2003 - P06598 - sign - temporary

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--. LtALIO ua.alpm From-CITY OF ORONO P. 3 +8522494618 T-883 P.003/003 F-173 Sec.13A4 RIGHTS OF SZIBJF.TS OF ARTA Subd. 1. Type or data. The rights of individual OP whom the data is stored or to be solid Shall be as Set faith in this section. Subd. Yafermadon required to be given individual. An individual asked to supply private or confidential data coots-ming himself shall be informed of• (a)the purpose and hue:Wed use of the requested data within the collecting Stam agency,political subdivision.or statewide system: (b)whether ho may revise or is legally requited to supply the requested dna:(c)any blown masrgaeam arising from his aupplyusg or'erosion to suppb' private or confidential data:and Id)the identity of other persons or entities authorised by state or federal law to receive the dos. This requitement than not apply when an individual is asked to supply investigative dant.pursuant to section 13.82.subdivision S.to a law enforcement officer. commissioner of revenue may .lace the notice renuired under this su.."vision in individual income az or uta. , tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether be is the subject of stored den on individuals.and whether it it classified as public..private or confidential. Upon his further request,an individual who is die subject of stored private or public data on individuals shall be sbown the data without any charge to him and.if he desires.shall be informed of the comets and meaning of that data- After an individual has been shown the private data and informed of its meaning,the dace nod mot be disclosed to him for Six months dtucaher unless a dispute or action pursuant to this section is pending or additional dna on the individual has been connected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subjecrof the data. The tespoosible authority may require the requesting person to pay the actual costs of making,certifying.and compiling the copies. The tesponsible authority shit comply immediately.if possible.with any request made pursuant to this subdivision,or within five days of the dao of the request,exchuding Saturdays.Sundays and legal holidays.if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual.and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure whey data is not accurate or complete. An irdividaal may contest the accuracy or completeness of public or priratc data concerning himself. To exercise this tight.an individual shall notify in writing the responsible authority describing the nature of the disagreement. The tesponsiblc authority shall within 30 days either. (a)const the data rowed to be uuecurare or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual:or(b)notify the individual dear be believes the dace to be cornett Data im dispute shall be disclosed only if the individual's sntement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant in the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In 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 furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local,state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. • 5. 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. ,L .- a . • I . IL. 07 <,. - Ct��-y�C First Mi le Last COY'h ys /.33 13rc). el • � h J Address 5635 , 5g 47 /. . -7 Ciry Stare Zip Phone I understand my ri • as stated above. , ,04 Signature /