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i, , �� ��,—�•— � v���rr.�tr� �u U`//L4/`10 14:UU � :US/US NU:�'L'C <br /> � ' • <br /> $to.13.04 R16�TS OF BUW�C'r$OF QAT.I <br /> 3ubd. 1_ 2yp�vf dstA. Tho�1ppu o[lodJvldud on whom��dao b-smrod or m be sio�ed ahall be at mt bah(n thU�ecdati <br /> Subd,l. Ws��tlan e�dexi to ba�It�n In�vida4l. M I�IWduol esked m�uPp1Y A�i�►ere or oonAdande!doa aonaeraln8 bl�elf d�all <br /> be hil��of (a)dce pu�pocA uid Imm�ded use ot tRe t�qu�+�ed daw ahAb�rhe caneadn�amre aYepoy,pollditit aubdlvSdon,or�tewiAa synem: <br /> (bl ar�ether h�nqy raN�a ofi U lao�lly reqvirsd m supply tM raquerrad dau:[c)�try Imnoun��vneequeace ari�Ug from hlt eupplyltK nr ml►�61qy�a�app�y <br /> prlvaoe or cpoAdenclal d'a;s�d(d)d1a idcnriry cl ottie�peRon�a�enddes�udtoti=�d by anie or fedelAl INw�n Kceive dle da1a. Thl!toqWtel�oept shu11 <br /> aot�ppty when�n lmdividual la s�lced ro eupply I�rpela�dve dnm.pnreutnt ro sacdon 13.62. Nhdlvieicn S.ro�I��►artfolM,etA�t 01�eer. . <br /> ,., <br /> nut cc ► ' vl <br /> __.. I�ntuucr�y+n�Inec9�x!_u(on rho�ao fone�, - • • • " <br /> Stisd.3. Accen to da�fa by G�dloidual. Upon nquesi ro a�esponsible ou�o�la.ert Indl�lduu ihall M lnfonned whad�er 6�L du aubjeee <br /> ot RorN dw on indlvtdwh.aa�d whed�ar it i�ola�slAed u publ�C.P�ivue or cwJidentiel, Upon 6i�lludier naquee.Art ladivWual orho 1�the subject <br /> ofswtrd pri•,Aa or:pubtl�dtu�on i��vidud�shtil b�sqown tise dao wl�uut aay a�e oo hia oM;it he desle+a.9hali he iofennad oP d�e wn�enc <br /> s�ed me�nlnr of di�a dam. Ahs�on fesfiruival h�s beeo slwwn d�m pil��m d�o�u�d Ialbtmed of Ie exvims.rlue d�o aeed twt b•disclns�ro,hlm for <br /> afx aw�s d�ere�fpe�uhles�a dtipute er�odon purauant to ih�s�ecden h pandln�or addidon�l dara on�he Indlvidud hAs been oollected 4r erea�d. <br /> Ths t�spu�ble�othp�a th�ll provide cflpiei al ohe privue or pubtic da�upon�equea er d�e lndlvldu�!�ubJ�et of d�•daea, The neapousib(e auMotixy <br /> tlwy etqul�e du mqu��dnr p�nne�io pay tna acwel eosoo M auithss.eertll�rino.�nd toeip�lfs�g ehs eopi�e. <br /> Tlte nespnndDl��udrodq.ehall eomply Immedi�oely,if po�ible,w�d�a�s��ueet mado puteuant co d��s subdlvlaEon,ar Mi�fdn flve day�of <br /> �he d4�e af�h.nqu�s�eaetudlnt 9�urda►y�.9undsy�ond 16ge1 holldvy�,I�b�qnsdlate compllrtice 1�not po�ihle_ ]Nbe wntlot aomply wid�the teqtuse <br /> alUdn[het der��Ao ebsll eo Mlbrm des Ittdivtduol,a�m�y ha�e an�ldlrional fi��a■y�wid�ln whlcb m comAly wi�h she eequ�tR,�Kch�ding Saaird�y�, <br /> S�md�ye and letd holWaye. . <br /> 8ubd,d, Peopd��wWe detg i�net aecarot�or eompls4e. An 1nw11�iduvl m�y eoraeu il�o acc++aoy or canplerono�ef publle or pri�a�a <br /> dio eoaeernina 6imsel� To�xerclia rhis dghr,on�ndt'vtduel shell�aah in wridnB�he responaibk eudwdqr deacrlbina dsd nea�ro aP rhe dlcegme�ncns. <br /> ' 'Lht�e�pen�)ble iu�horiq dlell��ddn 30 d�ys eirher. {a)ceRecr rhe dam feund e�be ioneaeeur�te or In�w�nplee��tnd amempt no nbafy pao�aclplencs nE� <br /> irteaeuna or Iqcnmplere d�a,IM1udUa neipienu�r+med by d�e lndiv�url;or(b)aodfy rhe�nd�ridWal t�.�he bellews fhe da�s�o be wn�ea� Dan� <br /> ip ol�puce�h�ll be diaeloimd on�y ff ehe indlyfdusi's s��ament of dlsioroement i�Inaluded wltb tha dieelosed d4aa. ' <br /> 39N demrminatlon o►the neponsible buihodry r►�ar�o�ppealad pursuent eo db prorlawnc of d�e a►dmin{:rndve ptoeadd�e Aot�elatin�w <br /> eellta�ped caees. , , • <br /> , � �. . <br /> ' IfATA PRIVA�Y ADVESORY � � <br /> . tn�ocordancv with M.S. 13.04,Subd.Z, 'Itighcs of�u6Jocts of da�a", we would like to iafonn you thai your requ�st <br /> for a permic or 1lcen�o fMm the Cliy oF Orono or any o�it� �epanmenc�,mgy requlre you co Yumish cenaln p�l•nce or <br /> coaPtdantiai lafotination. . . <br /> You are nodfled �h�u; . � <br /> l, the infornaezlon you Curni�h wW be used to decermine yuur quaiiftcation for�he pecmie vrlieenae�oquested. <br /> 2. You m�► rofvs� to supp�y d.-�a, bu! teittsiil may req►il�e that the Ciry dtq�r the perml� or ltunee. <br /> � 3. The�info�tian may be�ah�red wirb ocha�Ideal, srate or falacal agcocies te rhe extent nece�sary to proceas <br /> the pecmlt or licettme. � � <br /> � 4. . tf your �equaer.ed permit or ficease reqptres Couacti act�On �a app�ove. 6eme infpnaacloa iaad become <br /> ' public. � � <br /> S. You have cen�n clghts under 1tii.S. 13.04 (avatiable upnn raquest) to rtview pdivato data on yourself. <br /> 6, Yaur tull neme is zequired to p�aees� thls appilwion oc permic. <br /> , ' F O � Mrdd Luc. � . . <br /> � �� <br /> t <br /> '�j C�Cri� � , , , <br /> W�y 9da �ip ' Phon� <br /> � ' I•undaratand my tlglits as sr nbove.. - . � . . <br /> �I�naa�e . <br /> -l/l ' d _.:OO� I ' �N � ,,, , ��3S 11W�3d �NIa11�9 S3N0�-�3013 _; WdLti � £ „100Z ' l£ ' I �� <br />