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JU (218 23:38 FROM: TO:9522494616 P:2'2 <br /> Jul 8-2008 10:43am From-CITY OF ORONO +952249461fi T-746 P.003J0)3 F-751 <br /> Sce.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. The rides of individual on whom the data is stored or to be stored shall be as sei forth ill Utl,S c(:iipn <br /> Subd.2. Information required to be given individual, An individual asked to supply private of confidential,Jars urn• rq;ng himself shalt be <br /> • <br /> informed ore (a)the purpose and intended use of the requested data within the collecting rrAre agency,political subdivision,or statetvide system;(h) <br /> whether he rttay refuse of is legally required to supply the requested data;(c)any known consequence.arising from hie supplying or refusing re supply <br /> privete or confidential dain;and(d)the identity of other persons or cntltiet nuthatized bysteie or federal law to receive(he data. This rcgtrirgment sham <br /> not apply when en individual 1s asked to supply investigativo data,pursuant to section 13,A2 subdivilion S,to a law enftrcemen:officer. <br /> The cntrtmiesiontr_af reeve je izt inindividual,jncprne lay or pammiliK4furAl <br /> i➢attucsioi1F iActesd of eta those forms, <br /> Subd,3, Access to data by individual Upon requesere a responsible authority,an individual ehall be informed whether he is the sebjectof <br /> stored data on indiriduale,crud whether ii,is classified as publ ic,private orcontidential. Upon his further request,an,rid ividu;ii who is the subject of <br /> scored private,or public data on individuals vial.be shown the dem without any charge to him and,if he desirea shall be informed of the content and <br /> manning of that data, After en individual has been shown the private date and informed of its mear.irg,the data need not be diec:lpeed to him for six <br /> menthe thereafter unless d dispute or action pursuant to this sectierl is pending or additional dela tier the individual has been collected or created Tie <br /> responsible authority shell provide copies of the Ovine or publie dale upon request by the individual subject of Vie deem, The responsible authority <br /> may require the requeeting person to pay the actual eons of making,cer tifyine,and camp iline the copiee. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this aurid ivision,or within five days of <br /> Me dun of the request,excluding Saturdays,5undoys and lege]holidays,if immediate coinpi Jane I;:nor.possible. lfhe cannot cumply with the request <br /> within that time,he shall so inform the individual,and may have an additional ve days w ithih which to comply with the:request,excluding Snturd'nn <br /> Sumdnys and legal holidays, <br /> Subd,4. P7oceriuee when dAta is Th0t5ceuOte or complete.An individual may contest the accure.cy urcontp]eueriessofpublisorprivate dew. <br /> enflaming himself To ore vise this right,an individual shall notify in writing the responelble atthnricy describingthe nature of the disagreement The <br /> responsible authority shall within 30 days either: (a)correct the dam found so be inaccurate or incomplete and artempi to notify peel re;it write of <br /> Inaecumtre or incomplete data,including recipionm named by the individual;0f(b)notify the individual thee he believe the data co he correct. Detain <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the dieelosed data. <br /> The determination of the reaponaiblc authority may be appealed purl sant to the provisions of the edmihitr give procedure set relating eo <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to i11ft'rm you that your request <br /> for permit or license from the Cry of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> • <br /> You are notified that; <br /> The information you fllraish will be used to determine your qualification fur 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 Iicense. <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 /> S• You have certain rights under M.S. I3-04(available upon request)to review pi ivate data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> First Middle _.._ <br /> Lays <br /> Addreaa - -_ <br /> City State <br /> Zip Phone <br /> 1-understand my rights as stated above. r <br /> �_..._- • .T ;,,r <br /> ,,RPt;nanun <br /> �� ai'r1� ,,1'I l� li �llfia�.'`>w� 17.Illt lll .l irllWl�'i�tl���!lii�I 32 <br />