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FROM �: � FAX N0. :612331337355555 Aug. 28 2006 11:46AM P2 <br /> Rec.13.0a RICH'f5 UF&�1bJECT5 OF DATA <br /> � <br /> Subd.]. Typc oP dace. Thc righte�f individual on whom[hc da[a ia Rtm�cd or Po bo slqredl ghnll be ua act fortl�in diia Acction. <br /> SubJ.2. Informt�tiun roquired lo bc diven individuul,An individuel sakcd to aupply privatc ryr conlicl�tltinl dnln�unctlming himuelf e1m11 bc <br /> info[mcd uf; (o)thc purpoac flnd intcnded uec of thn rcqucxtad d�itn witliin kl�c callccung etatc agcncy,�olirical kubclivi.4ipn,ur eu�tewide eystctn;(b) <br /> whethrz hc nmy rcfuac ur ie ledully roquired tu eupply the rcqueated dutu;(c)uny known coi�acqucnce ailirsing Flnn1 his S�Ipplying ur refi�aing to aupply <br /> p�ivatc or confidcntial data;and(d)thc idcntity of otl�cr perxuna ur cntiticx uud�orizcd by etntc or tcdcral�9w to roceivo I.I�o dnla,This co�uiremtnt ahull <br /> ❑ot apply whon gn individual is aRkcd co aupply invcRdgativc data,purauanc tn accci�n 13,R2,Auhdjvidion S,to alaw enTon:emenl ufficcr. <br /> Thu commissioner of invonuo mav nlacc cha nocicc rcauircd undor thia aubdivision in tha�udividual income t�or eroaer�y.,��,r�J'und <br /> inst:ivclions inctcad of nn I.hosa forma, <br /> SubJ.3.Accaas to�aca by individiml, Upon ibquoscto e inspons ibla aul.lioriry,Ail indiviJun�ehldl be informeJ whether l�e is thc eubject of <br /> eto�d duta on individuula,Nnd whethcr il.i�CInBSified oe puF1iC,privnio or canGilenlinl.CTpun Uie Cudh�r ra���ea�,im individuEd wl�o ie thc subjcc:t of <br /> xwrcd privt►te ur public dut��un indiviJu�la bhnll be shuwn tbo dAIA wi�hou�wny chnrgo ro hlmend,iCh�desirce,eh�dl be infoimecl uf the content nad <br /> meaning of tht�t Jutt►. After�m iadiviJunl hug beo�t sl�own Iho privoto data and h�fonnod oPica meitning��t�e Ji�tu ae�J nuC be dircluaed w him fur eix <br /> monc6e�hcrcuftcr unleed u diapute ur netlon purnuant In lUis secuan is pouding ur nddi[ionnl ilatn on Ihn bndividunl hua b�en wllcetcd ur crented.'I'hc <br /> rcapnnaiblc authoriry ehall p�rvidc copice of che privute ur publiC Jut�t upon reyuebL by 6he inJiviclunl dubjcct of the dnta. Thc roeponeible authoriry <br /> may rcquirc thc rcyuwting peroon t0 pay lhe octuul cosls of making.certlt�ing,and complllng Ihe cod�ce. <br /> 'J'herrbponeible uuthurily ghnll eumply lmmedloldly,if poasible,widt nny cequcdt mt�dc pw�n�ant to thie qubdiyiBion,ol'wlthln f ve deys of <br /> the dnte uf tl�e reque�t,excluding Saturdnya,5imdayg and legal holi�ye,if imnuJinte cumpliancc iA na��,onniblc. If hc cannot coa�ply wilh t�rCyu�at <br /> wl�hln thAt Gimc,hc shRll ao intnrm thc individual,and may havc nn odditianal fivc deya within which tn emm�ly wiih t.l�u roqueal,eacluding S�dunluyd, <br /> Sundnys anA lagal h�lidayA. <br /> Subd,4,Procedurewhendntsisnotnccura[aorcomplow.Anindividualmayconwstthoacc�rncyorcomple�eneaeufpublicurprivutcduta <br /> conccrnjnghimaclf.TocxcrciecthisrighkunindividuulahuUnutifyinwriGn6tlrerdeponsiblcnuthurityalcec:ribingthenttturcofthcdisag�ncmcnt Thc <br /> respoilsible eurllol'ity shall wichln 30 days cither. (fl)correci the d�itN fuund[o bc innuCurute ur incon�plctc nnd�tncmpt to notify pnat i�ccipicnta of <br /> inuccuYate or incomploto data,including rocipicnta nurtuxl by Lhe inJividuid;or(b)nuwfy�he indivi�uul Ihac he bclievcx thc data tn hc correct. Data in <br /> diaputc almll be di�cloaed unly if the inJividunl'a gulUem�nt.uf dleugroement ia incluJed witu t6e dieclqecd dnta. <br /> Thc Jolerminution vf Che rtlspon8ible nulliMity mny be app�aled pureuunl W t6a provi�ione of�6c adminiatrativa prpcodwr ACt rolR4ing 40 <br /> cantcetcd ceacN. <br /> Dt�TA E'R�'��CY A�1VISURY <br /> Tn aceordancc with M.S. 13,04,Subd,2,"Righte of aubjeete of data",we woulj�like to inform you that your reqiiese <br /> for a permit or licenae frum the C�iry nf Or�no or any of its departancnts may roq�}ire yau to furnish certain private ol• <br /> confidontial infotmatiun, <br /> You are notif ed that: <br /> 1. The inCormation you furnish will be uged to determine y�ur qudlification for th.e permit or license <br /> r�quea�ed. <br /> 2. You mAy refuse ta supply data,but rafiisal may rcquire that the Cit�deny the permit or lic;�nsc;. <br /> 3. Thc inform�tliun may be Ahpred with other locpl, state or federal agencies to the extent neeessary to <br /> process the permit or license. <br /> 4, If your requested permit or licenso requiras Council action tci apprnva,�onic information may become <br /> public. <br /> 5. You have certain ri6hts undcr M,S. 13.U4(avAilable upon requeaf)lo revizw privo.Ce data on yourself, <br /> 6. ��Your full name is required to�roc ,s t s application ur permit. <br /> � /��1�'<. E� ^� � cJ <br /> Flrpt Mlddlc �.nal <br /> c�-'�f� (,�;G v �,�_-',� � _---___._ .._� '` 7�f <br /> Add�eAo G <br /> ,���--. /���-J `�I' �� ���) ���` �.�p <br /> C�iy 9tntc Zlp Phonc <br /> I understand my rl�hts ae etate a e. <br /> l � � <br /> slgnaiare � ^ <br /> ��,�.��'�.��-����� „.,. . ��,���i4��1� �2 <br />