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07/19/2995 69:49 6123368600 NOVUS PRINT MEDIA PAGE 02/06 <br /> Sec.13Ad �GHTS OF S[18JECTS OF DA�'A� <br /> 3ubd.I. Typ�of dera. 7'he ri8h�of individual on wbo"'the dats'ie awrtQ or co be soaced sba11 bc as aet fortb in this axliott <br /> 3ubd.z.1�'orn�sdoqroquitrdwbcgiva�individuai.Aatadividualasked�osupPlYpm'a�corcon�idenoaldatacoace�oinahimselfsh�llbe <br /> infotmcd of (a)tba purposE end'moeaded uec af the tequcate0 Aata airhin rhe collecunY��aB�Y�Politio+l eubdivisivw�smo�wida rys�an;(b) <br /> wh.ther ha mqy refusc a to 1ege11Y�N���PD�'���;(�)aoY Imwvn conecqua�cc�ieing from hts supplying or tefuein8��PP�Y <br /> . privar�or confdential dam;sad(�t6e identity ofo�persons or endties au�borimed by snoa vr�dera!Iaw m rea:ive d►e dara TLis requicw�cnc ahall <br /> uiot apply when an indivi4ual ie aaknd w aapply in�sti8ativs dam,pursuun to ta�tion 13.82.subdivieion 5,co a Iaw wfoxccmeat ot'ficer. <br /> '�f'hn o�..,...uai�ee oi�vq�y D1BCP!hc nodx�m��red tl0der this subdivjnion ia tlic fq{�ividuai itu'^ :ar :refimd <br /> i <br /> 3ubd.3.A,acee ro daa by imdividual.Upon requcatto a rosD�bie au�bwi�y,an ind+viduai a6a11 be iw�'arn�edwhe�be ia the subjax ot <br /> swPed d�ta at��od►viduoJs,aud w6et6ac it i�e claasified se public,pCivate ar confideputiel. Upoo bds�v�hec roqueat,an ind'Ividusl who is t6e subjoct of <br /> etored Pttivste or publlc d�ta on mGivldusl9 shall bc ahown the cWa wir6otx aoy cbarea to himi ost4 ifhe desires�shall be infOttned of tbe wnbent wd <br /> m�oin8 of tbae dara.1►fter an individual ha9 been showa tbe privabc de�a and iuforaed of ita m�enioR t6e ds�a need aot be dioclo■ed 6o him for siz <br /> moa►ths thorcafter�less a di�spu�o ac acqota putsuamt W drie secdota is pending or additioaal cbu oa nc�individwl hos baa oollectcd or craocd.Tl�e <br /> rcepone�k�ba+ry eha11 prov9de copia of the privete o[public dats upon rcquesc by she iodivldual eabject of tUa daoa. 71u Kespafuible a�tha�iry <br /> �Y►�9wn t�r��,e+cing persoQ to par the scwal costs of roeka�B,cettifi�og,end co►'npilias du�ee. <br /> T6e tesponobk au�hacrty eholl�b'immediaoaly,ifpoew'b1q with aay�st mede pwsuuat co tbia aubdivi�iom>ar witdin ftvs days of <br /> �6e datc of tbe tw+xsc,e�ocluding 8awsdeYe>Suodays ead legal holidsys,if imcnedi�oo cocnplisncs ie mtpossibk.Ifhe cauuwt canplywith d�e requeet <br /> w�ithin q�at mne,he sball oo i�artn t6e individual,eAd me�Y htve�eddition'1�ive deys witbin+vhich oo cot��y aith ehartquest,exch�ding�Ys, <br /> 5�mdeprs and lega16o11d8ye- <br /> Subd.d.l�Cocedurvwbandataieaotaccurrteorcom�pleto.Mindividuslroaycantesttheac�aeYw'°orn�leodnessofpubuaorprivpfzdeca <br /> wnoaviu6 6imself.�'o wce�cioe th+s ui�ae,an indivi�at sholl nai�'y tn writing�he rrspo�iblc aud�a�iry descr�bioa6�he mpu�e oiwe disa�oa►�aa�'Ib�e <br /> rrspppsible 9utt101'icy ehall within 30 daya dehcr. (s)eoct�.wi tbe dats faimd to be iaaeeurak ot iDeomple6e a»d stte�lpt to norify paet reeipie�s of <br /> ioauurate or incauplere dasa,iaeludiug reeipiems�by the iudivi�l;or(b)mdfy du iadirvidual that he believes the dstaw be eoarect Data in <br /> dispuce eF�e1)be disclosed only if thc it�divid�wl's sTacement of disa�raemwt is ipcluded wi�h 1lie di�tosod d.►a. <br /> 73e deteRninspion of the respoAeible authmiry may be appealed purauant w tb�provisione of tbe admioiartsdve procodure aet teleting to <br /> contes4ed naee- <br /> DATA PR�VACY ADVISORY <br /> bu aceordexlce wi�th M.S.13.04,Subd-2,"Rights ot'subjects o£data",we would like bo ie£o�noo you thst your cequest <br /> £o�s petmit o��icense from rhe Caty of Orono or any of its deparane�ats may rec�uiure you so fu��ouisb,certain pnivate or <br /> con�£idential ir�fornoation. <br /> You a�ce nolified tb�at: <br /> 1. The imforn�adon you �iunish wi� be used to determin�e ymII quali�ication for t�►e permit or licaase <br /> reqne.sted. <br /> 2. You may refuse to sup�ply data,but refiisat may require t�hat tb�e City deiay tb�e permit ox license. <br /> 3. The iva�'o�xnation naay be sha�red with otheic local, state rnr�ederal agencies w tb,e e�.teat aeeessery to <br /> psocess the�e�aait or Gcense. <br /> �4. If your requea�ed periauit oc license requires Covnci)actxot�to�pptove,some i�tfo�nooa4�un may becobae <br /> public. <br /> S. You�aave certain rigb,ts under M.S. 13.04(available u�o�tcequest)w revi�ew privace daca ou Yo�asel� <br /> 6. Yowc fiill name is uircd to process this application rnr permit, <br /> l�1� M, an� l,e.e. s . C�v�ln r � <br /> �.�' �ne rnaa� z�.�t ��b � <br /> GU�f �01 h��e a�t, �� yfln (��� ��'� f��id�n� <br /> � �d�. N �.�i 1 0 ro�0 M� 55 e�cfi�c, <br /> ���� M <br /> �� �n� � �o,� Q/�19 <br /> �nnderst�n rig6ts ss above. �-1' I� ��D ��� � <br /> w <br /> 32 <br />