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Aug-11-2000 02:36pm From-CITY OF ORONO +9522464616 T-717 P.003/003 F-600 gex.1>1.0/ R1rtrTa of susJECT6 OP DATA Stubd. I. TM of dam. TAo rights of individual on whom the data is stored or so be oared shall be as set forth in talo section. vidual. An individualadrodto61AWyprlvateorW11FAmllaliaoacOneenllag,hiroseltshAtlbe Sebd Z.iNbnlreNor►roqubad m be given rear liticil subdivision,or waw(de systeas;(b) infbtned of (a)the purpose and'mended lire saftheupply itis requested dem within they known dint score gismo f erthir to or rehsine to gamy wbether he may m4useor is legalty required to wpply the seep Dread nttiica authorized by sMc4c�al 1rw bteerive�Thu nequirensntt shall privets or confidetNial data:and(d)the Identity ofotlia pataotts trot apply when est individual is asked to supply investlaattve data,pursuantla 8690011 13.82,sobdivisioa s,m s law enfbrec"�sat Drifter• s.. may otter the scute neouired_under this auhdiyiahnn:n the ind[v_fd1�' ----------------------- Subd ].Awas re data by individuol.Upsn mquoto a responsible authority.an tudivldaal shall be ir&mad wbsaher be litwthssubjof Individuals,and wheeler it Is classhfied as public.private or eonfrdential. Upon his%rdw request,its individdel who is the subject of cored data on In stored private public drab d individuate daale shall be shown the data without any charge M hirn turd,ifhe"pos.shall be lofmood of the comteat and 90 Win for six eneatsing of that data. Auer ash individual has bcen dawn the privale do"and«add deo 1 dam 64 i"Viduathiss bat+collectego be d 0 asaskd.The ow da tharealler unless a diepate or notion pununette this section u pending t:spomlblc authority shall provide cops the individaal subject of the duo. The responsible arthertq v es of rho privets orpubik data upon eegtheat by 41 may require the regwslieg poison to pay the aoeual Costs ofnahing,earti"ll,and eompiilft the:copies. The rorponsibl .udarley shall comply immediately,irpossible,with any mgaest made pofntnt to this subdivision,of within Ave dttye of t: lhedata oftherequest,erxcludis&Ssaadays,Sundaysand legal helidays,ifiminediasacomplianceisnotpossfblernnotcomptudiegSaetdr imyt►t within thattlms,ho shall ao infbrrs the Miv ideal,and MY have ant additional five days within which to comply with gandays and legal holidays. Subd.a. ProccdurewhisrrdataisootaccurateOrcomplete.AnWAvidualncyeoWAdeteeurecyoreonnpleteneworpubiicorp�so'w concerning himself.To exercise deli tight an individual shat l notiry in writing the tt poaibte wlharity dwctrbhtha ere ata be menti of responsible authority shall w111hin 30 dace either (a)cornet the data fog"so he inamim or inwmplesaend asearrpt inaccurate or ineanplede dao.including mciptents named by the individual:or(b)notify tic individual that he behoves the data to be oorfotx.Data in ret is included with the disclosed data. aorta shall be ese mifig only if the responsible ratelity of dieagna'>� uant to the visions of the aebtinietradve Proeeduss sot relstiea a The detarninattpn of t8a raaporaible authority may be arra i>mPao cwcsted cases. DATA PRIVACY ADVISQBY lin accordance with M.S.13.04,Subd.2,"Rights of subjects of data',we would like to infohltn yout'hatyourTegltest for a permit or license ttom the City of Orono or any of its departments may require You to furnish certain private or confidential.information. You are notified that: 1. The information you furnish will be used to dctermine your qualification for f1Ele permit or license requested. 2. You may refuse to supply data,but refilsal may require that the City deny the permit or licMt. 3. The information may be-shared with O*CT total, state a federal agencies to the extent necesisary to process the permit or license:• 4. if your roque0od permit or license requires Council action to approve,scene information may become public. S. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. Middle teat First 55B —310I'i Addrns Ctry Stare ZIP Pha0e I understand y riots sat stated above. sf�aar.ts M U 32 E 'd 06TS*LSTSS 3OIA83S lIW2iac Q R m SS=ZT 600Z 1T 2nq