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<br /> Oct-30-2008 04:48pm From—CITY OF ORONO +9522494616 T-019 P.031/041 F-351
<br /> Sec.13.04 RTGCiTS OF SURJTCfS OI�llA7'A
<br /> SuDd, I. Type of datu. Thc righis of individual on whnm Thc Aara is stored or w bo stored shull bc as set�unh in[his section.
<br /> Subd.2. lnfonnAFion required io be givcn individual. An individual askod to supply private or eonfidcnusl a�r.a conceming himsolfshall bc
<br /> infofmdd of: (Q)the purpose anA inlrnded use nt[ho f0que3ted dstuwi[hin tho Collectin6yt¢2��eltCy,political subdlv�sion,or srs�tcwido system;(b)
<br /> whcthcn c�may fefuse or i�Irgnlly requirCd to supply lho rcques[cd data;(c)any Icnown cansoquenee arising from his s����piying or rofusing�o�uppiy
<br /> privatc or confidemial daw;und(d)[he idofltiry oPolhcr persons ot on[ilies aulhonzed Dy s[ate of fedaral law[o f4ozive llu dnt¢,This requircmcnc shal I
<br /> no[apply whdn an individual Ia Asked t4 Supply imescigppvc QaTa,pursitatt[to sec[ipn J 3.82,SuDdivision 5,To a I.iw cniorcclnon[o�cor.
<br /> Thc cnmmi�sinne.r of rrv�y rlace rhe nnlicc,�f�irr�i��nde�rhie cub�ivia�nn in tha individi���i�ncn�pn c x
<br /> I�St�L�tions in.cre�1 of on�ho c ry prms,
<br /> Subd.3. Accoss[o ds�a by individunl. Uppii roqutst[o a responsiblc au�horiry,an individuai shall be infom��d who[her he i�thc subjcc�of
<br /> s�ored dutu on individuals,anQ whethcr i�ie classified as publie,privuce or confiden�ial. Upon his fuRhor roquesc,un ir�.lividual who is che suDjec[of
<br /> �tored priva�e or publie dcta on individuals shall be shown u�c dnta wirliouc any ehargc co him and,if he dcsirrs,sl�all 1�informcd of dio content and
<br /> mconing of�hai dc,ia. AR�r an individual has been shown che privato dara;,nd inCormed or iu meaning,u�c 4a�a noed nut bc disclosed to him fur six
<br /> rnon[hs[hrrcaftcr unless a dispu[e or ac[ion pursuan�ta�his sec�ion is pcnding or addi[ional data on�he individual has n�cn colloc�ed or crex�ed. Thc
<br /> respnnsiblo au�horiry shall providc copics of�ha privaia or public dara upon requesi by che individual subjee�ofchc d�.�a Tha rasponsiblc authoriry
<br /> may requiro thc rcqucstins poison ro pay the accu�l cosw of making,eer�ifying,und compiling ihe copice.
<br /> 'ilie rasponsible au�huriry shull mmply immedia�aly,ifpossiblc,wich any raquesc m�de pursuan��o[his sub�l�vision,or wiihin�vc days of
<br /> tlu QAw of rhe request,exeluJing S�turdays,Sundays and lcgul I�olidays,if immediaie complianco is nor possiblc. lflzc�;,,,no[eomply waJ�U�c requasi
<br /> within Tha[timc,hc shull so infonn�ho individual,nnd mny h¢vc an addi[ional fivo duys widiin which[o comply with Ih•;r�tquesl,axcluding Saturdays,
<br /> Sunduys und Icgal holidays.
<br /> Subd.a.Yrocedurcwhenda�aisnoiaeeurareorcompleta, Anindividualmuyconta4crheaceuraeyorcomplc�.,nassoFpublicorprivA[eda[a
<br /> conccrning himsclf. To oxePCise lhis ri6ht,un individual shall nolify in writing�he responsible authoriry descrlblhg Ihe n�d.urc oi du disag�eornenl. Thc
<br /> rceponsiAlc authonry�hall wiN�in 30 days cl[Ilaf, (a)cofftct lhr dnt¢tound to bo inaCcuratc or incomplcTo and altcm�,i to notlfy pRSI rccipicnrs af
<br /> Inaccu�ace or ineompletc duta,including rocipizncs namcd by�ha individual;or(b)notify the individual[ha[he brlicves ine data[o ba corrcc�. patt�iii
<br /> dispulc shall bc disclosed only if Ihe individual'y yt¢�cmrn[ot dlsag�eemdnt ie includcd with rhe discloscd da[o.
<br /> The de[ermination of the ro�ponaihlc au[horiry may be appc��lod pur�uan�to�he provisions oi ehc odminis[r�u vr proccdurc aci�elating to
<br /> conres[cd caqes.
<br /> 1)ATA PRIVACY AUVISORY
<br /> � Tn accordanca with M.S. 13.04,Subd.2,"Rights of subjects of data",wn would like to inform you that your requast
<br /> for a permi[or liccnse from the City of Orono or tiny of its depaRments may r�quire you to fi,rnish certain privA[e or
<br /> confidenti�l information,
<br /> You are notified that:
<br /> 1. The information you furnish will be used to determine your qualificacion for d�c permit or licensc
<br /> requcsted.
<br /> 2. You may refuse io supply daca,but refusal may require that rhe City deny ihc permit or license.
<br /> 3. The information may be shared with other local, srAte or fcderal agencies to ihu extent necessary �o
<br /> process the permic or license.
<br /> 4. If your requested permi[or lieense requires Council aetion co approve, some in li,rmation may beeoma
<br /> public_
<br /> 5. You have cenain righis under M.S_ 13.04(available upon rdquest)to review private data on yourself.
<br /> 6. Your full name is required to process this applieation or permit.
<br /> ��1/1�__ �Li'Z�'f l� i l7✓�� ,.
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<br /> Addrees
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<br /> I understs►nd my righcs�s stated above.
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<br /> Received T 'ime Oct. 30. 3; 24PM
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