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• , 06,20-Q7 10:40 Fro�-Brst � F�°°�a�n . +61233�566T �'`� T-042 P.004/004 F-451 <br /> , � � ^„ �'�.• . y5� 473 �3435 [ Turt. 19 �07 65:i9Ph1 P4 ' <br /> --� <br /> �' • • ' <br /> _;: <br /> � DAT PRtVi���Y A VPSt�d�`� � . <br /> J���an��th M'�. '�3.Q�4,BUbd.Z,'Rights cf s�bjec�s of dats",wQ wottld like to in�orm o�ths <br /> your request for a.permit ar license from Ehe�1#y af�rono or any of its departments me Y � <br /> fumish certain privata cr conttdent�i inforrnat�ian. Y�4uire yau to <br /> You are notified that; � � <br /> 1. Th�it�ortrt��Qn you fum(sh wt(t t�e used to d�:#9rrnin�your quat(fis�on for the permif ar licenea . <br /> rcqu�sted, <br /> 2. You rn�y�'efu�s fo supp(y date, bu��fusal may req�ire that the Ci�y derty ghe perm�t or IEcense. <br /> 3. TF�e(�fa�rriatlon may b�sbareB wJtt�othel°loCai,�tate o�f�deCS!�gencis$tp the extent necessary <br /> tc proCess the permlt Or IiCertsa. <br /> 4, 1f yovr r�t�ested permif or licanse r�uir�s C+��rndl actlon to apprave, som�infarma#tan ma <br /> became publt� , y <br /> 3. You have c�rf�;in rt�hts urider T�.s. 13.04(see�fatlowu�g P�a)to revtew privata data on ou <br /> Y rself, <br /> �. l�ou�ftrlf nani�is requlred to process this appl�oqtion c�r permlt. <br /> �tRS'� , MICtDl.� <br /> RAS <br /> ADDt�3g <br /> �1N 5TA'!'�,Z!P <br /> ,PH{�NE <br /> � (urtderst�nd tny�iehts stated ebov�. . <br /> �r , r',�,,,,t� �'��t����`? <br /> stgnature <br /> , jq._ , : <br /> L 4 . •� <br />