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Apr-02-2002 11:08am From-CITY OF ORONO +g522494616 T-963 P.007/OOT F-018 <br /> , � . . <br /> SaC.13.0�i RIGHTS ON'SLJBJECTS Ol�DATA <br /> Subd. 1. Type ot data. Ttu righR of irtdividual on whom tha data is srored ar to be stocod sha!!be as Sct fonh in dti$secdon. <br /> S�+bd•2• Iaform�ti�a reqa3r�d to 6e�tven i�sdividual. Au iodividual asked w supply privaa ar confidenaal d$ta coeeerning himself <br /> shal]be informed of: (a)[he purposa and interided use of the rcquested data wid�in the collccring stsm ageney,policical subaivision,ar sra�ewida <br /> eys[em;(b)wheeher he may refuse or is Icgaily required�supply�hc requesred dasa;(e)any lawwn consequenec arisit�g from his supplying or <br /> refusing[o supply privuce or co�denrisl dara;�(d)ihc iden�iry of achc�persons or enades au�horized by siate or fedcra!]sw eo reccivc the da�a, <br /> This rcquircmenc shall no[apply when an iadividu�t is askcd�o suppiy invescigaavc dala,pursuanc[o secpon 13.82, ��(��sion 5, ro s law <br /> enforeament ofPee�. <br /> The caYnmiacinneY Qf�venue mav nla.. norice re itrd nnAer chis suhdivi5ion in the irxiividual incarne ax or o��nertv tax reR��+A <br /> instrveriens mst�8d.of on dmae forms. <br /> Suhd.3. Access to dat�by iadiridual. (3pon requesc ta a responsible aud�oriry,an irrdividual shall be infotmed whenc�r he is the <br /> subjec[of srored dara on individuals,and whethcr ic is class�ed as public,privau or confideedal. Upon his furiher�cques�,an iridividual who <br /> is the subjeci of scored privatt or public dac�on individraals shall be st�own thc data wi�hou�any chuge co hirn and,if he dcsires,sha11 ba info[mcd <br /> of thc concent and meaning aP shut data. After an individual has been shown ehc private data and inPormed oF its meaning,ttu data need aot ba <br /> diselosed m him for six mon�hs cheraaft�r unless a dispu�e or ecpon pursuanc w dus seceion u pending o�addirional darn on dia individual has been <br /> eollacr�d or erca�ed. 'T'he Rsponsibla aurtwriry shall provide copirs of the privare or pub1�dara upon reques[by ihe i�ividu�l subjtcc oF dtic data. <br /> 'fhs responsibl�auihori�y may requirz rhe requcst'tng person ro pay cha aca,�1 casu af making,ca,x;fy�ng,$�compilins che copies. <br /> 'Ihe responsib[a suchoriry shall comply immndiauly,if pa�sible,wi�h any rcq�uy�tu�de pursuane ro this subdivision,or wishin Pve days <br /> of the d�se of�he roques�,exoluCing Sacurdays,Su,days and legai lwlidays,il immediate compiiance is na�possible. IP hz ca�ot comply wid� <br /> tbe reqness wirhin chat cime, he shalt so iaform fie in4lividusl,and may havo an addiiioeal f,ve days w�th�a which co comply wich ehe requesc, <br /> excluding San,rdays,Sundays and legai holi4ays. <br /> S�bd�4. Proceduro wh,ea data is not accurate or complete. An ir�tividual may conces��he aeeuracy or completepess of public or <br /> priva[�daca concerning himsetP. To exercisc this right,an urlividua!shall notify in writis�ehe respansibic aadwriry descn�bing rhe nature of the <br /> di�grern:en�. '11�e responsiblc autttoriry shall within 30 days ei[her. (a)correec the dar�{ound ro be inaccuraa ar incompleee and attemp�W ao�ify <br /> pasc re:ipien�o@ inaccurace or incornplece dax,,;ne►ud;ns recipien�s named by�he indiviaua�;or(b)nodfy�he udividua��a�he bc�inves the data <br /> cn be corrccc, Data in dispu[e shatl be discloscd oaly if rha individual's statement of dixegceement is included wirh thC disclosed dara. <br /> 11�e determinadon of�he respan,ihle auttwriry may ba appeaied pursua�t co the prov9sions ef d�adminisRative procalure acr relaang <br /> ro coarzs�ad cases. <br /> DA.�,.TA.pRY'V.�CY ADVISORY <br /> In accordance with M.S. 13.04� Subd. 2, "Rights of subjec�s of data", we would iike to inform you ihat your <br /> reques� for a permi� or licensc from�he Giry of Orono or any af i�s depar�mencs may require you to furnish cer�aiti <br /> privare or confidenTial information. <br /> You are noti�ed tha�: <br /> 1. The informaiiou you furnish wilI ba used to determiae your qualification for che permit or license <br /> requesced. <br /> 2. You may refuse co supply da[a, but refusal may require �ha�tha Cery deny[he perrmit or ficense. <br /> 3. 'Fhe informacion may bc shared with other lxal, state os federal agencies [o the ezten�neccssary co <br /> process the permi� or license. <br /> �. If your requesced permit or license requires Council action w approve, some information may becocne <br /> public. <br /> �. Yon have certain rigt►ts under M.S. 13.a3(available upon r�quest) to review private data on yourself, <br /> 6. Your full name is required to process this appliCa[ion or permit. <br /> �'-�-�D W iLu k� ��5��1 <br /> Firs� hGddle Las� <br /> �2i b �kE� ��5�� f10 <br /> Address <br /> �DF�it PRA I�UE 1'1 W 5'S346 (52r�6`Z��D90 <br /> c�ry sa�e ziP pbo� <br /> I unders�aad iny rights as stated above. <br /> � -�.r— <br /> Sign3ru c - -- - <br /> . <br /> 6 <br />