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TY OF ORONO � 6124730510 09/24/96 14:00 � :03/03 NO:Sz2 <br /> _ . <br /> Ssc.13.04 ltlGl�TS QF SUBJ�CTS OF DA'i'.i <br /> Subd. !. 'l�pe c(dats. 'IAe d�ha of indJvidui!oi�whom che da4�f�cro�ed ar w ba smisd�hilJ bs as see forth In thia uerian. <br /> Subd.1. inPoRaatlna requdr.d to b.�f.�+Iadl•idc�al. M tadlvidu.l ufcad ro�upply privia or oonfideari�dia canaerning himaeif,�t►al1 <br /> bs Intortned of; (�)d�a purpoce at�d iittaaded uu ot du�equesced da4 widdn nc�coticcdna lnie�genoy.polldcal aubdl�i:ian,or�nrowuie sycmm: <br /> (b3 drhedter M nuy reNse oT is le�lly rcquired m supply she raquessed dau:!c)any Imown eonsequence atitit�g from hls supplytn�or�eNslt�W supply <br /> privue cr conttdandsl d�n;and(d)�he idendh of odiu persom or eedoes wd�orixed by su�e or fedenl law m reccive d�e dara. Thi�requlrcmc�c shull <br /> not�pply whcn an individu�l ir a�ced co mpplY��e�riguive daa.pursuani ro�ecdon 13.82, subdivision S.to�I�w enforcemenc offieer. <br /> ,, <br /> a ca�ttiui.gne[' P eygrmc mq� ulace the oodce r�quirad uader this subdi�islan in �he indlvldual income tax or orooem mx rol'�nd <br /> " _' jntuucdont i��oeuct u�on�o�o for�n�. „ <br /> Stitbd,3. Aree�s co data by tndlridaal. Upon rrquest to�rcspansibie wthoriry,�n lndividud shall be lnformed whather 6a b the subject <br /> o[�eoced drta on iadtvidwds.and whrdlar ic i�elus[fied ai public.Ppvue or conflderuiil. Upon 6is ftfnher rcques�,an it�ividual who b che subjeet <br /> of sooted pri�4re oc pubilc dAu nn Indtviduds shill be stio�+m�l+e dua withouc ury charEe co him end;if he deslra�,ih.0 be infotmed af�he contenc <br /> u�d mbsnias of tfiat da�x. Afur sn iadividual hu beao shown tho pdv�te dta►utid infocmed of iu meanin�,the dan need not be diubsed w.dlm for <br /> d:mondu theraafinr ur�lers a dispu�e or acdon punuam ao �his secdoa es pendin�or addirional dan on the indh+iduv hai been oollected or aeareci. <br /> fia mponsibie authpriry ciull pro�ide copia of rhe privue or public daa upoa reqvesc by�he individual eubJect of dro dan. The re:pnns3le tutho�iry <br /> eaay requi�e du mquestin�pmrsnn ro pry d►e aCaet cosa ef malcin;.cettil�in`.�nd eomp(flaa dse copH�. <br /> 'Ihe Kspontible wthoriry.�hAll comply immediately, if possfbk.wfd�a�cequesc medo purcuant w d�is subdivision,or widsin fi�e days of <br /> d�e due of ehe requee[.excluding 9uurdays.SunQays end Ic;d holldsys,if frmnedlace compllance u not po�siblo. If�he camae comply wldi d�o aquesc <br /> wlthitt thu�luse,ho ahell w it►form rhe Iadividusl,and may ha�e an.ddieiodal flve d.y:wid�in whtch w coraply wi�h�he requeac,axdud{ng Saturdays. <br /> SWnd�yi n►d Ic�rl holidiyi. <br /> Subd.4. Ptotedure wh�o dnta is not accurat�or eomplate. An indlvidu�)rtuy eo�n die acceirsny or wmplerenoa�of publIc or privnie <br /> dia concornin�bimself. ?o axercise rhis right,an indiViduel shall aoeil�ia wridng ihe responsibk�urlwri�y dauibin�d�nantro of tho dlugreemcni. . <br /> Tfu�e:p�n�ible�uthoriry d�all within 30 d�ys eidier. (i)comc�die dam found�a be inaccunte or inc�mptea ftnd�aempt ta notify ptu roeipients oE <br /> ttweeucate a�I�caroplete dpu, Inc(udln�racip(ent�nartud by �e indivMud:or(b)notfPy t4e individu�l that he bellevea ihe dats to be¢orseet Da(A <br /> la d�Cpu[e ihall be discln�ed anly if tha u�dlvidu�l's aaiemen�ef dlnareem�►c is lncluded with�he di9cloud d�. <br /> 31u dotatminsHon of ehe rcsponsiblo auihoriry may bo appeated pursuwi w�pruvislons o[du admini��ndve proeedure aet rol�cin`w <br /> con�essed otaes. <br /> � YIAT,��, ACY ADVI¢ORY � . <br /> !n xccordance wich M.S. 13.04,Subd.2, "Rlghcs of�ulijcets af data', we would like co tnform you that your request <br /> for a perntit or ltcenso from the City of Omno or any of ita depanments may requir�you to furnish certain priva�e or <br /> confidential Information. <br /> Y'nu are na[Ified that; - <br /> 1. The information you fumish wiil be used to decermine your qnalification for ehe permic ar Iieense requosced. <br /> Z. You may tafuse to supply daca. buc refusnl may requlre thac the City deny the permlt or licc�tse. <br /> � . 3. Tha infarmacinn may be skand wich och�r loeal, sta[o or fedetal agencies to[he excent nccessary eo process <br /> the permic or lkensa � <br /> • 4. . Tf your requaated peRnit or Ilcen�e requirec Councii ect�on to approve, some infannatton may become <br /> ' pubitc. <br /> S. You have certain righ�s under M.S. 13A4 (available upon request) ro review private data on youraelf. , <br /> 6. Ynur full name is requir�d to process.tlils application or permic. <br /> . �(O` � c�J�Q If lS0� � <br /> �� Mlddle Last. � <br /> . �;rn,�o�.� � �D �� S�-C � a�1 -- <br /> �1oa � ,� .. � Y`(�v.s s�aa � 9s - ys-Cooy� � <br /> c�cy. . - sam zip photw <br /> ; <br /> ' I•uctderstand my tlgtits as scaced ubovo. <br /> �no�u�e _ . <br />