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• 011s0/2098 09: 52 r634344933 HARMONY HOMES INC PAGE 03 <br /> $ce.I1.OJ RIGHTS OF SUB.IIsCTS OF D�1TA <br /> 5«hd, i, �ry�,���f��i;un, The�iglirs of'indiv�du�l an whom thc dsta is arored or ha he.cored shall hc as sct Forth in this scction. <br /> Suh�l.?. Informotion requirod to be gi�cn indiv��lu:�l, �,n indiviJual�akcd to suppiy rriv�te or contiJenti:�l el.�t�cnncemin�liimaclfahall hc <br /> inFormed uf': 1:�)thc purpose nnd intended use uf�hc rc��uosred da4�wi�l�in�he cnllcctinµ.atace agcncy,political subdi�isiun.��r;;r;�icwide�ystem;(b) <br /> whc�hcn c�m:ry rctiise or is Icgnlly required to supply the rcqucster.l d��i:(c):�ny kn��wn cnn:rcyucncc ariaing 1"rom his supplying or reFusing co supply <br /> privntc qr ennPid�nti�l da[a;and(d)thc idcntiry afochcr persans or cntities nuthorized by srnt�:or PcJcral I,�w ui reccivc[hc data.This rcquircmcnt shall <br /> au�;'Pply whcn;in individu�l i.g laked tn?uprly invcstigativc dntn,pursuont to scction 1J.8:2,;;ubdivision S,ro�law cnforccmcn[offccr. <br /> The com.Q��spyoner 4}' .�v49up��y�Ince the norice reAuircd under rhis subdivi;�i�n in the i�idividual income tn or orooerry eax relund <br /> instructions instc,.�i ot�on those,�;Q�S. <br /> Subd.3. Accccs to data by individual. Upon rcquest to a r�sponsiblc authoriry,�ui indivi�lll�il shall be infol'med whcthcn c�i9 thc guhjcct of <br /> storcd d�t�on individu�ls,�nd whcthcr it ic clascifcd sa public,private or confidcnunl. Upcm his ftirthar rcques�,nn iadiviJu�l whu i<the.ubjcct of <br /> swrrJ pfiv.uC or publie ilor,�un hldivldualc sh�ll be shown the dat:�wjchout any eharae ro him and.if he desires,shall be intormed of the conrent an(1 <br /> meaning i�Pthcrc data, ARer an inQividual hax been shown�.he prl��re d����qd infnnned of ita mcaning,thc data nced not be discloscd ro him for six <br /> mon[hs thoreatter unless v dispute or action pursunnt to this section is pending or�iddieioe�)l,lat�ro�the indivi�ival h�s hern eollecced nr ereatod. The <br /> rc.qponsiblc suthoriry ahall providc copics of thc�riv�tc or public data upon rcqucst by the i�ndi�idual subje�e�if�.he d�c�, The respposihle audinriry <br /> m�y rcquire thc requcarinp pc�aqn tn pay thc a�n��l costa nf making,ccrtifyinR,�nd compiling thc eopics. <br /> The responsible aunc��nr.y shall comply immediorely.If possible,with any rcqucsi madc pursuant ro[his subdivision,or within five dnys ul' <br /> the dntc of thc rcquest,oxcluding San�rdays,5undnys nnd legul holid�ys,if immedi�r�cpmp���nce ic np[pocciblc. If he cannot com�ly wi[h du requcsc <br /> within thnt time.hc shall so inf'orm the individunl,�nd may have un additiunnl tive days wirllin whi�h t�comply wich the rcquest,excludinR S�turdaya, <br /> Sundnys nnd legal holiduys. <br /> Suhd.C. Prnecdure wl�cn data is not�ccursce or enmrletc. An individusl may contcat the sccuracy or complcteness of public orprivq�e datn <br /> con�crning himsal G To eicrcise�his right.nn indiv{�ual shnll no�ify in��rl�ing the responsiblc,wchoriry ilegcriHing dic nsturc ofthc disagracmcnt.Thc <br /> rospon�ible authuriry shnll within 30 dnys either: (n)correct[he dnti tounJ tv be inneturaY:e or incomplere ond attempt to nptify paqt reeiricnt.s nf <br /> innecur�i�e ur incc�mpleee dnta,in�:ludinb rccipionta nnmcd by thc individual:or(b)norify ehc inAiviOval�.hnr.he believec the dst�ro be corrcct. Dat�in <br /> dispute shall be disclosed only i1'thc individual'A statcmcnt of disegrccment is included with the disalosed dnta, <br /> Thc dctcrmination of thc rcapon.qiblc authoriry may bc eppealcd pursuant to thc Frovisions of the ndministrntiv�proccdure act rclnling ro <br /> contcstcQ cases. <br /> nAT�► PRiYACY ADVISORY <br /> In accordance�vith 1�1.S. 13.p4,Subd.2,"Right;ofsubjects of data",.wewould like tp infqnn ypu thatyour�equest <br /> � for a pcnnit or license from the City of Orono o�arry of its deparlmenr.s t.r�a.y cequire you to fumish ceRain private or <br /> confidcntial infonration. <br /> You arcno�iGcd �h��; <br /> 1. The inform.ation you furnish will be used to detennine ypur quaiificatipn foc the pertnit or liccnse <br /> requestcd, <br /> 2� You may refiisc to si�pply data,Uut refusal may require chat the Ciry deny the permit or lic;ensc. <br /> 3. The informatioq mfl.y be sharcd with other local, st�te or federal agencies to the extent necessAry l'o <br /> process the permit or licensc. <br /> 4, If your requested pc:rmit or liccnse rc�uires Council actio�u to approve, some inforn�ation m�y becomc <br /> public. <br /> 5. You have certain rights uncicr M.S. 11,04(available upon reques�)to review priva�e d�ta on yoursclf. <br /> 6. Your fiill name is requiced Co roccss this application or ncr.rmat. <br /> �� ,�_,.�—`-�=� � <br /> F'rx� Middlc <br /> � Lnst <br /> � � � �� <br /> Address <br /> ��d��,�•� �� _ �'SU �' Z,- �� 3 - 3--/l� <br /> City Stare 7.ip PhonC <br /> I undcrstand my ��y��y a5 4tntcd ab c. <br /> ...�-�• ��� <br /> Si�+nnturc <br /> �'�,i �d � � � �rvn�mwirr•.rTrnMnm. Y�I �'�1' � <br /> �•�,p� w ,iC� 7y d] '}J � �r° s� 'y,�P <br /> A`aY1I�f�: �t N � �1�Y L��tCtJ�<�.1��r,r,[��������,y (J1(ILL^"Tk�'.}��'� �2 <br /> �ii4Ml..�l � , �:!'!.�Iwl�rii,.ricFll�.nF1:i1 kAls'.�l1�IrY'�.Ii���11.�i <br />