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TY OF ORONO � 6124730510 09/24/96 14:00 (�7 :03/03 NJ:522' <br /> See.13.041t1G1�T3�F SUB,I�CTS OF DAT.t <br /> Subd. 1. Type of dsts. 76e dshes o[Indlvidu�!on wham ths darn i�ioored oe to ba zroird�haU ba air set forth in chls uerion. <br /> Subd.1. Laformatlos rsqtdnd to M�iadt•idml. M(tdividual uked ro�upply privia or oonfidenda dza wnasrning hlnueif,�hall <br /> be Inlo�med af; (�)tha purpoce�nd inunded uu ot du requesrzd dua widdn nc�colieedn�ltat�e�genoy.polldra!iubdl�islnn,or mue+vide ryudm: <br /> (b)rviuther M mir rafl�se oT b le�ally rcquired m supply the isqu�ued dau:(c)�ny krown con�equeaee�riting from his cupplyln�or sell�tlt�ro supply <br /> privue or ooMden[la!dfa;snd(d)�he idenrity of odie�persom or enddes aud�orized by su+e or federal I�w m reneive d�o dua. Thh requlremeac uwll <br /> no[�pply whee�n Individu�l ii esked co mppty Inve�agadve da�s.pursu�nt eo ce�don 13.82.wbdivision S.to�I�w enforcemenc olfker. <br /> ,. � <br /> cnm�sgner QP ovg�c mn� alac�rhe nocice mauircd under�'s sybdi�iaiQn ia ihe individual income rax or oroos:cv uz�,plSfrid <br /> . �` l�s�dont in�mu�uE on�o�o tom,�. „ <br /> SuEd.3. Arceu to data by Iodlvfdual. Upon rcquest lo� rcspnn�ible�utbo�iry,ut Indi�fdud shal!be infotmed whethcr 6e h the sub)ecc <br /> o[ttond drn on iadividual�.and wiuchar ic is elasslfied a�public,p�irate or conMen[td, Upon hi�fiud►er rcquest,an individwl who i��he subjxt <br /> of�rod pri��uo or publk dw nn indlvidu�ls siull be ehoWn�he dua widiou�seq ehzrp co him�nd;if he deslrea,ibdl be infortned of rhe contenc <br /> uod mhnin�of th�e.daa. Ahsr an iadividual hu bean�oWn the ptiw�e dan utid fafom�ed o[in meaniuR,the dat�emed ewt b�di�ebsed co him far <br /> ti:mondu theraat4er uiilesi a dispu�e or aedon punuuu m ihis secdon es peMln�or addirio�l dan on the indh�idud hu baan oolleeced or creaCed. <br /> TUe�pont�le�utdpriq thall pmvide copiat of�he privue or publk daa upoa nequesc by�he indlvidua!abjee�of d�e dan. 71te t�uponsble tufic+riry <br /> eq�y requlte tbe roquestin�p.rsan ro pry dta aca�l cosa ef maklns.urtiNtn�.�ad compllia;dw eop��. <br /> The ue�poniible w�twriry df�li comply iramedi�tely, if possibk,wich aar roquest medo puralant cq Wis�a�bdiviaon,or.rith)n fi�e day:of <br /> d�e date of che roqueec,exctudina 9uutdays.Sund�ys ond la`d holld�ys,If inanedlaco compltanw u na po�:iblo. If1�e car�a comply with d�e reques� <br /> witbin du[cl,me,he ahall a it►form rtw lndividusl.aad may h��e an.ddlrioa�l flve days wldiln whlch co wroply,wtd�the request,exeludh�Sawrdays, <br /> Svnd�ri ind le`�l holldtya ' <br /> Subd.�. Protedun Nh�ti dnia is net oceurat�ur eomplete. An(ndlv�fusl nuy co�u tde ucuraay or compluano�a of public or privaca <br /> dua eoaeern�bimself. To exercise rhis riaht,an indiViduel shall naily in wridny�6e re:potuibk sueho�y deuttbina d�e nentro o(tho dlu�reemenc. . <br /> 'tht�e�tpon�lbl��ultwriry thdl widtiir�30 ds�ys eidter. (a)correcc tke dam found�v be inaccunte or inonmplefe�tW�a�npt te nodfy put roeipknts eE <br /> imecucate o�In.caroplete dpn,Includln�recipienu nsmed by �e IndivWual:or(b)aotfl5r the individuol tMc he belleves d�e dua to M eotrse� Daa <br /> in d4�ptte�haN bn dltclo�ad anly if the uuflvidual's tneemaae of d(syreemrne Is lncludad with the diuloud d�a. - <br /> �1ie detstminadon of�he rrsponsibla au�oriry may bo appealed pursuao�to�pro�isbnt o(ikte adminuuadve proerduro aet rel�cin` w <br /> wnu+�ted c�res. <br /> � pATA PRNACY AD RY " <br /> ln�ecordaivice with M.S. 13.04,Subd.2, "Itlghu of su6Jecta of dua", we would Iike to inform you that yo�r nquesc <br /> for a permit or licertse from the City of Orono or any ot its depanmeuta may requir�you to furnish ccrteln private or <br /> confidenNal iaformation, <br /> 'Y�u are natified that: <br /> 1. The informatlon you furnish wW be uscd to decermiae your qualificuioa for the permit oriicensa requ�s[ed. <br /> 2. You may ressfvse [o cupply daea, bur refusal may cequire thac the City deny the permlt or licctt�e. <br /> 3. The informacion aoay be shared wich och�r loeal� scace or fedetal agenciea to the exunt nccossary to pmcess <br /> the pecmit or licensa . <br /> • 4. . If your requaeted permit or license requirec Council action �o approve, somc infarniatlon may become <br /> ' public. , <br /> 5. You have certain righcs under M.S, 13.04 (avai�able upon request) to review private data on youra�lf. . <br /> 6. Ynur tull name is nquired to process_tbls application or permit. <br /> � iia� � .��' ��a l� <br /> "�.�cn� � _ ° m�� s��ao 9�a•3y�� [�OY� <br /> c,ry � sa� z�a rho� <br /> ; <br /> ' I•underatand my dghts as :caced ve. <br /> 8igno�uro <br />