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JUN. 5.2007 4�46PM KAUFMAN ROOFING N0.592 P.3i4 <br /> Sec13.0a �YG�TS OF SUSJ�C'1'S O�DA7A <br /> Subd.1. Typo of daTa. Tha righls of iadividual on whom t�e��a is searod or ro be arored s6a1]be as sec foRh ia c�ia eecdoa. <br /> 5ubd.2. Infomo�ion reqaired m be�veu mdivriduaJ.Ra individ�181 asked to suPP�'W��or cqn6dendal dam oonceming hia�olTshall 6e <br /> ioformed of: (s)tho pueposc ond imteuded uso oCthe roquc�ed dom vvi�eho eolloePPS�ugeucy.poHrieal Bubdivision,or smo�wide sys�em:(h) <br /> w6et6er 6e may reti�so or io te�sUY requi�ed�o supDb'th�requeaoed d�;(�)anY Imown conecquma�isiag fc4m his 9upplyi�s��B��+PP� <br /> luivam or coofideaiial dsa;aad(�d��idwtity of o�herporso�s or aui4es nuhorimcd by srat�or fad�ral faw m roceive ehe da�a.Thi9�i�n�s6alt <br /> noc�ply whco�individual is sskad w aupply investigstive d0a,pueeuaat ro stxtion 13.82,subdivisiop S,to a law eoforcemo�oiLear. <br /> The eomo�iaaioner Qf�enue mav�lace die noticernn�jrj.�jd�r thie su6divieion in rhe indivic�sl inoemc tax or omorm.mn,�und <br /> in�'Q,�,e insooad of on thaseloQr�. <br /> Subd 3.Access�o dara by iodividual.Upoa request�o a coSpoqa�bic authority,en iudivldysl�hal1 be infatmad w6�6e is the sttbjoa of <br /> swred da�oq in��d�1a.�d whe�her n is cla�ei�iea�public,priwa or aonfidandal. Upoa hia fict6er raluast,sp iadividusi who ia me�bject of <br /> stored priva�o or public dam on individuals aball bc s4owa tbe dara withoue any o6arge to him and,i4he desaes,shall bo i�Fortnad oPthe concepc oad <br /> meauiag of tb�ds� A�r m�mdividual hss boen shown�ha privau data ond inf'ormed qf ia mca�ipg R6e deta nced noo be dlselosod w him for aia <br /> months�hereof�erunless s dispu�a oe acrion pwsuont w[6iS sation is pcodmg or additionsl dasa on d�o mdividual has bem colleetsd or aesred.Tbv <br /> reBpomable mtbor;ty s6�1!provido oopies of tbe private�pubGa d�upon roquest hy me iadividu�l sybjac otthe datu. T6e napon�We aulhodry <br /> may[u�uire tbe requestmg pa4soo W pay dte acRual costs of mok6�g�oeRifyio&�d��P�46 t6e copies. <br /> The rcFponsible nu0hority sfisll oomply imeaediatelY,i$'Poasi6k,wi�6 aay roque�s msde p�usumt b this subdivision,or w+�bia frva aays of <br /> chc daoe oTtbo oequeat,exclud%g Sawrd�ys,3un�ys a�d l�al hotidaya,if immedia�o 0000plisax ia voc p��ibie,If 6e cmmot cbmPly prith�ho reques� <br /> withia�6oc�ir�1�ahall ao iafarm t6e indiridual.ead may hava en addirioeal£ve days wic6in which w aompty with the ro9ucs6 a�cludiag S�NMays, <br /> Simdays and Iegal holidsyr. <br /> Subd.4.Prooedurowhcndataisnotpoc�ao�orcom�leCe.AaiadiVidualmayconteatthear.eiaaryorcomplo[enossefpuhliaorprivatedatr� <br /> tonCo�ing hirtuolt To wcaeise t6is right,an indlvidua15ha11 pedfY���5 Ibe�bk auchorlry de��ins me onhue of tlu disagre�Tho <br /> responsiblo a�nhoriry ehull wirhie 30 days dt6or: (a)corrccc rhe d�n t7mmd bo be inaeeurrte or iaeoropicu and a�oe�np�ro noiify paSt rocipients of <br /> maaurute or iocompb�e dats,mclvdia�racipienla oamed by�6e individ►is1;or(bI aoqfy t�e individual that ho bolievas thc�a o0 6e e�ra;s.Da�a in <br /> diepure e6a11 be disclo�ed oaly i1'tho iddividua]'s e�mt of diausreemene is ineluded wiFb�ha�isclose�dnta. <br /> Tbc derermmadon of�6e responsible au�hority m�Y bc sppexiled p�asynnt�o ihe provisio�a oYme admiuianative procedure aac rel�;ng�o <br /> eoaWsood qsas. <br /> bArA riuvACY anvisoRv <br /> Ia accordaneo with M.S.13.04,S�3bd,2,"Rights of subjeers of data",we would liks tA inform you tbat your cequesc <br /> for a permit or lioease from the City of Orono or any of its depanment&uiay require you io fiimi�h certFtin p:ivate or <br /> confidential information. <br /> You aze noafied tha[: <br /> 1. The information you furnish will be used to determino your qualific�tion for the permit or liceasc <br /> tequested. <br /> 2. You may refuse to supply data,but refusal may require that the City deay�he parmit or licease. <br /> 3. The ieformation msy bc shsred with other local� state or fedosal agaaciea W the extept aecessary to <br /> process the permit or liccnse. <br /> 4. If your requosted permit or lieense cequires Council action to approve,some it�formation may become <br /> public. <br /> 5. You have ccnsin rights ttnder M.S. 13.04(available upon requesc)w review private data on yomsel� <br /> 6, Your full aame is required to process this applical.ion or permi� <br /> �C7 bc t��l" �'e e h tv�Q,.� <br /> � <br /> 6'i�se M9dd1e 1Lace <br /> �S 2� Z�� ��,� S� <br /> aaar� <br /> Nl�l.�, �N �s�/�.� <br /> �4' 9t�sa xip Phonc <br /> I underatand my rights as sta ab4 <br /> si�natute <br /> . , ry� a w,��;, ��;'�G,;;.1�I' ;� 32 <br /> �q 4�" <br /> �:� <br />