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CiTY.OF;ORMU) 6122494616 05/10/99 10:315 :02/08 NO:210 Sec.t7.04 1UGHTS OF SUII.!>rCT3 OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be u set forth in this section. 1144.I. tafermation required to be given Individual. An Individual asked to supply private or confidential dam eoncendtg himacif shall be iafornse4 of: (a)the purpose and intended use of the requested data within the collecting Stam agsocy,political subdivision,or smetwide system; (b)whathet he may tefuse or fa legally required to supply Ors requested data.(4)any known coawquaucc arising ham bis supplying or refusing to supply privwe orconfidendal dam:end(d)the ideadty of other person or eaddss authorized by state or tedcral law m receive the dam. 'ibis requirsment:hail not apply when en Individual is asked to apply investigative dam,pursuant to section 13.82,subdivision S. to a ltw enforcement officer. 1by gyMjWizJoUr ofrevenue May place the notice teauired under this ntbdfvWon in the Wivi4utl Worav az or orooenr ax ly!%nd ructions Insmad of am Most km' Subd.S. Access to data by individual. Upon request to a respottaible authority,an todividuat shall be informed whether he is the subject of stored dam on individuals,and whether It is classified as public,private or conndennal. Upon his further request,an individual who is the subject of stored private or public dam an individuals shag be shown the data without any chargs to hire and,'If he desires,shall be bttonned of die eoatent and moulAS of that dam. After an individual bas been shown the private data and informed of its meaning.the dam need not be disclosed to WM for six months thsrsiMf union a disputa or action pursuant to tads section is pending or addidoual dam on the individual has been collected or created. Tbs responsible authority shalt provide copies of die private or public data upon request by the individual subject of dye dam. The responsible authority pray require the requesting person m pay the actual costs Of nt"S.certifying,tad compiling the copies- The respotWbis susharity shall comply immediately,it possible,widt any request made pursuant to chis subdivision,or whbin live days of the dam of rho ragitm excluding Saturdays.Sundays and legal holidays,if lmmedlata eomptiance is not possible. U he cannot comply with the request w&W tut dine,he shall so Want she Individual,and may have an additional flys days within which so comply with the request,excluding Saturdays. Sundays and legal holidays. Subd.4. F?ondure whet date Is not sccurste or complete. An ladividuai may contest the accuracy or eomplereness of pabilc or private 4am eotreesettag hMseif. To exsmim Otis right,an individual shall notify in writing the responsible sudtotity describing the pawn of the dtsagtrsmett. The mpsasible authority shill within 30 days either: (a)correct the data found to be Inaccurate at Incomplete Ind attempt to todly past recipients of inaeeumse or incomplete dam, Including recipients named by the individual:at(b)notify ON Individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement Is included with the disclosed data. Us dearndnadat of the responstbie authority nuy be appealed pursuant to Cie provisions of the adtninistnadve procedure act relatirtg to eontssted cues. DATj& PRLYACX ARVISQU lA accordance with M.S. 13.04, Subd.2, "Rights of subjects of data ,we would like to inform you that your request for a permit or license from 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 futzfish will be used cc determine your qualification for the permit or license requested. 2. You may retllse to supply data, but refusal may require that the City deny the permit or Iicense. 3. The Information may be shared with other local,state or federal ageAcies to tate etreot necessary to process the permit or license. 4. if your requested permit or license requires Council action to approve, some 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, First Middle Last Address City stem Zip Thome I understand my rights as stated above. SignaN[a /