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TY OF ORONO � 612473Q510 09/24/96 14:00 [� ;03/0� N0:522 <br /> . . <br /> Ssc.13.04 it1G1iTS QF SUHJ�C'fS OF DA'i'�1 <br /> Subd. 1. Typs cf dsU. 76e d�hu of indlvidui!oi�whom che data I�c�o�ed ar w be srnced shalJ be ai see fonl�ln chls ucdaa <br /> Subd.l. Infom�rtlus reqidr�d to b��t�n lad(•idml. M Indlvidud ailcad to�upplY priwa or oonfidendtt daat concsrning hlmreif,�hsll <br /> ba Iniom�ed of; (t)the purpoce and i:tteaded use�f dte requess�d d�4 widda�hc collecdn�lnie age�xiy.PnUdcxl aubdtvisian,or snte�vicle syuem: <br /> (b)whecher M may mNse oT i�keallg required m supply rhe raquessed dau:(c)ury known eonsequenee ariting from hts aapplytn�or iellulag ro supply <br /> privite or conMendal d�a;and(d)dte idendty of odie�persont or enddes authorized by su�e oc fedecal law m rrxetve d�e dara. T'hEt requlremene shull <br /> no�apply when�n lndividur!if asked�o mpply In�enis�dve daQ.pursutnt ro�sednn 13.62.subdivision S.to s I�w enforcernenc otCfcer. <br /> ,, <br /> �►o cumm,ys{gna QP reveeuc mq� ntaee che nadce r�auirsd under this su6di�istqn ia �he indlvidual,�eome x or eroocm m�,;�ellind <br /> _ �" JaEuucdont i��cl_uf on�,io�o torm�, „ <br /> SuEd,3. Aceees to data by Ind[vidu�l. Upon rrquese ro�rcfpansible wtho�ry,tn iadi�fdual shall ba lnfocmed whedtcr 6e b the subJeec <br /> o[�cond drn on indlvidwds,aAd wMdter ic i�clas.�ified ai public,ppvate or conMeptial. Upon his A�rTher tequea[,ut individuil who Is the subjtct <br /> of seored pri�ue or pubiic dw un indlvidu�ls shill be 9f►o�ihe dara wi�ouc ury c6u`e w him end;if he deoices.ah�U be infonned of the wntenc <br /> �nd mMning of d�tt.da�x. After an iadividusl hai beeo shown�ho pd�ue darA�nd icfom�d o[in meanin6.the data need nor6a Ciubsed to dim for <br /> d:mondu thersatter unleu a dispute or action punuan�m �his seedon es pendfnQ or addirionsl dau on lhe indlvidud has been oolleec�d or created. <br /> Ths tesponiible�uthQriry tiull pro�ide copies o!rhe privz�e or public dso►upon reqvett br ihe individuat subjeec of d+s dvn. The re�ponsble tutAadry <br /> puy ttiquire the raquestin�parson ro pry die aCaal cos6 of maktn;.certi{yin�.�nd compl8aa rhe eopN�. <br /> Tbe�esponeibte wrhoriry.�i►alt comply immediately, if posstbk.wfch aap roquest mado purcuant w�41s rubdivirian,or airhln fiye days of <br /> d�e dite af d►e raquetc.exc[udin¢9uutd�ys.Sundays and le;d halldoy�,if inxnedlace compllance is not po�sibte. Ifbe c�m�o�compty wid�d,e aques� . <br /> withlr��ha�da�,ho aha11 w it►fotm�he individuRl,aad may hs�e a�►.ddlriodal flve d.ys wichin which w wn�ply whh the requeat,exeludipg Sacurdsys. <br /> Sbml�yi�ad ic�rl hollday�. <br /> Subd.4. Peoeedue�Mhi�ti dnea ta net occunt�or complata An indlvi�ual m�y co�neu�he aecunay er eomplerenw�of publ[c or privam <br /> dva eo�orninj bimself. 7o nxercise ihis right.an indi4idue!shall aoeity ia wridnQ�6e responsibk iurlw�i�y dde:ibl��d�a nentro of ifio diugceemenc. . <br /> Tht tespoMlble�uthoriry d�ell wi�hin 30 days eir}►►er. (�)correcc die dam found w be inucunte or tnecm+plea�nd�aompt ta nodfy put reeipiena oE <br /> ieaeeucate or in.camplete dpu, Includina�acipfenu nsrtud by�e indivMual;or(b)aotify the ie�div�duat th�t ho bel{evea the don+co be oots�ee� Dat� � <br /> ia dbcpu�e alfall be dizclo�ed anly ff tha indlvidwl's atieament ef dis�trxmenc is Includad with die discloud dara. <br /> �'lu determinadon o(rhe rcsponstb�o auihoriry may bo appealed putsuaot w�provisions o[rhe adminu�cvdve procedure act rtl�an`w <br /> wncesrod cares. , � <br /> ' DATA PATVACY�V�¢ORY � <br /> In accordsuce with M.S. 13.04,Subd.2, "Alghcs of su6jects of daca', we woutd like co infocm you that your request <br /> for a permlt or ltcense from the City af Orono or any of ita departm�ents may require you to furnish certain priva�o or <br /> confidential tnformation. <br /> You are nattf[ed thet, � <br /> 1. The informetion you fumish wili be used to decermine your qnalificacion far the pernoit or licensa requosced. <br /> 2. You cnay rofuse to aupply daca, bur refusal may require thac [he City deay the permlt or liccnse. <br /> 3. Tha infQrmation may be shared wich othar loeal� sta[e or federal agencies to the excent nccessary eo process <br /> the permic or license. � <br /> • 4. . Tf your cequasced pecmit ur licetue requirec Council 'etion to appcove, some infarmat[on may become <br /> ' public. <br /> 5. You have certatn righcs under M,S. 13,04 (availab[e upan cequest) to review private data on youra�lf. , <br /> 6, Ynur fult c�me is requir�d to process_thts application or permic. <br /> . CA � <br /> . ��, �}�,.'�°d . S �Z 11 L"` <br /> _ <br /> � �� . - ��,� � �-j qS�-3 y�—Co� <br /> �n, . . b'a�a Zip Phone <br /> ; <br /> ' I•underst my rlghts as s ubove. <br /> 8ign <br />