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<br /> , DEC-18-96 WED 13;51 MORRIES FAX N0, 161�5449213 P, 03
<br /> STEUEI� FICHTE� RRGN P��� ��
<br /> � 12/1Bf1996 11:16 612-54�-3633 ,
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<br /> Sen.13.04 ltTCrl�'C5 C1F St!$,TF'.CTS O�'Dl1TA
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<br /> Subd. 1. Z}pt o!datn. Tl�c ri�Du af Wlv►duil ari wboa0 fLe d�t�!f stBtCC or W De smRC sbs!!�u stt fnrth ia tEils seefloa.
<br /> 5ub4.2. Iafo�tlon�9ttired ta bc�m IndIridual. An lndividual atked to suPPIY privozt or confi�cutitil data ooaCernl�g himssl!sh�l'
<br /> be isfurmed aP. (a1�F��F°sc aM InceMed usc of USC re�icsred d�n witbta the Collultt�ltste aSeoCy.DdliGr�l rubdiv�ion.w�mtewide sys�mt
<br /> � (b)whathon c�ma,Y nfu�uY i�la�xlty raquired tca 3�yp�y tbC�CQuet�ad d�ei;(c)anY 1�10Wi1 C0�2�q�taCC tt'tafag f�om 6is au�plyia�af rl�ItsittT ta s11DP�Y
<br />� . phvue ar ronfiddncal dstas and.(d}the identiry of o�t�pcc�c+as os p4�ms authvriz�d by:am vs ladarn!l�W tv eeceiva the dsa. Th3a cequlrcawat sha11
<br />+ nu�apyly wnen sn Sr�dlviAual is utccd ta sunrlY fr►��oYaavc dab►.pursuant ro seeaon 19.82, �ubdivf�fon S,B>s lrw enfoKemeh�offleer.
<br /> iC �+MitSi �es of .venu e aetice rconired u de�file subd�vicion 'n �h �ndivid.�y� inc��� Y � � Mx ^d
<br /> i {nsm,cc►ons irw�ead9F 9t� oiL f,Q�• ,
<br />' • Subd.1. Acc.�to dAta by��vldusl. Upen Rquest to a Rspanaibl��uthori�y,in indlvidu�l������4d�'b��r he is ths subj�et
<br />� of yxvoed da�eu lndlv3duaI�.�,ttd wAedSGf it iE Clau;fied as A�blac.ptivatc�C caMdend�f. Upoe hii tU1'ther teque�.aa iadiVldusl Wao i��lie s�i�1C�t
<br /> f of smced Private ae publ'�e dam yn�diYi3uals shs11 be zhow���he ds�s wish��t ury chs�o�n huu jnd:;l he dosirss,sLa�l7 be�nfom+rd oi d�a aon�+sc
<br /> and aiCenl�$Of tl18�Qe(a. A$e►ui iTldi�ldu31 hLs Deen shvwn lha p�lva�a d�ta aM InFacmcd Of i1s������►°G��1 ba disctoiad m him for
<br /> Si7G awnthi the�EAftsr�utlless a C�Spu[r Ar acrian pvKu�n�m ihis ircdon ii pend�+a or ulditioml dV t�nn Q�e cusdof rh daca. 'iTsa rssyvn blatr�or{cY
<br /> Tl�a rq�r{wrulbla*u8ivri��+tft�ll pro�ldc copics of t!►a pdv�R��r pu0llc d�id upori�RQuCs�oy�h4�a duat�s'�J
<br /> enay t�e�ul�a ska nqu�6t�ne pwreon�v p�y tt�o ecaA►l�osc�of malc:as,etctifYi�b,tnd sda�pilini c�P
<br /> 't�,o�sponsil>1e auttwrip�shAli�umply itr++medi���y,i!possible,u+;�+any r'e9aes���de P��Ru'��'�u�ivision,o�wld+ln ll�a d�Y�nt
<br /> �pad�d��d�e r�quesc,�xcludtn�S�rardaYa,SUndsya ind]s8�►����ys�����lzcecompllanoe i�na�Dosslble. {fhe canuot com�tY wl�h�e requefc
<br /> wj�hln d+ai tlma,!�e sEul1 so inform�hc 4ndiri�Nal,nnd m�y tfavc ut oddiaaual tivq da77 w;rhi:t wk�h to comply wiih tha reQuea�c�Gl�siln�S�tuniay��
<br /> 5undayx snd kgd holid�ys. ,
<br /> � �wyQ,q, procodare xbcn d�ja Fs aot sceurot�ar coaupl�te. M Indlvldval m�y conDest me asevrecT er completensu ot pubilc veydsau
<br /> dad eone��nln�ht►r►self. To ezcntte d�ic rtgh�,�individu�l c►ntl natify in w�{tin�t��tespOnslbl�tu�bodty detc�ibiny dsa p�cute of�t8 dls�ffreeaun�
<br /> �s�e responsibia authoricy s1�a11 witl�in 30 daYs nither. (a)coreecc�he�3aa faund to 1u iaaeau�or iucompteu rnd uedmql m itDafY a�Tt���n�ol
<br /> it�accurue or fncc�mplele�u�a�in�lndin8 recipiaa�s nuuad by rhe inelividual�or(b)aoqFy Un individu�3liwt ba tmllar�a tba d,�w to Le Cvrreee. D,ua
<br /> ia diipute sh¢{f be diSFlbied oaly fi thd IMividusl'S�tatemant of d�toyrcunent is ineluaed wi�eLe dlselestd ea�a.
<br /> '17te delertein�rion nt the rr�pancibk audlol�cy t++av b!spDe�ltd pursuu+t ta 1ha pcarisaons of tLe admirt;atraGva prorlsduce 11�c rt10d0;tb
<br /> COAtES�C�C9SRS. .
<br /> , . � . AT F A Y A .
<br /> In ati:COrd3LCe lutth M.S� t3.0�,$ubd.Z, '1Righta ef subjcctx of dat�'.we wotildlikp'to infoca�ybu that y4ur scqucsc
<br /> ior a pe���or license from the City of Orono or auy of its depsrtr�eflts may require you to furntsh certain Priveda oY
<br /> �pnfidcntial infornitti�e.
<br /> Ynu a�'t not�fied that:
<br /> 1, The infvrinatiau you'��r�is�t�Il be t�e�to dotermine your quali�ication ior thv permit or liccnse rtQuoated,
<br /> '2, ' Yuu miy refu�e to supp)y data, bu� �tfLLia) a►ayr�quicti thuc the Ci�3'�a7'��D��� ar liccnae,
<br /> 3, . T1ie informatian�may be sbared with otber local, stata Or federsl�g�na�,to the ezteine ncttssuY to procc�
<br /> c�e permii vC 1lcenaa b�a�e
<br /> 4, ]F yuur rcquesitA pe�mic nr licensc rtq�ires CounC�l acSiott to agp�Ove, aeme infv�atioa m�y
<br /> public�
<br /> �, You have c,ercain rigt�t� undcr M.S. 13.04 {availabla upon reque3t) to ravie'uv privace dnta oa y�ursalf.
<br /> 6, yRur full name is required tn DmL�ss tltis appllcstion or permic•
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<br /> ' Middlc �
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<br /> � Q.�,,d S�a �Gy I �� .
<br /> 'wa"u MN - .
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<br /> PCW
<br /> � i isadcrstnad a�Y �6�� u t tod above. •
<br /> � � 2.Q��/ '
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<br /> 6{grc.mm
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