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07/09f2007 23:46 6514303706 CRAFTSMEN HOME IMPRD PAGE 02 <br /> . <br /> . <br /> . <br /> � 9oC.]3.M RTGHT5 OF 31TBJECfS OF DATA <br /> Subd.1, Typc of dnla. The rigMs o£individual on whom�he da�iF atotecl or to be srored shall be�v aa forth in dtis soction. <br /> Subd.2.informaUo��equi�d w be given individual.An individuffi eaked M supply priwle or c�demial data cuncerninH hirreelf sheD ba <br /> informed oE (s)the pwpose end intcnded use oF[hc raquesoed datawithin the collCcong a�tc agency.policical aubdiv�9ion,ar 9ffitewide system;(b) <br /> whether be may refusc or is le8alty rcquired to supply the roquesred da�;(c)arry knovm consaqucna alising from hie aupplying or refuaing ro supply <br /> prive0e or confidemiul data end(d)the idemiry ofother persons crr entsttee audtorized by s�rte or 1Ddern1 law ro r�ive the data.Thia rcquircment shall <br /> not apply whcn un indlv.idusl ia asked to supply imeatigative da�,paeunM to section 13.82,aubdivision 5,to a Iaw tnforr.errnem officu. <br /> 17t�commisai�tl,r.r of revenuc may elace thc notice required under this sybdivision in the indjyjSl4l�l incomc tmc or nrot�e[lv t��fund <br /> n cN n;ies[ead of on_t�j seSl fo�m�. <br /> Subd.3, Accesa to data by individunl.Upon requa¢C to n responsiblc autl�o�ity,an individual shall be intbcmod wheeher he is che subja.t of <br /> sarced data on individunl�,and wha�hoT rt iv cl�aified as public,privnbe or co�fidcntial. Upon his furchcr requesC an i�ividuul wt�o is che subject of <br /> storcd privaee or pubtic data on individuals ahaU be shawn thc dam without any chargc m him and,if hc dcaims,shall ba in fomwd of the com�c and <br /> mraning of th9t data Aftcr on Individuel has been shown the privatt de�and infortrrcd of iCs meaning,the data need not bo discloaed to him for gix <br /> montltl Ute[enfter unlesa e dlspute ar acxion putsuant u�thiA aextion 19 perlding or aAditionell dAb►on thc individuell b0.s becn collected oi Cteaoad. Thc <br /> responsibla authoriry shull pro��idc copies of tho Drirvet�or publit detA npon roqueat by Ihe individual aubjett of tFle daffi. The teeponeiblo aatltariry <br /> r�y rc.quire the requesring pe�on to pity[ha ecwal eoafs of ineking,c�,titifying,end compiling the copios, <br /> ?he te5rx►nsible nutho�lty eh�tll comply immedlEwely,ifposaible,wilh arry rcqu�mude pWsuartt m thia subdivialotl,or within frvedeys of <br /> thc da�of the tequest,cactuding SetuNayq,Sundeys and►egal holidays,if fmmediate complienx it1 not possble.ifhe cannol cotnply�the tequest <br /> wi�hin that dme,be sha11 ao inform tho i�dividunl,anA may have��dditional f ve d�within wtiith eo camply with thc request e�weluding Sahtrcl�s, <br /> 9undeys end legsl holidayn. <br /> Subd,a, Roceducs when dan ia na�eecu�nte or comAle�.An individual may am�the ncaca�y or axnDleocnwg ofpublie or pm��dala <br /> concoming him9elf.To cxettl9e 1liis�ght,an individuel shell nodfy in writing 1he tesponsiblc aulhotiry des�Tibing th¢naturt of tlte dis�oer�1C'the <br /> responalble authoriry ahaJt within 3o daya eitha: (e)correcc thc deta found w be ie�aocmaoe or inoomplere and am,npt oo notify pn9t�ecipicnb of <br /> inaccurate or incomplde dtr[a,including recipicnts named by thc ntdividueh of(b)nMify thc indivi6ua)thttt he 6al icvra the data to be correct.Data in <br /> disputc shall be disclosed on►y ifthe indivldual's starem�t ufdisogt�ec�ns is includcd wilh du disclo.aod da�. <br /> The detertninacion of the�pon9ibla auchoriry may be appeeled pur�uem bo the provisions ofchc adminiatrative procedur�ecc alating to <br /> coMeSoed casea. <br /> DATA P ACY ADVISORY <br /> Ie accordance with M.S.13.04,Subd.Z,"Ri ghts of subjectv of dota",we wou]d like to inform you that your tequest <br /> fot a perrnit or license frpm the City of Orono or any of its depectmentc may rcquitc you to furnish certsin private or <br /> conf.►dential infortnation. <br /> You are nptified that: <br /> 1. The information you furnish will be used to determine yout qualification for the permit or license <br /> reque9ted. <br /> 2. You may tefuse to supply data,but refusal may rcquire tihat the City deny the petmit or license. <br /> 3. The information may bc shared with other local, state or fedetal agcncies to the extent ncccssary tci <br /> process the permit or license. <br /> 4. If your requested pctmit or license requires Counci)t�ction to approvc,some information may become <br /> public. <br /> 5. You have certain rights undcr M.S. 13.04(available upon request)bo review private data on.you�elf. <br /> 6. Your full namc is required to process this application pr permiL <br /> �0.�;e,� �. 3 y� l � n <br /> �,�� <br /> 7 `� 55" ��an�e �� � 5 .� 1 �1 `� � <br /> �aa� � <br /> �i ho� 1� I� 5r��{3� (� �I `�30-�`� <br /> Clry 9dte Zip Phone <br /> 1 nade�sts�nd my rightv ss st�ted wbove. <br /> \ � � <br /> � <br /> 81Rnatac+c <br /> ,�- - - <br /> __,,__.�.._.........,.:.,,.,_•..•— - <br /> �_`:�te�L�e;Fbml;`,,;. . . . ,, 32 <br />