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Sac.13_U� ii�GHTS Of�'tiUH.16CT5 OF'oA"�'A <br /> 4uhd.�_ "�'ype oT drtr. "�!�s r1�tit�of Iwd�v�dual on wtiom tti¢�fat:/�storoU or to b¢atored ana1�br a��ct Pur[ti In tti�s�cct�on. <br /> tiubd_2_ Iwformrt�on ra�yuirrd to be g�vcw�nAlvtAua�. An�nd�vMur1 rs4a+d to supp�y prlvatc or cowfMcntfal Artr co..ccrnlnq AfmsNf�na1�be <br /> �furmc`l uf- (r)t urq�vr rn�l i� wVcd u u!tnc ra-yucatctl Aata wltw�w t ollcct�wg r aKe^cy.polit�ca�subd�v�x�u��o wl�lc nyY[cm�(b) <br /> wti¢ttier F¢mr r¢fv s or�s ly rcquircd tu aupp�y 1tia+roquastM data�(c)+�wy�c�own cow�aque�cn�r�siw�from Aia�upp�yt�R or�'aFusiw�fo nrpply <br /> privrte ur cowftdcntl�l Ortr�,�af�(af)tM1a-IJentlty of��tM¢r perwnr or ewtlt{o r� o����,a ny.i��e o�r.,ar.���..w ro�.,ca�.�e�ne a�....-r�.�..e.�..+..�...e....�.+�� <br /> �ot rpply wAcn+n�ndfWdurl�a ay4ctl ro x�pply fnvor[fgnHva datr�pursurnt to aec[1on 131i2.subd�vlalon S.to r�aw cnforccinant oMcr�. <br /> T � i t M1 4 � V Af bdtv�� 1 / I Id �� d <br /> In t � In f f f r <br /> r Subd.3_ Acc¢as to drta by 1�dlvidual_ Upo�r¢qu�-at fo r rwpa��slb�P autFor�ty�aw 1�dlvldual sM1 1 ba 1�for���a�.d wM1¢tF Fo�s t�tic subj¢ct of <br /> tored da�r u..�..a�.��a..,.�._o..a wne<n«�<�x c�rsaiMcd�w pub�lc�prlva[v�� ..naso��.�_ uvo�F�a f�`Ttior rcyuo�[.rn Iwd�v{dual who tn t ubjnct of <br /> M pr�vat�o b11c d�f�u wd�vldur�a aFrl�ba�s ttic data w �y etiarqe to ti�m awtl.if ne Jestra.-s�s a�l b¢1 Tor��a�af�rf eFa conta.-wt awA <br /> n�ng oT tnat daca. A1trr rw�ndW�Uuql tiae b¢en sM1 wn tne nrfvrte,d to rnA�nTormad of lta m ..�..¢.�ne m�a need n t b¢dlac�oseV to M1Im f��r etz <br /> Y vh¢r���e�s a di�p�t¢ur rcNo�purs�ant t�ti�s s¢cMon b pn�d��/�or sdd�Howr�drtw�w M¢t��flHAuv�F��h¢¢n o�Irctrd or crq[¢A. '' <br /> •c.sponstb�Kru�tiu`iry s a�1 prov�d¢coplcs of�Aa-pr�vat�e or pu41�c�/rta upa��rW ucat by tl�r Ind�vldua�aubject of thc da�a_'i'ti�rvapo�albl¢ruttiorlry may <br /> rcyu{re�ti¢rea�ua-stlnR PKs�m to prY��e+ctur�c�st�oP mr4lnq.,c¢rHty1nK�rnd aromp111n6 tF¢coPlca. <br /> 'f'A¢rcaponstb�c autAurlry�hr��comply ImmWtat¢�y�If pux�Ib�¢.wltti any reyu¢r[mrAr purouan�[u ttils aubdNLlun.ur wi[61�tivc Jay�uftAe <br /> olth¢r¢Qu¢at�excluJt�R Sata�rdrya�Su�days s�ti�ega�tiotlAays.,If imm¢dlrta complla�ce ia wot por�tb�o_�f M1e cannoi comply wlfF tbe roq�¢at wltbin <br /> t1�a�H�wv�I�e xhr11 nr�t�(orm�t�u IndlvtOual�an�l may nrvs aw addHlunrl ffvs drya w�tAtn wM1�cA to comp�y wt[I�tM1r Rqvost�azc�uJtnk Saturdrya�Sundaya <br /> eoa��o�no�mar._ <br /> s..na.a. v�«w...e wn�..a.�.�.ooc o��.,�ore o��o.,.p�eoe. n..�oa�.��m��...sy�o..ee.«ne�ccur�cy or complcten¢w of publlc o�p�v.ee a.�� <br /> �o r..�..�n+...s��e-ro o=e.��.e.m.rtgwt.ao iodividual sAr��ooHfy io wrlUog the reapon�lbM�u�l�urlty d¢�cri�Ing tb¢oatur¢of t1�e Jisagrea��cnL TM1s <br /> c�p..o.�me....nor+ry.�.an w�r.n�..a�aoy:c�r.ne._ (.)�o��ec �n�aa�a ro.,..a.o ne�..��v�o�e o��..�o...n�e o..a.rre...��o nonry p..•.ec�niene.or <br /> a..«o�a�e o��..�o...p�e«data.ioNudioK rcciptenb� med by tAc intlNfdvd:or�n>ooNTy tna ioWvWual that M1¢n�uroa<ne ao<s�o n.>�o���c u.��i.. <br /> a�.�...�e.n��ne a�.��o.m o..�y�r.ne io.u..�a..ars a eo ora�.��ee...�o.i.�..a..aee..���n�nc e����o�m aa�.. < � <br /> o ae«�...s..�noo or.ne.-�.rw,..m�r a.,cno[y may be rppa�eA purauant eo�1�s provbbna or me�a...o.�.e.�.n..e p�o�ea.,.Y.� ..e��+..Q w <br /> �o..r�.ea�:.e.. <br /> UA'1'A PRIVACY e1DV[SOAY <br /> In accordanc¢with M.S_13_04�Subd.2."i2lghts oi subjects oi data••�w¢would�iK¢to irtforcu you that your reques� <br /> for a permit or�iceus¢F m th¢CIty oi Oro..o or any oY its departm¢nts may requir¢you to furrish c¢rtatu private or <br /> coa£dc�tia�informatio�_ <br /> You ar¢notifi¢d tt�at= <br /> 1. "1'he in[o�-R�aKon you furnisA will be used to detei-a�iu¢your qua4fcaKort foc tM1¢pera�it or licanse r¢qu�ted_ <br /> 2. Yuu may r¢ius¢to�upply data�but r¢fusal may r¢quir¢that ih¢C3ty d¢ny th¢p¢rmit or lic¢na¢_ <br /> 3_ The in£ormation may be s4ar¢d with oth¢r local�state or Fed¢ra�ag¢nci¢s to th¢¢xtent nec¢ssary to proceas <br /> [h¢per«�ft or lic <br /> 4_ IF your ¢qu¢sted permtt or �ic¢nse requires Counci� actlon [o approv¢, aome inF rmuttoa may b¢com¢ <br /> public_ <br /> 5. You hsv¢c�rtain riqhts undCr M_S_ 13.(►4(avsilabM upon rcquCst)to rev.¢w private data on yourseli_ <br /> 6_ Your fu��nsmc fa rcquir¢d tu p a thLs applicaKon or per«�it_ <br /> �,4�'� p --�� � -- `r7,lo/z� - <br /> r'�... ��'1 i �vn a�r a.� <br /> 3�/ Z 5/ <br /> .+aa��..., <br /> �c�s;e�� w��✓ _ �'33 1 �2 -5��—'7S� � <br /> c�ry ____ se�eo z�p vno..a <br /> 1 underst�and my Ahe a st M a . <br /> � <br /> .\1K�aturc -� — _ <br /> Raset Form <br />