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Fro�n�ELDER JONES INC 952 854 4909 05I23I2007 15:30 #279 P.003I003 <br /> r <br /> S�ai3.ol 3tIGHT3 Ok'SYJBJ$GTS OF DATA <br /> ' 4u6d.l. 7Ype of d�Sa. The ciahn of lnClvtauel on wDom fie Cam ia ataroa or eo b�storod aholt be es�rc for�h in this seerion. <br /> . Su6d.2.IrtfostnationleqttpndmbeP.�YetifiCNlGtml.MfcWivi�lelaSkeds�auPP�'Pm'oaoorcon4ida,wldssaoom�nmgBio�sslfHho116e <br /> iaf0[IIIe4 01:(6)the Ph'[�os��d imondod u:o oflho roqueaeed deb within�e eolleeting atate eedo�y.D�itical aubCivIS101L or ateoCVV1A0 sY9x�r�(D) <br /> whether he m�Y retl,se or is leseillr reQuiurod to eu�alY tho raQue�ed d�s:(�)enY Imowu conea4u�ce a�isII►8 from kus supplying�nfuaing to sWP�Y <br /> private oc 000r►acudel dam;ma(a)r1w idmtiry ofo+l�pasons or.neities wohmizad by rtata or fediaral laww reoeive the eeti.inls nputrrmatt stmu <br /> not apply when en mdivid�l!S asked to fupp�invesri�etive Ce�s,P'�a'eoeffi w Sec,Cwn 13.62.�bdfvision S,w a law o�'w�oamoot�oer. <br /> 8M 11aP��fd�Q16"��mi n,�Asr rhis aLtvlh^ ion m thc'��•iividuol inooma er nroemttv ra<r�tmd <br /> Sub8.9.AOC899 m dan by iodiric�ml Upop roqtmckte n wrpons�le audsority�wn io�di�vidwl ehell be infnotAv+d whxherhe is tit0 St�}lmt of . <br /> � atorod dsss oo�v��uls.w�a whdlw a is cls�esificd as pubtic.yri�ate or cocdtdentiel.Upon hia fiathx coqueat,�individusl wtw ia tiu suqjecc of <br /> aW(eC Dil�ate at{ubUt GSm On h�dfviduals shsli bc aFwwn dw du�.vithout any cbas�ge oo him,md,ifho desi�w.abe11 be itlfoliGsd oftLe�otlT�en4 <br /> c�ming of Zhac deeL ARer in inaividuel has been shoNm Sha pTivate aem ana�MortneE orip�&�e asts c�d na bc aisdaoso�m hi:n ior su <br /> momhe ffiae�[tmtear a GiSpoW�ecGon puisuan�so this seatioa io pandiag or sdd'+don�l d�nn ow d�e indiyiduel Aae bee�n colleCOod�oeated.Tho <br /> �ponat6lo autluriry oh+ll provide oopiaa a�'4he private or Dublk dem�oa rWUOSt Dll the 6�Q1Vf0Us1 subjcct ofsl�dsm. Thc ieapo�'blo ovdwri4y <br /> m,vy'n4���Ws�"B P����Y tde ecttltl ooste of ineldnp,certifY�&���S�►o�P'�". <br /> 2Lenspou��e o�haiRy eMJ1 eamP1Y ite�vediu�6ea1Y.idD�e�31e.with i11Y��P�umtID tliia fubdi�ipoc,or whhinfivo d�o ef <br /> the d1We C�f�e�L mro11tC�8 Setu[Cays.SlurdeYS nad�e�1 holidaya,if iam+odioto ooe�liaoae u oot pouib►e.Yfheeaeaot caam�h��tb She lequeat <br /> :ritl+to d,nsamo,h�e6a11 w iaform tl,e iodiv�duni,nnd enay have an addhlac�el five deyl�wt�hu�wfitchw COmP1y wld�die requat,oaJudin6 9ow�daYa <br /> S�s and IeRel hWlCayf. . <br /> 5abd.a.proad�aewhmmratsnoLeectiu8�sor�arnpleoe.nnindc,riauotowyoo�c�h.acna.oroewmpteo��publioorpnvarosdalet . <br /> ��64uarolf.To oxoreioe t6is r��,aa indivjdual ebnU aot�r in�rtitinE tho rospom�b[a tt8honty deoonbing fie Leaae oftbe diasgie�oc+�c'Itw <br /> reapaosibk e�uduoda�u wathin 3o dars pt6ec: (d)co�r�the dara to�ma m bo iaaav�.te or Inoompletc end aa.ropt to notify pest rocipieom ee <br /> •fnaccurayc or incomplom aom,meludini z°°'P►eeb nea�ed bY ma indNidwA:aor(b)noA�dro inGiviCuel tt�a3e beliWes'Rfa Cemm be conva.D�m <br /> � djspu0o eheD be d1EClosod ou1Y Kti10 1LWvl�a1's SLii�I1Wtt of di�s��t is incHdod wii fhe disolosed data <br /> �c daatmmae+on of du twponaib�a.�uthority maY��PP�G�Lumttp the DrovitioR9 of�he adm�llisteaUVe�oced�R�eGLl91�B m <br /> co�nesood ceues. ' <br /> , DATA $ZyAC'Y ADVISOI�Y <br /> • In accoxdaln,ee with M.S.I3.04.Subd.2,"RigMs of sub,)ecls of data",we would 1�7ce to inform you that your e+equest ' <br /> tbl�a pamii or license from the City of Orono or any of ita deparuneats m�ay e�uire you to iivaisb�eettaxtl Di'�vate or <br /> conSdc�ttial iaformat�on. <br /> You are aotified that: <br /> 1. The ivafozmadolR You fSlrltieh will bo ueed ta dctcrtx►ino your quslification fae the pe:mit or liceane <br /> �e+equesud• . <br /> � 2, You may refuse to supply data,bur refusal may requir4 thet the City deny the permit or license. <br /> � 3. Thc information msY 1�e shased witla other locml, Rtate or federal a�etieies to tt�e eXidli n�e�cessary co <br /> . � proce�es the permit ot lice�ose. <br /> 4. If your reyuestsd percais or liecnse requiures CowDcil setion to aDDrovq some infarmation may becozne <br /> � publia <br /> S. You heve certsi�l lilglsts w�dC[M.S. 13.04(availablc upon rcquost)to review priv�te data on yoursel� <br /> 6. Xour�UII name i9 t�equired to proccss this applioation or perrnit <br /> �� t Jl <br /> �,� ,�dk � . <br /> . � � �►aa.�aw � <br /> Qsa 34 �'- LO�+a <br /> �be z�p �� <br /> . Clry . <br /> . I uvderstand my rights as sbove. • <br /> /,�/ <br /> s�gnrmre <br /> 32 <br />