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10/20/2009 13:41 7634344933 HARMONY HOMES INC PAGE 03
<br /> Sec.11.04 RIGFPrS OF SUBJECTS OF DATA
<br /> Subd. I. Type ofdam. The rights ofindividual on whom the data is stored or to be stored shall be a.4 vet forth in this sactiorm,
<br /> Subd.I. information required to be given individual, An individual asked to supply privyte orcenftdential dam conecming himicirshall be
<br /> infirrmed or (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statowide system;(b)
<br /> wlethcr he may refuse or is legally required to supply the requested data:(c)any known consequence arising from his supplying or refu4ing to supply
<br /> privntc or confidential data;and(d)the identity of other persons or entities aurhorizcd by wire or fcdenl law to receive the data,This requirement x1311
<br /> not apply whet+an individual is asked to supply investigative data,pursuant to section 13.8,,subdivision 5,m a law enforcement Officer.
<br /> 1bgcommisgioner f vcn a notice req>Lrra undeLrh"it visin.1n the individual income ._�.
<br /> iasttuctions�gstcad of nn those form`, �x.+•��tar iefuLrd
<br /> Subd 3. Access to data by individual, Upon request to a responsible authority,an individual shall he informal whether lie is the subject of
<br /> stared data on individuals.and whether it is elassifled as public,private or confidential. Upon his further request,an individual who is the subject of
<br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and
<br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for silt
<br /> months thereafter unless a dispute or action pursuant to this section is pending or additional date on the individual has been collected or created The
<br /> responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
<br /> may require the requesting person to pay the actual costs of making.certifying,and compiling the copies.
<br /> The responsible authority shall comply immediately,ifpossiblc,with any request made pursuant to this subdivision,orwithin five days of
<br /> The date of The request,cxcluding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannotcomply with the request
<br /> within that time,he shall so inform the individual,and may have an additional five days within which ro comply with the request,excluding Saturdays.
<br /> Sundays and legal holidays.
<br /> Subd.4, procedure when data is not accurate oreomilicte,An individual may contact die accuracy orcompleteness of public or private dam
<br /> concerning himself, To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the diangreement.The
<br /> responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notifyt pearecipiof
<br /> ents
<br /> inaccurate or incomplete data,including recipients named by the individual:or(b)notify the individual that he believes the data to be correct, Data in
<br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
<br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedurc act relating to
<br /> contested cases.
<br /> i
<br /> DATA IVACY ADVISORY
<br /> In accordance with M.S. 13.04,Subd,2,"Rights of subjects of data",we would like to inform you that your request
<br /> for a permit or license from the City of Orono or any of its departments may require you to famish certain private or
<br /> confidential information.
<br /> You are notified that:
<br /> 1• The information you fumish will be used to determine your qualification for the permit or license
<br /> requested.
<br /> 2• You may refuse to supply data,but refusal may require that the City deny the permit or liccnse,
<br /> 3. The information 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 /> 61 Your hull name is required to p ss this application or permit.
<br /> First INiddre
<br /> Last
<br /> Address
<br /> al �5 / i Z.Z3 -C)52 L
<br /> carr
<br /> State Zip Phone
<br /> 1 understand rights as stn above.
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