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CiTY OF ORONO � 6122494616 04/22l99 13:48 � :05/05 N0:837 <br /> $eC.!3.04�lGHTS[)F SIJBJ£CTS OF Dr�TA <br /> Subd. 1. T'ype oP data. 'I"ha riRhts of individurl on wh�m th�dap is store�!or co be stored a1wU bc aa aot fvnla in thi�socdon. <br /> Subd.2. Inf�rm�tion r�tdred to be�rcn(polviduad• AA Indiv3ducl�isked to supply privata or confSdenCal Qap coecarnirig hlmself shall <br /> be l�tfotmed of� (r)the purpose dnd intended use of che rcquescrQ data wi�hin the coUec�ing Sata egency,pokitlC�tl dubd[visinA,or s[atawida eyaKm; <br /> (b)whechan c�may rcPlue or i�lap,rGy�¢qulred to supply fha requeamd dafa:(c)enY Irnown conseq�ience a�i�In,g tYnm hie yuPPlyia�er re}Uaiay to s�ipP�Y <br /> ptivAua or confidautiel dacq;and(d)t6e idencitY of other p�raons or entides authorizad Dy ahte o�fede�allaw ro receive the data. 'Ibis requ�remeni atall <br /> ttoc 4pplY when An individual is dsked r,o auppiy invezrsgadve Qaru,purn,ant�o secGon 13•B2, subcti�iaioa 1,co a!sw enforcement oltfcet. <br /> '�71a GQO�RVA61q0�[,�p��v�nu�ma�ylacC i C R ��g��jrc� und r�,6 su4dir�sion in��e indfvjdyq�_jqcom4 nx or proD{�tv tax rcftind <br /> + � � ons,��a4 410�1�4.AQ.L?�� <br /> Subd,3, Acces�to dqta by indlrldu�l. Upon roquese w a respanaiQlr eutharuy,an individuat shall be ia[otmed wAelher ho itl che aubjpct <br /> 0�iW[Od CIBf�Atl L'1QIYICU11I6,an�f wtiether it is classllfeQ as public,privau or confidential. Upan his N�rthar rcqueu,An indivl4uat who is thc subjeet <br /> o(9tored povqte or pnblic detd o11 tttdiviQuala sha11 ba shown the d�ta wid�ont any cheltge to him atk1;if he daircs, shall bo inPorrned ot the oontant <br /> qttd m�anuig of d►at dBW. APoCr an individual has been shown thc private data en6 infecmad of Its maoning,the data necd�ot be dlxdo9cd to h�m for <br /> !iz moptha dxr�afwr uNc�9 8 diapute or aadon porsunnt to thix sacrion 4s p�ndtng or xdditiartal dar�on the ir+cliv{dunl hRs been colloctbd or erentad. <br /> Tha teSpaqsiblo aurhorlry sbmll pro�ida cOpies of the p»vac�4r publie datY upon roquese by rhe individual subfect of tAe darn. "1'he ralponalble authoriry <br /> msy zrqui�a th4 requas�nQ ponon ro pay eh�acwal costs of makulp Ceztifying,end compilin�the copiea, <br /> The rosponsibla authorrry �hall epmply immediakly,]f poasihle,With a�y request m�de pursuAni to this subdivision,or within fi�e dpy�of <br /> tha datA of the raqueze,nzClu4ing Saturdsys,Sundays and la�al Melltlays,ff immedlote aompiianca is not possihle. Ilhe cannot comply wish the request <br /> within dfst tkroe,he shell x�mfarm rhe lrxfividusl,ar�f may hsve xn add'ttional fiYe days within which ro comply with ttlo nsqurEt,exCludllfg Satunlays, <br /> &uhdaya and lo`ai holidays. <br /> �tzd.4. Prar�edure whe�dats fa not accurata ar Comptele. An individua!may contcst tEto accutAey or eompleDene�s o(publte or privaca <br /> Q�ta cat�tarstin�himsalf. 7o axeraise U�is n�bc,an indiv�qu�shall eorify in wridn;rhe nxponsible authority describiog die�aars eP the disagnemea�. <br /> The respnnsibla auchorlry ehall wiitrin 3A days ei�her; (a}corrsct the dera tound to bc faxcwr�te or incamplem and attempt to nodfy past recipienu af <br /> iaqccurnce or incomplou dxfa, includin�recipiencs npmed by�he indivi�ii�el:or(D)noufy ehe inAividual ehat he txlleves�he dete ro be cortec�. Daw <br /> In dispub stwll bc disclosed oNy if thc indiviQuaJ's statemen�of diAagreement is included�vith nc�disct�rsed 6aw. <br /> TTte drterm{n8Z1ua of�3fe respanaibie auth�eiry rru�y be sppented purausnt tv tha provisions of thc admit�srroCve prncaduro acc relo�ing m <br /> cont�stad crses. <br /> nA�TP�Y��Y�n 4R� <br /> in accardaz�ce with M.S. 13.Q4,Subd.2, "Righ�s of subjeccs of data", wc would like co inform ynu chac your rcquest <br /> �ar a permit or licec�se frnm che City of Orano or an� of its depercmenes may re�uire you to furnish certain private or <br /> cnn�dential imformati0n� <br /> You are notif'tcd ihat: <br /> 1. Tho inforYnatinn you Purnish wi11 b�used to determi.ne your qualiticAtion for�he permit or l9cense requcsced. <br /> 2. You may rcfuse to supply data, b�t refusat may xtquire that the City deny the permit or licr_nse. <br /> 3. 'I'he informatiott may Fae shxted with oChrr loc�l, s!ate or federal �geneies to the aztent neces.sary ro process <br /> tha pcttnit or ticense. <br /> 4. If your zequestad permit or license rcqufres Courac;l accion co apprave, some informatinn may becorne <br /> nuhlic. <br /> 5, You have cercain righcs ur.der M.S. 13.�4 (av�ilable upon requesc) to review private Qata au yourself. <br /> �. Your ful.l name is raquired to process this applfcation or petxnit. <br /> `���v.�� t- �R�h� „'��� <br /> Firsi Middle La9t <br /> �.,�...:. 1J(7 1 Yl_aCl�_���rl��a_� . <br /> A(J�rB .. _ <br /> s-Y'�(`�1..1.f,-t/ "1��. <br /> Ciry �' ' — snte Zip Phano � <br /> T undeFstand my rights as xcaced above. <br /> ..��r-�_.W_.__._�� . � <br /> Sisnaacro <br />