HomeMy WebLinkAboutrequest for property info ORONO ADMINISTRATIVB OFFIC$S
INFORMATION DISCLOSDRE REQIIEST
MINNESOTA GOVERNME1�iT DATA PRACTICSS ACT
R�UESTER 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.
Date of Request: I ' z� � v` I
Reqnester Name: �0�` c , c �- • �10 � ��
3 ��0 ('`��.1 -t-: �� s i�.a�� � �s
Address: �'..� Sa , lo � 5�-�e e-F City: •
zip. �5 �-U 2.
.
Ho�e phone: '���- - g I 7�J susiness: 3�'� � 0 23`�
Description of Information Requested: �� ( � C��'�+e'�{5 '
�.� � � '� 2� � GJ P2 r��� �A�n e
Requester's Signature: �'Y\C� �•
BELOW IPFOR1rIATION TO BE FILLBD IN BY DEPAR ONLY
Department: 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
Reaarks/Ca�ments:
Authoriaed Signatnre:
Fees: x = $
No. of Pages Rate per Page Total Due �