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<br /> $es.23.Q4•LtIGAt'S 88 SLJ�$C'fS OF DAY� • ---. ..
<br /> , � Subd. l. '6�e af data. Y�o ii9btt oi 1ta�lvidtu�0�1 a6om tl��d�n�laas�ced oe to be statad ehsJl be ai see Penh ln�is meoan. •
<br /> Subd,l. IaYoea�do�teqvLtod to ba�sa Indi.Id4a3. M[a�rirldwl ast�ed to euPPfy QA�ace or oan�idaedal da�eaneernin�hltnadPahyl
<br /> . be it��ed of; (aJ du�u�poie atu!iiftaadtd(lae o!the tequeaad d��wlth�a the�ollacsln�lvie�epey�PoLlel�l aubdivtdan,e�sdtaarids syetnm:
<br /> (bI abethar ho m�r mfl�ie ot is Isgtlly r�qulKd m supPW 4►a Isques�dnttt(a)�ry known eon�eques�e ariting from hls mPPly In;or iePltalqg ro aupply
<br /> ' pti�be oaelldantla!darsp and(d)�h�fdendry o[odtiar psesons oe eadcas aud�oel�d by au�r ar lederal law m rtcelve�e da�a. Thf�reqults�fope ahall '
<br /> aot eppty whan on iediridurl Is asked ea sopply tave�dgadve daa,punvant m s�edon'l�;$2,mbdlrision S.to a te�eefoe�rnenc o(6rer.� ,
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<br /> �( � v e ' subdiv' f 1 or o rid
<br /> '�•"� � i�utevcdon:ie�a�c!_u(o�� ao fgm+�. . , � ' - � " ,� '
<br /> . . 8nbd.3; Aeeesa to dafm by Indl�idual. Upon�equese b a�amibte authori,ry.in la�lvtdual�II M Infor�aed whmther 6e L�e suDJ+ee
<br /> ut�coted dw,oa IDdl�iduals,ead whodter ic i�d�lfied aq publ'u.p'tirue er conOde»rial. Vpon his flsnber re�ues�,�n is�ridual e�ri�o ta d�e�,bjeat '
<br /> or�end Pri.wa ue putiila dw an iodtri�u�ts s6a11 be�,o�a�da,��rltl�ou�a�ehu�e w h�ea�:if bo deai�aa.9half be latbemid of�e mn�enc
<br /> �d�olmila�of d���.da�. Att�r on tadividual h�s baen showa rhe pd�ua d.m nnd informsd ot la aennia;.me�aa eeid out ba dl�ebsed to.blm Par
<br /> ei�e ameat�e aher.�il�e►rt,lai�dl�pute e��edan pucsvart�m fil:ieedoe Is petfdla�or addidornl don on U1a individud has beea oolleceed Qr er��. . ,
<br /> '4�tapv�tbl�au�pdqr c6�11 pto�ido�opiec of d►e pclv�ae or public da�upoe requesc hy rha individua!gubjaet of rhe d�n� 'ihe taper�autAo�iqr �-
<br /> �nY ieqvite rho ee4W��i P�Q�A'Y dro seaal rossr nP�ieing.ear�lyieo.aed ea�pflla��e eopJes�
<br /> 'Llre tsspeneiWe suthodb.shall comp�y lenmedi�taly,if��bk.ghl��'et9ueac nuda pu�latu w Wis�ubdlvldon.or alfila fiva days oE
<br /> iha dste of�he mquec��fcef�din��uuNatYs.Svnd�Ys end 1e�1 holld���iP cn�edlare aompl�ncn b nocpa9s'bk. 1f'h,aema�comply�rlih r�e cequue ,
<br /> ' witqin tbex d�.lu e�ll oa.{Nbnn tlro lediridu�l,aad nay hsv.an eddldon�l Bue dryx wld�3n whiah co qo�ply,d(�a r5e mquen,eRa�ulfe�Sow�days.
<br /> _: .Svadwrs"�d ltsai holld�yd. . . ' .
<br /> Bubd.4, peeeedtu�whi�de��mt occur.ka or eomp�:ee, An IDdi�lun!nw�!eo�u me u�ue�Y or eomplerenas�oE�Mk or pm�aos
<br /> d�o ie�srttia;lilmrelG Yo acereise rhis bg6t.�n�sdlvlduel`shall np�il�r la rritlri6�hc rnspoaslbk wd�,y deu�lrt�dss�ot�a dls�ereea�cn� . ,
<br /> ' ?he teapaa�lEle i�nllodcy 6haJl wid�i�30 d�ya ei:her. f�aortee�dt�dam found i�6e miaur�ta or inaoatpisae and�mempe an nodl�►puc[eafpk�s oE�
<br /> i�aa ot lrqeompte►e dea.fe�ludln`�ipie,ati�a�ed b��U�dWbduel�oc(�)anAly daa�diYhlual fi�c he bclteves the dem co ba eorsee�. Dara . .
<br /> ia�Wpu�e�all be di�olatrd ody U�he icdivfdu�l's sn�smeas of dlA�tr.�meiu is ittsluded wi�h d�e disclosed daes. , •
<br /> �'he de�rminotion o�the tsepartiiblo awLorfry may 6o appaded p�t�uwt to 9po p�lslo�u of t!u adtnlnis�indva prarrdupe tct neles�na fa
<br /> wn�md waes. ' , � ,
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<br /> . la avcocaance wich I1R.�:13.Os,Subd.2, 'Righcs af sutiJoccs ot daca°, we would�9ka to�aform you chac yo�r requesc
<br /> . -. ..for a petmit oc tle��se fr�m the Cny► of Omno or ar►y ef its�epaccmenta:may�equi�you eo f�rnish certni�pr{Yau ar .
<br /> confidantial frifocinatton. • � . �
<br /> �ou are ncdfiad d�at� � � . � �
<br /> 1. Th�a infoeflaa�ion yov t�tptsh w�11 be�sed�bo dcmrmine your qnalifica�ion for the permit orlieeaae cequaa+ced. -
<br /> 2. You mqy refasa �o suPP�Y daa�, bn�ret4ual may r�qulre cha� cbe Clcy deqy iha F'tnnit or fi�tse.
<br /> � � � •, 3. Z7ie'inFormasian mey be�a�ared wich ot�ec loeal,sta�s or fedecal agmcies io the wcreui nec�asaiy.�a pcocess
<br /> �. che permic or license. � ,
<br /> . . 4. . If youT roquesc� petmit ar 1lceoaa tequ�rea Ca�cil u�oa �o appmve, some intorraulon �r become .
<br /> . ' � publk. ' . . . ,' ' , . .
<br /> � 5. . Xou�hava cer�in righcs under M.�. a3,Q� (av�a6le vpae reqe�es�) ro�roaf�► priv�te data an yo�u�self. ,
<br /> Your full name is�+equi�ed procc�s,_ flcatfoa or permit. . � .
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<br /> ' I�w�de�staad y dgtitr's�sc�d abo - . - . . . . .
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<br /> _ L/C 'd- l�OL 'oN � ' �ui �� iu�aad sauo� aaPl3 � WdC� �6 SOOZ 'tiZ '�pW � � .
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