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NOV.08'2001 16:12 612�229�54 GARLOCK ERENCH ROOFING #3219 P.003/004
<br /> Sec.t3,04 RIGHTS OF S[lBJEC'l'S U�DaTA
<br /> Subd.. I.. Type n�data. The riQhcs of indtvidual Qn whom rbc dua is stoced or a�be sooisd thall be u aet fvrth 1n mia sectbon.
<br /> SUbd„Z, [otormation req,�dred.co be�veo Indj.vfdu4l. An 1adiYiGua1 asked►n supply pdvite or co��rdead�l daca concerning Elm�elt shall.
<br /> be�formed.of: (s)the pu.tpose and I�oended ase of�e requ.ested doo wEd�.iu�a co1l�e�dnS fin�e o,�cocy,paqdca]suhdivfsion,ar arn.oawide s�rsrem;
<br /> �(b1 whedfen c�cnay reEuse�T is legall7 requi�d rn supply�ho roqueaced daea;(c)any feu�wA masaquence idsiag fmm his supP�Y�B at mNsiaa 1a aipP�y
<br /> pdraae er oonfidendal duo:and(d)�he ideadry 4f arher persopa or enddes aurhqrized by Sn�,ar f�doral law oo�scei.e�e dsts. 'Lhis requiremeac shal7 _
<br /> noc apply when an indkv�du�!i.s ssked m supply in.vesdgadva data_Pwsuanc ea secdon 13.82, 6uhdfrisian S, In B�lw Cf1F01CCW�OL Df�ICCf,
<br /> 'n•• �ommissia�er oP cevenu.�mav n.ace n'ce i d � der h� subd�v sa n e '. d'v � ' a e rax o ro oa d
<br /> insrtuc�ons�natead of vn�hose f�r�ns.
<br /> Suhd. 3. Access en datn bp tndividual. Upon rcep►es�eu a respnnsi0le ai��honq/,an individual shall be info�ed wherher he is rhe subjeet
<br /> of.swrcd.dars r�n individu.als,and.whe�her �f is classiFed as public, pr�.vace or confidenoal.- UPon h1s fv.rdu�request, an iAdividual whn is rha suhjeet
<br /> of sGarcd priva�e or puhllc da�a an indlviduals stsall be shmm che dara Wirhr�uc any charge r,a him and;Id he desires,shail be InfoRned of eA�e coa�enc
<br /> and mearung of cha[dara. Af�ec arl individual has bcro shown rhe pri�a�e da�i and.informed oF ira meaning, rhe da�need nac he dixlosed oo hiru for
<br /> sis mAn�hs thereaher��nJess a.dispuce or acr,ion pursuant�o rh.is secd.on ts pendi�B�r addidansl eaca an nc�individual bas heen eollacred or creaced.
<br /> Tht responsible au.�h.ortry s�all provide capics of rhe prirarc or public da�upon roquesi by[he indi�idual subjecc oF rhe dars. Tlu responsible auchor[ry
<br /> may rzquiro rhe r�q.uesdng persnn�o pav rhe aea.�al c�srs�f makIng, certiPying, and.cnmpilEn.g�Se copie6.
<br /> �e respansib(a a��rhod�y shall eornply immedia�elY, if pussible, Wi�h any requesG made pursuan�w this suhdivision,or within fYe daya of
<br /> the daoe of�he rcques[,exclu.ding Saalydays,Sunri�ys�nd.{egal Aolid�ys,if I.mmed.iaee complie.nce is noc passi6le, f.F he cannot c�rr�ply with the requesc
<br /> wi�hin that time,he shal.l.so inform r1�e individ.i�a1.,arld may ha.ve an aACior�nel PL�e days wichin whlch ro camply wi�h rha rcquest.excluding Saard�y9,
<br /> Sundsys aRd legal holidays.
<br /> 5ubd.4. P�ocedure ahen dn,ca Is n�t��ocurate or completa. M iMividual may coc�xs�clu eccuracy ar comple�er�ess�E pu.blie o�pd.yaoe
<br /> dars concemin�himself. To e:e�cise rh.is riglt[.a.n individual shall noufy lu Wadng�he rsspvnslble aud�ariry descdbinQ tli.e namce pP rk�e disog�eemen�
<br /> The responslDl.e aufi�riry shall wi�h.Ln 30 day9 cirh.er: (n)correc[tlte dara found m be ineceurar,e or Encnmpleoe and atterapc[o rsodfy posa ncipienss of.
<br /> f�ccuraee or incorr�plece dau, incl.udinB recipienrs named.by d�e individua.l.;or(b)curJ.fy the I�dfviduaJ thuc Gu heliev�s tbe dacs to lx�acrect Dap
<br /> in d.ispu�e shnll he discloscd onl.Y if die Indlvidual's sracemen�of d.isagreertun�is incluAcd wld��e disclosed daca.
<br /> Th�e daocruiLnadon of the respo�sibl.e au�horlqr may be a,ppeoled pursuan�m rhe provi6ions of�Jtie admini5rradve proced.,ire aec reladn�oa
<br /> co�usced eo,ses.
<br /> AT . ACY . �SORY
<br /> In aceordanee wi�h M,.S. 13.04, Subd. 2, `RighGs of siihjeccs of d�.ce", we w��x1.d Like to in�or.myr�u.that yov.ctequ,est
<br /> for a permi.t or ticens� f[o�n the �Ci.ry oE Orono or any of ics dep�m,ents may require you to fu�nish certain. privar.� or,
<br /> confid�n.[ial inforraati,on,.
<br /> Xou o�re nntif ed �haG:'
<br /> L. Th.e inform.atfon you fi�rnisl�.wil.l be used.to d.etermine your qiialiFxcacian �or che peruiic or license cequested.
<br /> 2. You may refuse to suppl.y d,ata, but reCus�d may trqu,ire tb.at rhe Ciry dca,y th.e permi� or license.
<br /> 3. 'Xhe info�matioo tnay be ahazed with orher Local, state or federal agencies to th,�exteQt aeeessa,ry to grocess
<br /> th.e permit or I.i.cense.
<br /> 4. [f your requ.ested pecm,it oc licease requires Co�uicil action to approve, some inforrna�ioa may beeam�
<br /> puhl.ic.
<br /> 5. You. ha,ve ccnain �i.ghts undec M.S. 13.44 (available upon request) to review private data an�oucself.
<br /> 6. Yoi�r ��.LL narae is rer{u.i.red to pmcess this applica�ion ot permit.
<br /> �A+r �°l.J l C_.9-�- I./� G�l V� i �
<br /> First ,,,�� M dle L�st
<br /> �13 �{S �vc� . S�a ,
<br /> Add� : ,�� ,�« � �� ,s r�� s~�� - ������
<br /> Ciry Sore Zip Pheoe
<br /> L u.ndc�s�and my righ�s as s�ated above.
<br /> � ��, .
<br /> Signorura
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