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12/11/2002 67:52 9524726539 WF SMITH CONST: PAGE 61 <br /> . � <br /> Sec.l3_04 RIGHTS OF 3IJSAECTS OE DATA <br /> 5ubd. 1. ?ype o[data. The rights of iadlvldual on whom�he da�is awred or oo be �ed ahall be aa set forth iu�Is sacdaa <br /> SuEd.2. in[ormstion req�red to ha��ea IodirSdual. An fndividual asked o�supply imraoc or coofldeadal dan coocorufn8 himself shW <br /> be informed of: (a)the Purpos�and tntended use of Q►�tecryesoed dam w�d�iu the wUecdnY l� eocY,PoGdcal subdivision,oc sacewide syst�m; <br /> (b)whethar he m�y tetUse ot is k�ally required co supply rhe iequesoed daca;(c)any lmown coas e arisinS iroa►his auPP�Y�B or cefusing w supplY <br /> privaa or confidessd�l da�:uid(d)�he ideuriry oE other persous or enudes�utb.orized by s�am or f tsl law to�celve tho dau. This re4uilem�°�shsll <br /> not apply when an lndividual is aslced to supply invearigadve daea.pursvanc ro secdon t3.82, �vision S,to a I�w anforeemaat o�icet. <br /> e o �ssi r o even e mevi ce che d e re ui und rhis �vis d► !� inc � � <br /> K <br /> - d on e fo <br /> Subd.3. Acceaa to dsta by indivldual. Upon rcques�to a nspoAsible eu[hodry��n la furtherall bea�indlvidusi wlw is the subjecc <br /> of smced dara on individua�s.aed wherhar ic is cla9si�ed as public,privace ar conAdendsl. Upo �9 <br /> of storod priva[e or pubiic daw on individu4ls sha116e showu rhe da�wi�hout sny cherga w him 'if 1�c des�es,eball be info'a°ed of rhe cnncent <br /> and meaning of d�a�data- After an iedividu�l has been shown the private data and infarmsd of ita meanina,r�e dan nced noc ba disctosed m R1na fo� <br /> aix monrha dureaf�er unlesa a disput�or acdon pursuanc oo�►is sacdoa is pending or addirioua] n•on rLe in�dividual has beea coUecaed or oraced- <br /> The iospoasiblc sut6oriry ahaU p����copies of rhe privace or public data upon rcques�by rhe indi idual subjac of the dan. 17xe respoaaible suthority <br /> may�equire d�e roques�person co pay rhe acaial coscs of makln��cerrifying,end compilin8 nc �opiea. <br /> '1't�e reaponsible aurhoricy shall comply irnnudiaroly,if passible, wich enY rcquesc mad pu�suan[w Wia aubdivision,or Wirhln 6ve days of <br /> t6e dam of fie[e9uac,eaduding Saw�lays,Sundays and legal holidays.if immediau compliance' noc possibla [f he canaot comply witti che nques[ <br /> Wi�a tbat rime,he sha11 ao inform rhe iadividual�uf�d maY have an addiqonal five days widtia w � ��o�P�Y Wim�e requeot,excluding SaNrdaya, <br /> Sundays and kgal holid�ys. <br /> $u�,4, pYy�edure w6en d�ta�not accurate or complete. M individual m�y co s[du accuracy or compleo�ness of public or privace <br /> dam concemin6 h{msnlf. To exercis�rhis riSh�.��+dividual shell nodfy in wriang thc rospoa,sihl authoriry dweribiaq rhp namre of�e di�6mm°of <br /> 'fba responsible au[honty shall wichie 90 days e'tther. (a)comecc rhe daca fouad oo be i[�accura[e incomPle�e aad sttsm c to noaiy paa P <br /> ituccuiate or incomple�e dam, incl�din�ncipieaa namcd by�he individual;or(b)noatq�he � iduel thxt he Delievas rhe data ro be cociecc Dara <br /> in dispuoe shall be disclosed onty if uu indi.idual'9 snt�mea�of disag a'�antu��i�pro�. �n,s of the�idministiarive procedure ac�reladng ro <br /> The dar�rminadon of rhe responsible authoriry may bo aPP� P <br /> conte9ted cases. <br /> D TA P A VISO Y <br /> In accordance wi[h M•S. 13.04, Subd.2, 'Rigbts of subjects of data",we ould like tv inform you that your request <br /> for a permit or license from the City of Orono or any of ics departmen�s ma require you to furnigh certaia privace or <br /> confidential information• <br /> You ate notified that: <br /> 1, The informacion you furnish will ba used to determine youc quali ication for the pecmit or licer�e requested. <br /> 2, You may xefuse to supply daca, bu�refusal may require cha[ City deay the permit or license. <br /> ' 3 �e �nf�rmation,may be shared wich other local, scace or fedaal gcneies to the extent necessary to process <br /> the pecmit or license. <br /> 4. Xf your requested perm.it or license nquires Council aetion to appcove, some informadon may become <br /> public. <br /> g, You have certain rights under M.S. 13.04 (available upan req est) tv review privace daEa on yourself. <br /> 6, Your full name is r�quired [o process this application or pe c- <br /> � � � �Y1n i�'� <br /> First <br /> ���� �� <br /> � naareu S S .� ��01-` � ` � <br /> s�� Z e'6oae_ <br /> C�ry <br /> I erstand my rights stated ab ve. . <br /> Signatnre <br />