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. � ATTACHMENT "II" <br /> CITY OF ORONO <br /> INFORMATION� DISCLOSURE REQUEST <br /> Minnesota Government Data Practices Act <br /> A. :R�7a.TE5'I'F3t OC (items 1 ) , � <br /> 1. Date of Roqu�N�t��'usu , � . , . <br /> 2, D�.,,�ter Na�ne (LaSt, first� ffl�C�.le� pfOU[STE11 MOT[: , <br /> '�`''�`�"'' I. A�ouest ir�0u�—►in�u 0���on inO�.�Gus1�.A1�+yo�M��De�n <br /> � -� � t��p��y��nlormed ot�t�m�a�w�q,1M O�:s neW no�D�O�u�au0�a � <br /> �� � � -� � W�+O+��f t11�q�i�t�1rMtfa�O�fOb1�O/�CIWA if ptr►O�I:Q O��OCd�O�►�M I � <br /> 3. Ad��s �if Tieeded) o�ro,+n.,c«�ca�.cua. • ' � <br /> It <br /> /,`d��--c''� �( �--- 8. Yae ma�0�r�Ouk�Q to Wy tM�ttwl costf of matiny,unil��nq anCt � <br /> �mDd,nq�na top�s ol�e+lamst+or►r�pw�tsa. <br /> . Ph�e (if r�eeded) .. ' � _ . � <br /> Driver's Li ense # <br /> S. Des cripti� of the infoziru�tian requested "1 ; � <br /> ' �� <br /> .! <br /> �E <br /> 6. ter Sign i� <br /> �:�, � i � �2- �� <br /> B. DEPAR'IN�Nr CCMPLETE � y� r. ` _ -- -- '� <br /> 7. Department• -- 8. R�ted Handled by: � <br /> 9. Requ�st Zype: _ persca� Mail Phone lO.Reque.sted by: �ject of ata � <br /> Not s�j ect of �ata <br /> 11.Ir.fozrnatica� Requested is classfied: 12. t: <br /> Public Na-�-public ��rovc-�d Denied Approvea in Part <br /> Private Pratectec3 No�n-p�lic (e�lain in 14) <br /> Canfidential 13. Authorized �; <br /> "'— Signature � '` <br /> 14. .RF2�IARKS - �TS �` . ( �`� - <br /> Sv•r V��T' t?��L.. , <br /> ; ' <br /> � : <br /> C. D�ARTI�NT O��LLTE t�E�i FEFS .ARE A.SSES.SID (Reoeipt to be issued) � <br /> Fees: Flat Rate X * 16. Fees-Researd�/Sir�rnary ! �- <br /> � � of P� Fe�es-Scneening of F`iles ' <br /> hSee ca�rrent fee sc�edule <br /> ! <br /> !. <br /> 17. n7I'AL AMOUNT DLTE S Rec�cl gy Date �. <br /> �. <br /> t <br /> ', f <br /> RF��7lJF.SI'flt PL,F.ASE IJUI'E I'T'ETdS (�JC�CID <br /> 1. Make rroney order/c3-►edc payable to City of Orono. <br /> 2.' I f mai 1, rcturn enti re fo=m and a�ry fees to: <br />