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� CiTY OF ORONO � 6122494616 08/16/99 10:38 � :OS/10 No:135 <br /> S�a.11.04 1tICHT�S O�+�IECTS UF DATA <br /> Subd. 1, 7Yp�of:MtN� 7'11R[1=fit�of jnQiridWl on whOtil UlC d�ts la�tOnd or W be i�orvQ ihdl be 11 iet fOrTh In M1Ii�ection. <br /> g� � ��Q����,y,�tv a�f�en indlridwf. An iMfvidual�kaJ t�eupply privem or cvniSdend�l data conceminR himzelf <br /> �11 be tnfurm+0 of: (�)dn►Yu���'►���usa vf the rcqusrted d��a wichin che culle�u�R Q�eu�Ra�y�?��iacal:ubdtvl�ion,oc�taeewide <br /> •yitem:(b)W1+�ih�i(1t miY��w or i�Imj�11y roQulrcd ro�upyly tbe i'equwaed d��+;(�)any known coruecrienco rri�InY from hif�upplying�r <br /> ro��i�m NVP�Y p�i`'poe or cnntMe�roal cbta;��d(d)tlu idcntiry c�'v0�er parwru or ontatiaR eudwrisul by:mto or federwl l�w m racelve thc dat�. <br /> T'yi� ►pqulremont �tiAll not aPply whon►n Indiv{0ual I�a�k�d w tupplr 1nVtitlg�Uvc dwU, pursuan►�o�ecpan 13.8Z, »�bclfYiKl��n S,�a�l�w <br /> ehfot'¢4menc o�v¢f, <br /> l��J�tc�.at,.�a.�c�.Iw�t• <br /> 9ubc1.3, AcceM to ds/R by ladiridwll. Upon requert to a ro�pocvibl�audw�iry,��individual�h�1J be infonned wMUief he i�thc <br /> Wbjovt of s�proc)dKt�on ipQiYIdVAIR,�na whcchar ii t:c���sitied�s p�btic,ptivau ur co�ndend�l. Upun his f�+rther rcquaK,I�tllndividuRl wbo <br /> it tha iuhj�t of stA�ed prinOt ot publie JY4 on individwJ;tb�ll bC�vm d�o Mta withwt�ny dwr�v to hfm�nG.if ha desiref, th�ll be inFormed <br /> of t11e Cont�nt tnd meo�u�of that daa, After An S�ltlfvidu�l haa bt�n ahawn d+s pnv�tc d��end infi,nned of ip tmanlnR� tho dau need r���b� <br /> dircloAsd W Nm fof f�ix rpoN�U d1(sR4Ror Vtllau'die�xt0e or aodcnl pursuanc w Ihir�crion it pendinj ot wdJttlon�l A�a on the irxlividual hR�been <br /> ppJapCted ot erC4t4a, Tha PO�ponaiblo 1luihoriry th�i!p�vvWe copla�oi�he priva4 or public dep�ufK+n rec�uost e Y+d C�mplli�th0=CoJ fet U(�e���. <br /> TM ta�yoqofble wuthociry mry roquire d1e TeWa�dnj perwn to pi�y tht a�W1.1 eo�p af m4ldng,�anitying� <br /> Ri P <br /> 'rM ro��oruible aa�hority a►�au oomp►y Inur�cdla�e�y,if pAufb{e,wid►It�y ceqVeat m�de p�nuanl to IJ�Ss subdlvitlon�or within tive dayc <br /> o(�11�druo of►he raqu���eaGludit�3�turdlyl, SunQ�y��nd Ie��t hufl6sy�,if Ifklrt'�eQlate oompU�ncv ia��e pva�ibis. If he crnno[comply with <br /> the roqve�l wid�3n Th�t Hm�,ho 1Ruq Ro i11lOCm tho indirldual,�nc{maY h�vo Rrt Ilddtcton�l flve d�ys withln which k►��mply wlth the cequvst. <br /> OxF�udirl�sewmRyr,Su�,Oaya Mna 1•�nt holidoyf. <br /> Subd.4, Proeldur+wh�n dat+�b not*eeur�tt or eomplRtt. Aa inCividutl mry rn�teit lhe uaovttey or camplat�neis of public or <br /> yrlvsp A�a�eu�oem►nit�Kll. T�eue�i�w Ws nYht.W�idividux!AhaU noeify in wrttln�the rospocuihla tuthorlry ds�``e Y�1Q llRem tIQD not� <br /> AI.�rNmsnc. Th�n�pouutMe aufio�t�y�h�ll w�d�l�3U d�yi.idw�: (a)coneac d+e drd im,nd oo be ira�cauratr ar 1�amp! P <br /> pu�rscipio�ollrusalr�m or inc�mplete d�t�.1neludfni nGCipwnt�rum�d p7 tlx Indirnlurl;or(b)nvilty ths i�,livlduRi rh�t ho beti�ves tho daW <br /> �po�o�t. p�p In dl�pute sh�ll De dlsolvrs4 oN7 if th�lndivlQusl`I ttatement of dlsegnorrietri It includeJ wlth q9v diiclo�ed�t�, <br /> 'ilyt Gte�?n�iMdoR of tht terp�asfble iuthority►nyY Tx eppedecl punuaot m thc provi�lons of cha adtninl�tntive proceduTv Yct selwtiny <br /> W ooiNwftad CN+e�. <br /> Tn aacvtdas�ca wlth M.S. 1�.04, Suhd. 2. "Ri�fitt�of subjecta of d�ta", wc would like to info�m you cb,at your <br /> c�cquo�t for a�rmit ot ltcenae f�viri th��iry of Orono or any of ita dcpartments mey requ'ue you to furnisb ccrtain <br /> private or cor��dGntial tnfoxmacipn. <br /> Ypu are potitled that: <br /> 1. Tha informatian you furrtiah will be u�cQ to d�termine yaur qualifi�acion for thc permit or ticettse <br /> raqu��ted. <br /> Z, Yoa�may refu�c ro supply daca, but xctusal met� rcquire 4hat thc City dcny thc permit or licande. <br /> 3, 'The i�r,for�aation may be eharcd wi�6 ot�c� local, SSa,tc or fede�al ageAcics to thC eztent nccessnry s� <br /> prcxe�s thc pehmit or liccase. <br /> 4, If yvu�rcqueatal permit or liccr�ee nquirca Cotiuicil action to approva, some informatian may becorne <br /> pubtic. <br /> � `�'pu have c;ciiain righta undcr M.S� 13.04(a�ailable upon r¢qucst) to revicw private data on yourself. <br /> 6, Your tu11 name ls required to proaea�th.[s application or perinit- <br /> ��� �� ���' �5C�,1 , <br /> Pir�� MiOdle Lau <br /> [� i1 �, <br /> .J G�.I L'V� Y I��.-, i... �� '-1 V"'�. � . <br /> Ad4n�e t <br /> 1��.�ti' 't-�O f'(._,�� �,_,L).�� ����� 2�' �-�-^----- <br /> CVry � <br /> � saoe �Ip Phon� <br /> ,� `' <br /> � llAdCfit�CS JS1�C �AIOS��VE. . <br /> � /�/� `/ �„ � <br /> algllttun •� ; <br /> � <br /> 6 <br />