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CITY OF ORONO � 6124730510 03/12/99 12:18 � :07/07 N0:024 <br /> ' S�c�-13.0��JGB'1$�A!�IiJ�L7'S OT DATA <br /> 5ubd. 1. '7yp�a�Mtt. 'ILc ei�6u d iod!•idoal ou��e dta ia wored or ro be uored itiall bo u�forth in�sacrian. <br /> 9ubd.1. lafinaMfo.�.qu6r.i a b�dwm b�i. wa Imdhfdu.l.slraa ro apply priv,u o�confsd�++cW d��ca+c�ndn�himufi <br /> �lu�d Ee.h�htmwd d: (a>dis purpo��od loee�ad us�of�e requeae�d dw vi�in�he colleedc�uue a�ency�Po�idW eobAnision.or aaawido <br /> ry�ean:(W�rh�d�ar b0�rsfbre ar.b k=sUy roquiroA ar suppty dis reqwsad O�u:(c)u�y iauwn ca�quena�arWn�frorn hia wpplyitK or <br /> �i���PPb'�or c;oelidend�t d�s;�d(��e fA�y ot oier pe+�o�or enade��ad by m�e or Pedont law�a►raceive�6e d�n. <br /> 7LIa nquinmen��A xoc ap�l�,rtisn an ladlvldwt is�ebeA w appiy�afw Om.puranw�rc eo aew�lqa 13.52,suUd)dsion 3. a►�i�w <br /> �olb�o�mea c[fker. <br /> Tbt��+T�d�����,�j vldee in t�e i�lY �•�ineaes ux er eme�rrv sr �M <br /> Subd.3. Aec�ar a ht�by N�N/rrl. Upm requs�t a a respontible au�uxicy.se i�dlvlJuwl afaH be Wlornwd wheditr he i�dm <br /> ab��of reorod dw on MdivlBwle,m!�rllethcr 1t iR cl�iflod ts public,prime or conAdenSaL Upoe hia Mrdrr nquear,aa I�qvidue!w�6o <br /> V QM wbjroc of�poe�d plvsr or pubUa dm an indirid+,ali�an bo sAo.rn�s d.m vi�ois ap cFru�e ro b'nn ard,it fio Oak�a.�lal!bs Warmed <br /> of�N cwwnc�nd�of d�t dats. AAer�n inlivWuol luu bean a6own die prfvete ehn end infornud of irs mwnit�.df�daa asd nat be <br /> di�Gbiod la Id�n far�t zroiMM die�osf�mr vdet�t disp►r�s or raia�p�vwaeu eo�his re�:tlon Ls pa�iing or nddttimal d�ta on tM indiv{dwi has been <br /> oone�ee�or�a:. 7bs ne�pon��a�iry�II previde aopies of Ihc privua a pubiic dad i�pon nqusst by tds udivid�al�[oi d�e daca. <br /> Tir ts�pon�ibls.wdfority mar raq�dra d�e taquesdn11'e�n�e p.y d�c ac�usl ca�s of n�kt�.cenifying,and c�npUi�the aupies. <br /> '11�e 1+�o�ie��p oomP�Y 1me1�LN1Y,if pntribie.�riQ�ury mquc�m�Je pursu�n w dJ�subQlvhkm,ur�ridlin fl+�dry� <br /> o(d�t d�te d�M requser�e�ludtA S�ard�y�.SunOay�and l�pl hoHd�y�.if lmrtNdlaa coeeq+liana is na�uaslbte. It'Ae cauae eronpty wi�h <br /> �wqa�'�d�t t"se.M�M11 ro bdonu the idividwl.�nd mty Irre m�ddido�l8ve�ya,ri�la w6ich a wmply�d�e reqnest, <br /> �s.m�aars.�r..a�ba�. <br /> 3�bd.1. 11�e+�Len dN�M uot�au�to os e�wpi�te. M udividwl tr»y coore�t d�e accuracy or compi�ronett o/pu�lk nr <br /> pelwfe d�a'ooroereio�hlewdf. 'to��arelie tbis rqhr.�n�diridiW rMll�od�in�rridM�he�esponsibla wthocity daeribi�tbs nMure of die <br /> 4�� Tbe eapo�is+u4�srfe�d�rtl vW�fn 3o dayi eid�or: (e)�d�e dr�IauN eo be Nnccurite ex Incompboe�nd�emp�to eoriry <br /> pYt t�qa�o►ir�cu�ar.iaoo�eplae dNs,lucM�dle6�clpiem rvned sy�e tedlri�l;or lbl oo�ify tht individ�nl dwt tin l�INva the dsta <br /> iu bs co�re�. D�is ia 4i�puk d�B b���.�loied udy I[the iadlrlduat'r�es of diapsemcn�i:included wi�h d,s die�kned d�a. <br /> TAe de�m of die re�polWbk xud�ari�y may De�p�eded putiwnr m tbe pravisiau�ef the admiAiyvadve prnc«fure sci rol�ting <br /> 10 ao�eM�d cate�. <br /> DATw PBIVw��DVIS�Y <br /> �aC�COfdi11CC 1M�t�t�.$. �3.�. s11�. 2. �RI�ILi O��Zff0�9 O��". �VC W011�d�1tiC[O�Ol'm•�OII�t�Mlf <br /> �.qua[tbt a permi[or tkenk trom�he�ity of Ocono or any of iis deparanenn maY nx�uine You co fiunl�h c�orcain <br /> private ar co�fidaicial infamation. <br /> Yvu are mcified.d�at: <br /> 1. The information.you Naraish will be used to detertnine your quatification for the pecmit or licea�e <br /> �• <br /> 2. Y6u a�.y zeltiue to wpply da[a. but rcfusai may nequire ditc�City deny d�e permic or licen�c. <br /> 3. 'I'he inf�onnstion may be shar+ed wifi other btal. �ate or tederal agcncies co the�attent nor.cetary to <br /> proceaa tho perntit or lice.�e. <br /> 4. !f ya�r re�d pecml�or tioe�eaqui�e:Caundl ac[ion co appmve. �informar�on may become <br /> ��� <br /> S. Yau�v�e cxcaii�►ri�us under M.S. 1�.04(availeble upem requesc)�o review prixate dari op�oursdf. <br /> 6. Yonr full naae i�nguirod[o proceas�is aQplkuion or permit. <br /> /���L�� ���CJl�/lt� l�fF����c� <br /> ptra �;oak <br /> ,�3 3 �i� �i v•�D��Q �a: <br /> �. <br /> ��� e�% /Y!N. S vI� �'s"/-�7-y9�1� <br /> +a �. zro ra�e . . <br /> 1 uuderYxaad my.rights aa stxced abovr. <br /> synare <br /> 6 <br />