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�ui-i�-4u � ui upm 'rrom-�ii'i "v� 'viiuhu +$�[�aad�io i-din r.GiiiO3d F-956 <br /> , . � <br /> et.l3. RIGliTSOFSU&JEGTSOFDATA <br /> � SubQlvisioa 1. Type ojd¢ta ?he rlgh/9 oJrndi�ldpa!o»whom!hB daaa is sro�ed 0•fo be sr�rcd shell be tt.t sE�fOrfg�n thir secliort. <br /> I SNbd.2. Iqformativn requ]!ed/0 begrvrrt lndtviQ�oL An fndividua!oskCd lo svpply pr+vat¢orConf�dentia!dalo concerning h(mseif <br /> l!be ormed of (G}Ihe purpore G�d intended use oJrhe reque.s�rd dara wirh�n the collecring a�rare agency,pofrtica!s�bd/vision,oi srarewida <br /> slem; whClher he may rejuse Or it legafly requJred�o supply the requcsled deta;(c1 erry krro+m tanseguerxe orising fsom hia aupptying or <br /> jusrng supply psivat¢ar conftdentiol da�a;a»d(dj�he�dexriry oJo�k�rpeisons wsnl/IieS Gvlho�ized byslate 0rfederRllmr to receiv[flre dofo. <br /> !s reg e�+ent shall nc�t apply when an o,dividuaf is askad ro svpp(y irrvesragarrve dara,pursuanr ro Jecrlon I3.82,subdrvrs�on S, lo a(aw <br /> e oree r qjJJcer. <br /> he commRs.Poner of rcvcm�e mm n1ac+��ht notice reaur.ad und¢s thtt subdlvision in rhe frzdlvtduaf trLme taz or arnoCrN!ax refund <br /> ! Inieti ins/COd o on rbosc terfie.�. <br /> uGd.3.Access io date by IndviQasC Upon.aqaes�rn a responaible aurhwiry,pn indrvidualsha0 be l�orn+ed wherher he ia rhe subjec� <br /> o tOrCQ ta on irrdA'Idttals,and wfrtlher ir is cJoss�ed os pyblit,private or torrJtdPntiaL Upon hfsJwlhsr requer�,an indivirluoJ who�s�he <br /> su ect of rcd p�ivate cf publtc Qata on individuob shal/br Shoivn the date wr�hortr any chorge�o him and,if he deaires,sholl be injormed oJ <br /> th ronte nd mea�+ing oJthat dat¢ ifJlei An individua(hAs beere shoivrt►he Drivare data Cnd inf0i�d ojils m�An/ng, the data need xot be <br /> dis loscd r tm for sis monfks lhereafler t�n/ess a dispuld o�acrion pursuvrtt to this setlion+.r pending or pddNlon4�dota ox�he individua!hers <br /> be G011e d or crceted Ths responsfble avtho�iry shat(p►ovidc coptes ojrlre p�ivare or public darc upon reqvert by�hc iadiv;dwel,cubJecr of <br /> the p►p, resporctJble crnrhorrry moy require thc requesting perso»ro pay thc oc/uaf costs ojmaktn�ttr7�ing.mid compiting rhe topies. <br /> e�csparstble authoriry shol/eomply l�rtmedio�ely,ifpo.esibfe,wi(h any reguesr madC purSumnl lo�his snbdrvisiOn,or wllhln five dayr <br /> ojr e dare the reques{erduding Saturdays.Sundays artd ICga!h0tidays.!f imrr�ediqle comp!lonCe is Kot possible. jf hc CRnnot Compfy wiih rht <br /> ieq est wit lhat time.he shafl so irrjwm�he Individ�rol,o�may havu on addirinna7fivc drrys�rirhin whieh to tompfy wid�J+a requeu,csclading <br /> Sa doys, tlndaya errd ltgat holideys, <br /> d 4.Pr�rdurt whe�dot01S no[pccurale oiContpfefe An Indivrdirel may contell the acruracy ortD�np7ereress ojpt�bJicorprrvate <br /> date conCer �tg himse(f. To exercise thls►igl�r,an �nd�vidual sirall norify in writ(ng tke responiible anthorlp�describing thC natu�e oJ rhe <br /> disa e�nex.,The reSpa�ri6le Gulho/)p+shall withGt 90 days cither: (aJ corract 1he dotafoandlo bd lnpccurate or incomplere and arrempt ro rwt� <br /> pAst ecipren pf inaccurote or lntompl¢rr dQIG,includiRg reclpienrs aamed by rhe indiv�duol;or(fij nor�thE IndNtdua!lhat he belldvts the data <br /> to be arett �Dara in dLrp�le sha!!br dlsdosed osr/y�f ti�e individual's.rratement of dlsa�eemenr'rs�nttvded with rhe d'uetosed dora. <br /> deesrm�nation oflht retponsiEla aurhoriry may bc appealed pr�rsupltt 10 ths provlttohl qf 1he adnrrnislrafivr protedure ec1 reloilxg <br /> ro to te:red es. <br /> D�T�[PRlVACYRDYlSORY <br /> In corderrte witR M 5.13.04,Subd 2."Rlghry oJsubJeus oJdaca",�ve would fike�o irtfoirn you that you��cqucs�fora permrr o�ltCense <br /> fiom I e City Orono o�Ony of i!s depRrl�xenls m0y require y0u rOf�►+rsh cerloln privafe Or Co+tfiGenria!infoimClloa. <br /> Yo notified fhGt; <br /> 1. The lr�fornrarion you juinish wlll be w'ed�o darermine your qupl�te�io�r for Ihe yermlt or license requesred. <br /> 2. � You may reJute tv nepply dara,but reJusol may requirc�hp�cAe Ciry de►ry rhe perr�lt or lltCnte. <br /> 3. The t+�formatiorr mrry be shared�vl�h o�her foto�.3tate orJaderA�agencies ro rhe exrent necessary to proCess the prrmet or <br /> license. <br /> �. lJyour r�quesred permit or licertse requises Cow+Cil action!e ppprove,some fqformarfon s�ay become pu6flc. <br /> 5. You have terla�n righu�nder HLS. 13.OJ(seefollo�ving pa�e)�o rtvlew p�ivare dnlo nn ya+rse(f. <br /> 6. YourJull name rs requlred to proCCJS rAis cppllcorion os yeim(I. <br /> PLE PRIM <br /> � ,� . -�lzr r� <br /> F�q rLtrQete Lasr <br /> � O L/nl�vt� G�2 ���0 <br /> dd�e �y / <br /> �f/�✓� ,� � ✓✓��(O <br /> ��y S�are Z�p Phone <br /> u e il ! ��va. <br /> � <br /> . a <br /> l� <br />