute orsaction is pendi g 'or aaa ti nal edatat-on
unless a di p ,
you has been collected.
B. You may be required to pay actual costs in making,
certif ying and/or compiling the copies of inf ormation
requested. �
Date of Request: �? 7-��
Requester Name: L�����'�'�
Address:
�p� _ � city: La�
z�P: SS'�/ 3�
Business: �� ' ��s�
Hvme Phone: ,
Description of Information Requ
ested: `�
.
Reqaester'. s Signature:
EELpW INFORMATION TO BE FII.I+ED IN BY DEP�iRZ'MENT ONLY
Handled By:
Department:
In person Mail Phone
Request Type: —
g ested B Subject vf Data Not Subject of Data
� y:
Inf ormation Requ
ested is Classified: ?ublic Private
Confidential Non-Public rrotected Non-Public
Denied Approved in Part
gequest is: Approved _
gem,arks/Cammeats:
Authorized Sigaatures
_ $
Fees:� X Total Due
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