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, , . <br /> s�.13.oa wcc�rs oF s�cTs oF aara • <br /> �ed. 1. Type of da�a. The ti8hcs of individw!oo whom the dt�m is troeed or co bs sooRd sbaII be�sa toct4 in�it�doa. <br /> Subd.3. Info�madaa required to ba givea indi�tdwl. �Vs individual�sked to snFPb�Privaoc or wn9d�sdal daa�coacernin�himutt sba11 <br /> ba infoeuwd a!: (a)thc putpcse and i�d we of fic cequaaed dao withia tbe collecaas frare ageaeY.polioal sabdlvision.or stsrea+ido symrm: <br /> (h)wlur!►er 6c maY ietuse os is le�ily rtquired m supply tAe�eqaestad dua:(c)eny Imowa wosequeace aris�n�!mm his wpp�Y'�oe nfusin�m suPP�Y <br /> priwsu or aonfdendal dan;�nd(�rhe idaacry of odur peesons o�entiri�:s au�horized by snte or fedetal law to meive me dua. 'L7�ic requirsmaec sh�1l <br /> ' noc apply when an individusl is�sked w supply invadgaave dara,punuanc co seccon I3.82,subdiviston 3. w a tsw enlorcemmc oPleer. <br /> The comn+ssionet of revenue mav Olue dfc noti e fem�in� �er G�is subdivisioo� du �adividual ' e tax o wc <br /> i„�.,,.,..�...:na.�.d oP o11 r11�se fo�ttll. , <br /> Subd.3. Access eo d�ta by iadividuul. Upo��equest to a ro�poosible au�o�cY,ao individual9hall be inMrnaed whethar he is�tte subjecs <br /> of swccd dan on individuals.and whed�er it is elassified as public.Pnva�or cantidzndal.m�����d�������of dtie wbaceni <br /> of uo�ed privace ar publlc daa on indivi�uds shM:tU be shown du dara w�d�wc any charg <br /> u�d r�eaainB of fisc dan. Afur on individuu has been shown rhe privsie dan and infomud ef i�s mosaia$,the dar�*aa�d m�be diselosed oo htm for <br /> six a�ondu rlu:eaf�or�nitu�dispuw or ucion pursusnt m rhis secdnn is Perdin8°T'dd'°°°�1 dan on t�e iadividual hss been eo11Q��,e��� <br /> The rtsponsible su�t►odq�shall Provide copias of d�e p�ivar�or publx d�m npon�equen by�he indlvtdual subjcc�of du dan. The tesp <br /> may tequire dfe tsquesriag person oo psy du aca�al costs of making.e�rafY�44�and compilias du eopies. <br /> . Tha rssponsible authoruy shsil comply immediawly.if possible.wid�any req�est made Passv'nc m�Its subdivision,or wirhia fiva days of <br /> fie dao�o[die rcquest,excludin�SaNNaYs.Sundays am leg�l holidays.if immedisu campliance is�e possibla If he caeooc comply wich du reques� <br /> wifiin rhac time,h�shaU so infarcn rha irxfividual,and may have an addiaonaf Rre dsys wi�hin which to comply wish We�eques�,excluding SaaudaYs� <br /> S1�pdays snd legal holidays. <br /> Subd.4. ProcedUTe N�en d�ta�°Ot aa�L°or eomplett. wn individuat maY conres�d�e accurscy or compleaness of pubtic or privace <br /> dua concorning himself. To exsreise�his righ�.sn individuai shall nodty in wridns��Po��b����N describiAg�ha nam�of��`'ua�8��of <br /> 'rhe cesponsble sud�oriry shall wichia 30 days eirha: (a)corrcct rhe d��a iound ro be inaccucaco or iaeomple�e sod amzmp�m nedfy p <br /> inaccucaw or incompleae da�a.ic�t�ding r�ipien�s named by du indiv�dus[:ar(b)nodfy d►a iadividual tha�he believes d�e da�a co be corcec� Data <br /> in dispuc�ahall be disclosed only if rhe individual's sntemen�o�i ag�le�n��u���p� up�of die admiaisr�eive procedure act relsaag w <br /> '11u dearminadon of tht rcsponsible wrhoriry msy pP' P� <br /> contLsrsd cnscs. . • <br /> A A P 'ACY ADVLSORY <br /> � In accordauce wirh M.S. 13.04, Subd.2, "Ri�hts of subjee[s of da�a",we wo u�re ou of i�rnish cer[ain pri a�Ce or <br /> � for a permit or licease from �he Ciry of Oroao or any of iu deparnnea�s maY n4 � Y <br /> confidea�ial �nfor�ion. <br /> You are notified rhat: <br /> 1, The inforanatioa you furnish will be uscd to decermine your qualificatioa for che permit or license rCquesied. <br /> ? Yau may refuse �o supply data, bu�ret'ussa may re4uire chac ch� Ciry deny �he permic or liaense. <br /> 3, 'Ihe informaiioa may be shared wi�h orher local�scate or federal ageacies to the exr.ent necessary co pro�ess <br /> the permit or license. <br /> 4. If your requesced permic or license requir�s Council aedoa to approve. some iaformacion may become <br /> public. <br /> g, You have cercain rights under M.S. 13.0�4 (availabte upon request) to review privace daia ou yourself. <br /> 6, Your full name is required to pracess this applicacion or permi�. <br /> Ficst <br /> Middle �L <br /> Address � <br /> S� Z�p Phone <br /> Ciry <br /> • t uaderscaad my riShcs as scaced above. . <br /> Signswte , • , • <br />