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10/21/2008 1.0:33 3205582499 WOOD CASTLE HOMES PAGE 03/04
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<br /> Sir-113A14 RIGHTS OF StrBdFCI'S OF DATA
<br /> Subd.1, Type of data. The rights of individual on whom the data is storod or to he stored shall be as set forth in this section.
<br /> Subd,2. Information required to be given individual.An individual Asked to supply private or confidential data concerning himselfshall be
<br /> informed of: (o)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system,(b)
<br /> whether he may refuse or is legally required to supply the requested data.(c)any known consaqutmce arising from his supplying nrrcfusing to supply
<br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or Moral law to receive the data.Tltis rcquirtancntshall
<br /> not apply when an individual in aolned to supply investigative dam,pursuant to caction 13.82,oubdiviaion S,to a law cnfocemcnt affiecr.
<br /> l pfic ommissiener of revenue may nlace tho_optj} �Uludlmder this snilivision in the individual income tax or pro.- m .fgpA
<br /> instructions_insmO of on those forma.
<br /> Subd,3,Access to data by individual.Upon requestto a responsible authority,an individual shall be informed whcthencc is the subjectof
<br /> storcddotaon individuals,and whether his classified as public,private or confidential, Upon his further request,an individual who is the subjectof
<br /> soared private or public dots on individuals nholl bonhown the data without any charge to him and.ifhe desire#,chap be informed of thecontent and
<br /> meaning ofthat data, After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six
<br /> months thereafter unless a dispute or action purvuant to this section is pending or additional data on the individual has been w1locted or created.Tho
<br /> responsible authority shall provide copies of the private or public data upon request by the individual su6jcat of the data. The responsible authority
<br /> may require the retpoesting person to pay the actual costs of making,certifying.and compiling the copies,
<br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within rivedays of
<br /> the date oftlic request,excluding Saturdays,Sundays and legal hol idays,if immediatccomplience is not possible. If he cannot comply with the request
<br /> within that time,he ohall an inform tha individual,and may have an additional five day#within which to comply with the requam excluding Saturdays.
<br /> Sundays and legal holidays.
<br /> Subd,4,Procedure when data is not accumie or complete,An individual may conrestthe accuracy orcompl=. ntssofpublicorprivatcdata
<br /> concerning himself.To vvercisc this right,an individual shat l notify in writing the responsible authority describing the nature ofthe disagreement The
<br /> responsible authority shall within 30 days either, (a)corroct the data found to be inaccurate or incomplete and attempt to notify past recipients of
<br /> inaccumcorincompletedate,including recipients named bytheindividual;or(b)no*thcindividual thathchelicvesthcdautobecmrcet. Daum
<br /> disputa shall be discloaod only ifthc individual's atatemcnt ofdisagrccmont iv included with the disclooed doth.
<br /> The determination of the responsible authority may he appealed pursuant to the provisions of the administrative procedure act relating to
<br /> eontestod cases.
<br /> DATA-PRIVACY ADVISORY
<br /> In accordance with M.S.13.04,Cnbd 7,"Rights of suhjr.0.4 nf&h1 e,eve wotild like in infrmn you that ymir request.
<br /> for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or
<br /> confidential information.
<br /> You arc notified that:
<br /> 1. Thu itlfutnlation you.furnish will be used to deterntine ,your qualification for the permit or liecnac
<br /> requested.
<br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
<br /> 3. The inthrmation may be shared with other local, state or federal agencies to the extent necessary to
<br /> process the permit or license.
<br /> 4. if your requested permit or license requires Council action to approve,some information may become
<br /> public.
<br /> 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
<br /> 6. Your full name is required to process this application or permit.
<br /> 9th et Cauffff.�sLLG
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<br /> City State zip Phone
<br /> I understand y rights as stated above.
<br /> SiRnalare
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