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,09/14/,20�4 14:58 6516344129 TCSP PAGE 02 <br /> . �• • <br /> . <br /> 5oa13.p4 ,�[GFfC9 OF BUBJECT$OF DA1'A <br /> Subd 1. 7"ypc of da4. 7�c righes of mdividcwl om whona tbe dam is stmsd or w br ataaed�1ra11 bc as sec�m this sxdan. <br /> Subd.Z.Infornasciam ivq�wod to 6e�iveo iadividual Att ioadividaa!askod to sapPkY�x arc�dendal dats oonccniyg�sdisLaII be <br /> iufaonod oE (a)ttic p�apo9e+►ad ial�aded use a�'the requcatal dam wi'+hna the oollectiag stace aB�Y�Politicsl sobd�visi <br /> whatherhemsyrefnseo�'isleCallYra9ucedrosupplYtherequsstadda c o�t.arstatcwidciY�;�b� <br /> pa�ive0c or corifidaatid deta;aad(d)the idcnti ofatbar �;()�0.rlmawn co�eqneax anisimg from 1►is aaPP�Y�B arrc£asmg w supP�j' <br /> �y pasaas oz eatities anrhotiaed by smm arfederal law to recdve tb,e da�a.This ruq�marart shsl( <br /> not appty when no ivdividoal is aslsd to 9upply mvenigadve dam,pyrs�,�ut to secGoa 13.62,subdivision 5,to a!aw e�afaa�emwc o�Zt. <br /> fllaca t6e n�'nce ica,�.,e.d.,,,a ��.• •. • ' ,S�lg4II7o�1W <br /> Subd.3.Acass w d3ta by iadirvi�ual.Upaa�eq�pt W a nspomsibls euzhozitY,a�iadividual ahall be oafaotaudwhedtczhe is Uu subJcu of <br /> stored deta am iodlviduxls.8qd WI76t}16!lt AS CIi99lf 0d ii pOb1lC,p�ivate or oo�SidentiaL Upon his furth�rxeqae9t,an nadividual who u t6e subjcct of <br /> swrod pxirvaoe or publfic data om 6adiridaals sh+ll be�isoana the data wptl�oat aaY°�ro bim atnd.if he d�sites,aha11 be i�u,Eom►ed of the contept apd <br /> mezaing of�hat deta.�4a im mdivldae!Las bada ahawa tb,o privaee dats and inf�ed of its rpa4oia��,tLe data Aeed mc bo discloeed w hi.m for su <br /> maut6s th�imlcas a disputa oractiosa pazsuant W khia sectioz�is pead'a�g ox addido�sa diva on the ix�dividael has baa colleeted or crcaced.The <br /> re9paosible uuthorEty sheJl provilde copies cf tLe putvaoe or Pablic da�a upon reqaest by tde iadivldaad Snbjat of thm data. The mpvosible autbodry <br /> �Y���6 xtl4��8 D�a to PeY the aconal coeta of noakipg�xnifY�nffi,��+�mB rbe copies. <br /> The responta'ble autttotiry abe�i comp(y i�p�ax1Y�i�pos�ibte,wich anY requestmida parsaa�pt bo rhia subdivisioa,oarwithm 5ve days of <br /> the datcoftlu z�4 ex�luding SatoxdaY9,Suadxys aad IeealholidaYs,l�Y6ruuedisteComptiance�s�motpossibk.ifheea�uoecompty wpth tberoguosc <br /> aithinYs � egal ho d a�oaxa tbe iadihidual,and tlo�ay have ari additiaaal gvo days witfti�►which�o cpytop�y xrjth t6ciequest,eXcl�iding SatWrd�tys� <br /> Saada w�d I y <br /> SabJ.4.Procer!'arewloaadafaisaoeao�maceorepcp�lete.AniufdividualQpsyc�xstthaaa�acyn►'wmple�ofpablicoxpQivatcdata <br /> concammg hirns�lf.To exarcise rhis xi�ltR en iadividal FhaD aoti�r m xriring the�+ospar�'bk�thoiitYd�nbing 8yonanae o£the disa�ropn�e�c Ths <br /> ifla�civau or iulom�lete dtt�,���e�x: (a)�ct tLe data�ound w be imeicaaate ar imco�mPlaee amd atoerppt�o nodfY P��pis.au of <br /> Ais�►ucc s}pll be djgeiosac( ��i�aamed by the mdividuel;oz(b)poHfY the iadividwl thschebelieves�he data to be wisecc Da�a ia <br /> �Y��t�IC�A�'1d119�'9 91iic�Cal Of(�jgi�DWpCQit 181GC�17d6d W!�tbC dASC�DfEd d8fi <br /> contested���adioA of du rrspaoaible auehoriry may ba appealad pmwaae eo the p�ovri�iaaa of�e adm�isns4iv�proeedwe ace mlaWog to <br /> Zn�co�danee with M.5.13.04,Subd.2,��Rig�ts of subjocts vf date",we wvuld liace to iafo�m you that yourrequest <br /> for a pennic oc license from t(�e City of Orono ot any olats depart�esrts may require you to�iunis6 cetlsin private ar <br /> confidenUiel infot�oaation. <br /> You a�e notified that: <br /> 1. The is�octnatia,n you fu�noish wil►be used tio dete�ine yout quali£teation for the petmit or lieense <br /> 1°equesCed. <br /> Z. You may refuse to suPP1Y�,but refusat may require that the CitY de�uy the pe�n,it ar uicense. <br /> 3. Tlae infuronation aaay ba sbared w�ith oth�r local, skatc or f�ederal age�ucies w khe exte�tt necessary to <br /> process the pematoit or]icense, <br /> 4. public.�uested pe�nmit or lioeage teq�res Co�mcil action to approve,some iu�famation may become <br /> 5. You have cextain rigb,ts uader M.S.13.04(ava�ilabia upaait request)to review privau data o�a yourse�f. <br /> b- Yous full natne is req�red to process this applicatiobl ar pertt�ik <br /> . � <br /> ��tst SG�.P1 Il� �rW' i ^ �'�i�.S �c�i i �`R� rCrot�S S��lll� <br /> dI'iddle <br /> � <br /> Addre� <br /> .�'`�- ` °�`�--Q- � <br /> I'Y�1� �..1�—,--- ��5 � �s.�-�s�-�l y� <br /> �a� <br /> �� � �o� <br /> r u�deta d roy rights a8 etated above. <br /> Signsin,t <br /> 32 <br />