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Oct 10 2006 9: 29RM HP LRSERJET FRX 612-825-1900 p. 6 <br /> Se�.13.04 RIGH'fSiOF 9U8JECT8OF D TA <br /> 3ubd. 1. Type of dats. Tha right of individaal on w6om tde dna ia storod or ro be stored shell 6e as aet forth ia this section. <br /> Subd.2.Infom�tion roquaed Oo given individual.An individwl asked to supply privste�confidentiai d�te conceming hanself sball ye <br /> informed of'. (a)the purpc►ce and intended u oft6e cequested data witbia the eolleeting atate agency,political sabdivision,o�statewide sys�em;(b) <br /> whu6erhe may refuse or is legally roquirod t aupply tha requested data;(c)any lo�own conaequence arisiog[rom hie supplying ar refosing to supply <br /> ptivste ar wnfideutiel datp;wd(d)the idon ' of other peraon�or entidos authoriud by sbsbe or fede�al law to naive ttte dsta. This roquirertunt ahsU <br /> mt apply when an individusl is askod to s ly investigative data,pursuant to aection t 3.82.subdivisioa S,to a law en8orcen►ent officer. <br /> iastructioea inslaed of on those femns. <br /> Sobd.3. Accass lo dsla by wdivid l. Upon iequost to a responsible authority,an individual efiap be infarmed whethar he is the subject of <br /> sbored data on individuala,aad wbetber it is cl aifud as publie,private�confideatial. Upod his further requost,an bidividual who is t6e eubjectof <br /> sto�private or public data on individuale a I be shovm iha data without any charge to him and,ifho desires,shell ha informed of tbe coatent and <br /> m�eniog olthat deta. ARer m iodividual heo cen shown t6e privste data and infomied of ila meaning,the dsta nad not be disclosed to him for six <br /> rnonths tlur�eRer uniees a diaputa oraction p rw�ant to d�is section is pending or additional data on the i�dividual 1�been collecTed or created. 'Ihe <br /> r+eaponsible audwrity s6sil pmvide cogies of e private or public da�upon request by the individual wbject ofthe data. 'ftie�esponsible autl►�ity <br /> rnay roquira the requating person ta pey dia tual costs ofmaking.canifying,and compilmg the wpiea. <br /> Tiu reeponeible anthority sbell co ly inuc�ediately,if posaible.with any requaatmade pwsuaat to this subdivision,orwithinfrve�ys of <br /> the date of tha raquest,exclading Seturdays,S s and legal holidays,if iauriediate complianoe ia no1 poasible.]Fhe caona com�ply wid►the rtquest <br /> within thet time,he ahall so inform tbe mdivid I,and may bava an additionel Ptve daya within wbich to cc�oply witfi Iho request,excluding Sal�udays, <br /> Smdsys and Icgal6olidsys. <br /> Subd.4.Procedurewhoadetais accura6eorcomplete.Anindividuslmayoontesttheaeeuracyorcompletene�aofpublicorprivatedata <br /> conca'ning himselE To ezeroisc t6is right.en 'vidual shall notify in writing Me responsible authoriy describing t6e�ture of t6e dise�eement. The <br /> responw'ble authority ahall within 30 days e' r: (e)cocroct tha dem found to be inaccurate or inoomplou and atbemp�to nodFy paet recipients of <br /> inaccum0e ar incomplde deta,i�luding rociy' ms namod by the individual:or(b)natify the individual thet he boliavas the daea to be conect, Data m <br /> diapute shall be disdosed oaly if the mdividu 'e s0atwnent of disagreaneot is iacladod with dro disclosed dam, <br /> The dotertaioatioa oP tfie roapoosi audwnty mey bo sppealed pnrsuant to tlio pravisions ofthe administrative procedure act rolaang to <br /> wnfaeted casos. <br /> 12ATA PRIVACY ADVISORY <br /> In accordance with M.S.13.04, ubd.2,"Rights of subjects of data",we would like to mforrn you thas your request <br /> for a permit or license from tbe City of Orono or aay of its depar�nents may require you to fiu�nish certain privnte or <br /> confideatial information. <br /> You are notified that: <br /> 1. The information you ish will be used to deteimine your qualification for the permit or license <br /> requested. <br /> 2. You may rofuse to su ly data,but refiisal may require that the City deay the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or 'cense. <br /> 4. If your requested pe it a license requires Council action to approve, some inforrnation may become <br /> public. <br /> S. You have certain righ uode�M.S. 13.04(available upon request)to review private data on yoursalf. <br /> 6. Your full name is rey 'red to process this application or permit. <br /> �t NORTHRUP R00 ING & REdM00ELING �t <br /> 4400 NICOLL T AVENUE SOUTH <br /> Aaaress (612i 25•3353 <br /> C�h' State Zip Phone <br /> I uuderstnnd my righta se stated a ve. <br /> Si�uture <br /> 32 <br />