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. <br /> . � E6, 6. 2006 9; 04AM SELA ROOFING & REMOD N0. 223 P, 3/3 <br /> , S �.Oa �tYG�S O�SC1s�CTS OFn.e,TA <br /> � � Subd.i, <br /> 1`ype of dara The righes of imdividual on whma�e da�a is ewted or m he�shall be as set for�h in rhis secdoa <br /> Subd.2,Irrforns�lionr�qaired m ba given iadividual Aa individual a�eed <br /> �fot,Y�ed oE (a�ihe P�apOs�end intcided ugo ofihe requested dara wit�in tbe aoiix�ag��vare orc�6denusl dara oo�hm�selfshail be � <br /> whedur ha inay ref�seolCis legallY r�9uiced w supply t�u��(C)�Y lm �Y,Political suhdivisioo,oT sfatewide gy�;ro) <br /> Prn'ste or aonRdendal da�a;eod(�ffie ide�siry oPoiherpersons or antitiee��y s�a or&deralA laweo rxe�v��de dma This re4uinement shBU <br /> �aPA1��an individual ie a3ked to supp�y inves�igative dm�A�asuant to section 13.82,subdivision 5,m a Iaw saforcement offu.er. <br /> I ' a i m g � rh ti . � , � <br /> e . al <br /> Subd.3.Aceeaswdarabymdivi�ual.UPa�reques�warespoueibleaurhoti �� <br /> sao�ed dat8 on individuals,gnd whciher is is cJasei6ed ag ub� �'� �sheii be iofoe�ed wh�therlu iy du subjea of <br /> s�one private or�ublic dbm on iadividuels shhi�llll be P �•Arivace or c�g�d�mal: Upon his fuirF►ertequeat,an iadividual w6o ia si�e subjec!of <br /> u�dividu8l has be�n,sbown�e daw wirhou�a�qr cLsrge+oo him aod,if he desires,shau be informed oFthe coattiu and <br /> mesna�g of thaz data. ARer an' Frive[e dar8 aad informed of i�mesnia <br /> aloDtha rL�imless adapuTe or action pu[Suent W chie sectiap is p°nding o[ed�tibbal deta oar the indiv'idual hAs boen collected pr��S9: <br /> respuifsble 8uthoziq at�s71 provide wpies of fiae privaoe orpublic dma upon teyuest by�d�e individua�subje�of�deffi. I�e � <br /> i �Y n4��rFquestiaY peisoy to PaY t�actual cos�s of maldng,Cpti�riug.snd cojmpiliog�e copies. r�0��� <br /> The responsible a►aTwciiy shall co�ly���',;fpossibi�wah <br /> 1he�Ofth6 nclursi�excludiag SSiurdays,5�days and legal ha�li ifi � uestu►ede y�¢suen�to this subdivisi�n,or withinfive dayt of <br /> h asu 4id <br /> wi � tsime,heshall so imfomt ihe individual�aad msy haVe sa stidivanal�,I�;nwhich to�abie.Ifhe aunot�omply wirh tha reques� <br /> 3undays ead legat holidays. �P�Y whh�er°9�BxcludimgSsturdays� <br /> ncapinghanself.Totxercise�ri�h5 mdtv'�'�u�a���lete.Anaidividuelamyico����Yoccaippletares3ofpyblicorP�ivaxdara <br /> co <br /> resPonsibk au[l�oriry sheq wit6ia 30 daYs either: (a)cotrect�found W ba� a���ry���e astute of�he disagi�,e�.The <br /> �faCcura:e or incomplea dsxs,�ncludiasrecipients nemed by t4e individuel;or � �w aad;�'Aasc reCipi�anra o}' <br /> disp�se sha11 ba disclosed oNy if dae iadiviidtta�'e s�ma�s of dis ro)xaT+fYlthe individual�athe belicvas t6c data w be correCt Daia m <br /> T�deaermination ofthe respoasible audioriry ma bea��t is iacluded�vith thc distlosed da�. <br /> conusted cages. Y �P��P�9uant W Z6e proVisiolps of t1�e adqt�iasadve procedime act ralaim�to <br /> A�pRIVACY AD� OR <br /> ����dancC with M.S.13.t�.,Subd.2,��It�ghts of subjects of <br /> for g permit or license from zh�City of Or�ono or au�+of its �"°we rvould like to inform you that your requesc <br /> cortfiderttial iAforxr�at�ion. �artmeu�s maY require You to fiunish cextaim private or <br /> You are noti�ted that; <br /> l. The infomzation you furnish will be used to detenmine your qua�ifioatirni for the pe�mit ot licease <br /> reques�ed, m <br /> Z. You may refuse to suppiy data,'but refussl may re4uira that tiae City deqy th��ii or license. <br /> 3• The ir�formation may bt sbsred vvith other 1oca�, state c�r federal agencies to the eluGnt necessAry w <br /> � P��:ss the Aera�it or license_ <br /> I 4. If yo�u reque$�ed permit or license ceguires Cou�c�l actidn to a�pro�+t,some iafom�atipa r�y�� <br /> pablic. , <br /> S. 'fCou have cerCBir�tights undex M.S. 13.04(avaiIable upo�request)to reView prjvato data on youtself <br /> 6. Your fqll aame is rey�red to process this application or�ermi� <br /> � <br /> � SELA AOOFIN�EMODELING,lNia. � <br /> 4100 EXCEI.�IpR BLVD. <br /> waarcae • <br /> �D#OOO1D50 <br /> � <br /> � �� , , <br /> z�n ra���2�'�?�5�' <br /> I nndlrstand no�1'rig,l�ts as stated above. <br /> / ' <br /> i �� <br /> � <br /> 32 <br />