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Sec.13.Q-i RIGHTS OF SL'BJECTS OF DaTa <br /> Subd. 1. Tvpe of daca. The righ�s oi individual on whoa�e daa is s:o::d or m be scorrl shall be as set focth ia[his secrion. <br /> Subd... Information reqirirrd to be�ven individual. An ir.dividual asYed to suFp[y privac:or confidendal daa cocceraing himself sfiall <br /> be infocned of: (a)the purpose and inL:nded use of etre reGuat-d dari v+ithin ehe collecdag'sam agenry,polirical subdivisioo,or satewide rysum: <br /> �b)whe:�:r he may rfuse or is le3ally requir.d co n:ppiy[he r_�uesced dars:(c)aay l�own cobs-:�ueace arisia3 from his supplyi;.g or refusing co supply <br /> privam or conr.dendal data;and(d)che idanricy of o�er peaors or enades au[horiz�by sca[_er fadd�I3'.V(0 R�tive[he da�a. This requiremeac stiall <br /> no�appfy when an individual is asked to supply incesrigaave daa, pursuaac ro sec�on 13.83, subdivision 5, to a law enfoRemeac officer. <br /> "Ihe commissioner of r.�:e:�ae mav oli:_ the nocce re�uired under this subdivision in the ir.dividual income ttt oc vrooem mz reFur.d <br /> insrrucdons ins.e�d of an chose forms. <br /> Subd. 3. ?,ecess to data b�indiridual. lipon r..;_at to a r_sponsible auc.`:oriry,aa individual shall be informed�vhecher he is the subjec� <br /> of scored daea on individuals,and whe:her i�is clsssifed as public, pr.vace or con.-:�eaaal. [;Foa his fur,her rer{uest,aa individual who is the subjecc <br /> of scor_d privase or pubfic daei on individuals shall be show��e daa wi�hout aay caar3e m hi�and,�if he desires, shall be iniomed of che concer.c <br /> ar:d meaning oi�ha�data. After an individual hu been shown che privarr,daca az:d icfor,ned o[its meanin3,che daca need noc be disclosed m hi.�n for <br /> six mon�s cher_siuc unless a d'upute or acrion pursuanc co 4�is secdon is pendi:.g or addidoeai data on che individual has beea collected or cresced. <br /> Tne responsible aurhoriry shall provide copies ot�he privac�or public dac�upon r:qu_sc by cEe i�dividual subjecc of che daci. 'I"a�responsible auchoriry <br /> may require rhe requesring person to pay che acnul cosu of r..aking,cerrifying,sr.d.ompiling [he copies. <br /> The responsib(t aurhoriry shail comply ir.ur:edia�ely, if possible, wirh�:.v�quest�dt pursuanc co this su6division,or wirhin five dsys oi <br /> the dac�of cha requesc,e�ciuding Sanzr3ays,Sur,days and 1e3s1 holidays,if is.medu:e complia:ce is noc possible. If he esnnoc compty wich the roquesc <br /> wi�`�in rhac dme,he shall so inform�he individual,and may have an addidonal five days wichin which to:omply wi�z the requ�st,exc!uding Saturdays, <br /> 5undays and legsl holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. An ir.diviZual may concest[he accuracy or completeaess of public or pri�•a�e ' <br /> data cor.ceming himselF. To exerise c,4is ri¢hc,an inCividual shall noa"ry in wriae;te resporsioIe auchor.ry describing rhe natt::e oi thz disagteemeac . <br /> 'Ihe responsiblz authoriry shall wichin 30 day5 eic.`.er. (a)c�.:�ce eh�dan four.d�`_=in3ec::��or ineonple[e and aaemp�to nodfy past reeipients of <br /> inaccurs:e or incomplece dara, induding recipiena named by 4he u:dividual: or(b)�odfy et:= iadividual thac he believes che dac�to be corroce Dan <br /> in dispuce shall be disc!osed oniy if[he individu�l's sacer..e^t of disagrr_meac u�.duded wi:tc che disclosed daca. <br /> 'I'he de�e:minadon oF the r:ronsibl:auchoriry r.:y be aopealed purn:�-c to the p;ovisions of the admuustr3rive pro.edure act relaciag ro <br /> conces:ed cases. <br /> D:�T�. PRIV:�CY :�D`'ISORY <br /> In accordance wi�h�1.5. 13.04, Subd.2, "RiQhcs of subjeccs oi daca", ��e would like to inform you thac your reauesc <br /> for a perm.it or license from che Ciry or Orono or any oi ics deaz.mencs nay require you to fumis� certain private or <br /> confiden�ial information. <br /> You are notified tha[: <br /> 1. The information you fi:raish will be used to de�emzir.�your qLzlification for the perm.it or license requested. <br /> ? You may refuse to suoolv daca, buc refusal may reeuire tha� the City deny the permit or license. <br /> 3, The informacion may be shared with other local, scac�or federal a�encies co the extenc necessary to process <br /> the permit or license. <br /> .�. If your request�d permit or lice:se requires Council action to approve, some informacion may become <br /> public. <br /> j. You have certain riQhts under �1.5. 13.04 (availabl� upon request) to review private data on yourself. <br /> 6. Your full name is required to process this applicac:on or pe:mic. <br /> ` � .c�����2��- <br /> ����� <br /> Finc �1:dd1= Luc <br /> �.�77 /�s �>h..� 1%0� <br /> � ?.ddrss � � , J�J`�J� '�/ -��/J' <br /> Ciry ) Srtte Zip P�ona <br /> I understa�d my ri�hts as stated above. <br /> ����/,i ,������- <br /> Signacur <br />