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06/03/2008 TUE 09:�2 FAX 76� 542 9001 DOLPHIN-MINNESOTA POOLS C�002/002 <br /> Scc13.�� RIG�ITtiI)FSU8.1�:C1'SOFDtT.� <br /> Subd. I. Type uf dula. 'fhe i'�ghls pf individual on whom tha dillil 13$LOYCd Of t0 tlC 5[OICd SfIF1II bC il$5!1�OIlII IIl iHIR ACCTIQiI. <br /> Subd 2. Inf�rmuliun rzquifed�u be givcn indi�idunl.An indivi�ual 7�k��1 u�supply pnvnte or contidentill dST�conccming himvclf shull b,; <br /> iu fi�rme�ol": (o)che purpose antl inre.ndeA use afche requcs�od d�un+viQtin�ha eolleeting ssa�e r,gcncy,pulitical sulxlivisi�n,or sta�ewide system;(b) <br /> wl�cdun c�mny reFusc ur is legaily re.qu�rr.d ro su��ply�he requetiiod dais;(c)any known cpnscquence nrisin�,lium l��s Qurp�vin�or rcfusing tu supply <br /> privak or confidcntinl dmn;�mJ(d)111e i������iry of othcr perso»s or enliliw�iulbori�,ed b}�sratc or fcderol Iaw W recei�z iha dar.�t.This rcquiremont a•h.tll <br /> nol apply�vhcn an indrviduul is askrd ln supVly invcs�iga�ivc duru,pursuanl lo saclion 13 A2,suhdivisinn 5_�u a law anforccnunt otTiccr. <br /> Thc commissioner of rtl�enlle m�y nlacc thc noticc rcumrod iuldef lhls_�uhdivision in the individual in�oiP�txx or nroncrtv tnx refund <br /> i�13I1'Uc i,qnc iiiotcnd oFon thwc li��rns. <br /> $ubd,3. Aeccss to dulu by individuel. Upol�requcst to n responsible aullloi ItY.�+n individunl shull be infurmzd�vhaThznc�i.¢thc subjeci af <br /> �lordd dAIA on indiv�duuls,un�wholhzr i[is cl:�sslficd s,q puhlic,pnv�ic or eonl'idaiuial, Z l�n his furthar reyuesl_a�I iuAividual who is che subject uf <br /> stotdd pfl��+fc or puhlic duw on inJiviJunl�ah��ll b�sl�own thc dutn without any Ch�1�gc to him und,il'hc dcsir�s,Sllnll Ue Illfqrmed ofthc con[enL and <br /> mtw�i�ig of Ihar dat9. At�er an individual has Hech shmv���hc privnte duW and inCohl�c�i nf its me¢nm�,the c1atS nadd f1ol be discloscd to him tor six <br /> monihs lhdf2a(tcl'unlcss a dispute or uctiun purSu,j��t m thi�scction is pcnding or ad�litionsl dsia on�hc individuul hus baen aU��acmd or crca�cd. Thc <br /> rospunsibla aulhai iry shall provide copies uf lhe privala oi'puUl ic da�upon reyuest by Il�e individuel suhjcet oF the dula. "Pha fasponsih��Authmity <br /> m�y royuirc lhd taquas�ing person ui pliy lhc aclual Cosls of making,ccrtirymg.und compilinR dic copics. <br /> 'l�t1d tdspousihle autho�iry shull cumply Imnlediatcly,ifpossihle,wuh any ie��ursl macic pursunn�t�this subdi�;sion.or wi�hin fi�c days of <br /> [he dnte of the reqUes�.eacludins Saturduya,Sun�nVs oitd lapol holidays,ifimmeJiala compliA��ec is not possihle.ifhe wnnut cOmply wilh rlx.rr.�ucs� <br /> wrthin lh�tl time,bC shall cn infnrm the mdrvi�u�l,3�1d tTlgy 118Vc an additionnl Livo il,yys wi�hin which ta comply with the raquesl�CXCI l�[I1i16 SBNfdflyS, <br /> Sundoys nncl 1eg91 liol idays. <br /> SubJ.4. 1'focedurc whcn d�m is nui�ccu(aca or cpmplcrc. An inJividu.d may cunlesl Ihc�curscy or complcteness of public o�nrivacc datu <br /> eonceming himsdlf. To cticrcisc this right,un m�i�idual sh�ll nntity in writin6 ihc respo��sibl�flu�horiry dcccribing the nulurc of ihe dic�prccmcnr Tlu <br /> responsible ilutkloflry SliAll tivi�hin 30 days eilhcr: (a)corrc r.r thc.dnrn fnund to he inaCCuiate of IncomU���a�id attcmpt to nolify p�s�i'�cipicn�5 af <br /> inuccumte ur incumplet�data,ineluding recipients n��mcd by the individual;or(b)nolily lhe ind iv iAual ihst he bclicvesthe dutu w bc coffac�, Data iii <br /> disputc shull bo disClusad only if thc individuul's s�utemz�il of dls;+gmcmcnt is include�wilh Ihe discloscd da�a, <br /> 'I'hc deldfminatlon ofthc respnnsible;tulhordy rt18y ba appealcd punuunt lu lhe pto�islons of[hc adminisutt[ive prucaduie ncl ielating lo <br /> � contcsted caecs. <br /> DATA PRIVACY AAVtSORY <br /> In accurd�nce wi[h M_S. 13.04,SubQ.2."R.i�hi.s nf suhjeccs of datu',we would lika co inform you Iht�l yuur request <br /> for r�permi[or license from thc Cily of Qron��r any of its dcpr�rtmems may require you to furnish cer�ain private or <br /> contidential inforn�atiun. <br /> You Are notitied thai� <br /> I. �I"hc informtttion you fiirnish will hc uscd lo detarmine your qualiiiculiun li�r tha permit or Iiccnsc <br /> rcquested, <br /> 2_ You may refusc to supply dula,but rzfusal may rcquirc lhnt the Ciry deny the pern�il or licer�sa. <br /> 3, 'I'he information muy bt sharzd wi�h pthcr lucul, stata or federal agcncics to lhc ex�ent nacessary to <br /> proccss thc perniit nr I icense. <br /> 4. If�our request�:d rerm ii or liccnsc reyuirzs Council action lu�pprove, soma information may hecome <br /> public. <br /> 9. Ynu have certain rights undcr M.S. 13.U4(av�ilrablc uP�m request)to review privr�lc d�.ta on yoursclf. <br /> fi. Your full namc is requited to process this r�pplicalion or pertnit. <br /> �� _ a/',�Y�' �Vt.�/� _ <br /> First �ddlc i.acc <br /> ���v �l w�� �1 �/ � ., _� <br /> Address ��y 1 (��� �� . ��o0 3 <br /> �� �� � �� , <br /> riry Swtc 7.Ip Phonc <br /> I underst�my ri�hts�ted �vc. <br /> i <br /> :� /�,�,. ' / / .�,r,_ `��L•JU�----•_..,_„ <br /> ..iR��a1u <br /> . !� / <br /> , � "`d xf�k`ti��" ,,� , 32 <br />