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Sec.13.0-L RIGHTS OF SL'BJECTS OF DaT?. <br /> Subd. 1. Tvpe of daca. "Ihe righcs oi i�dividual on whom tbe dara is s;o;:d or co t�e smrtd shall be as sec forth ia�his secrion. <br /> Subd._. Inforiaaaon reqirired to be�vea individual. ?.n individual uked co suppIy private or confidendal daa coccec�aing himself shall <br /> be informed of: (a)�he purose and inceaded use of che requestid daa within�e cotlecang'sa`ageacy,polidcal subdivision,or sacewide rysta: <br /> �b)whe:her he may rfuse or is Ie3alIy cequired co si:ppty�he reGuested daci:(c)any l�own coas��queace arising from tiis supplyi:g or refusing ro supply <br /> privace or conf:dendal daca;ar.d(d)the id�ndty oi oc�er persoas or endries au[horiz�Sy sra[_or fed�r�l law co receive[he dac. This requiremen�shali <br /> no�app(y when an individual is�sked,o slpQly incesri¢arive daci, pursuan[ro sec_on 13.82, subdivision 5, to a law enforceWeac o�cer. <br /> The comr,ussior.er of rvenue mav oizc: che nodce r:auirtd under�his subdivison in the ir,dividual income c�z or orooem taz refur.d <br /> insrrucaons ins.ead of on ct;ose forms. <br /> Subd. 3. �lccess to datz bv individual. lipon request co a responsible a��horiry,an individual shall be informed wherhec he is the subject <br /> �f stor_d daea on ir.diviCu:ls,and whe�er ic is clsssif::d as public, privace or cor=�eadal. i:pon 6.is funher request,aa individuai who is the subjecc <br /> of stoe-d privace or public daa on ir.dir•iduals shall be shown che daca wi�hout any caar3e � hi�and:if he desires, shall be iatocmed of the concenc <br /> ar.d meaning oi d:ac daca. After an individual has�een shown che privare dara ar.d iciormed o�ics meaniag, che dact need noc be disclosed ro him for <br /> siz mon�`u chereaicer un!ess a dispute or acrion gursuanc co rhis secdon is pendsg or addiaoa�l daa on[he individual has beea collected or creared. <br /> Tze responsibla auehoriry shall provide copies ot�ha privace or public da�a upon r.:,u:sc by�e i�dividual subjeu of chz dact. Tne responsible au�horiry <br /> may requir �he requesring per�on ro pay the acaul cos�of making,cerrifying,u:d:ompili.ng [he copies. <br /> The r.sponsible auchoriry shall comp[y ima:ediatefy, if possibte, wirh a:;+r.quesc m�dc pursuanc to this su6division,or wichin five days oP <br /> ehe dar�oi che uGues�,ezcluding Sanirdays,Suadays and legal holidays,if is.med��:e compliatce is noc possible. If he canno�comp(y wich the requesc <br /> wichin�ac dme,he shall so inform the individual,ar:d may have an addidoaal five days wi�hin which co comp[y wi�z the request,ezc!uding Saturdays, <br /> Sundays and legsi holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An ir.divi�nal may contest the accuracy or completeness of public or pri�•ate ' <br /> daci cor.ceming himself. To exerise chis ri¢hr.an inCividual shall nodfy in wridrg fi=resporsiofe authoriry dtscribing the nan:re oi thz disagreemea�. . <br /> The tesponsibla au�horiry shall within�0 days eia`:er: (a)corrncc�he data four.d ro��inaccu�r_or incompte�e and aaemp�co nad�j past recipien[s of <br /> inaccurace or incomple:e dan, inc[udin3 recipieca named by [he individual; or(b)codfy eF.: individual chac he bclieves[he daa to be correcc Dars <br /> in dispuce shall be disc!osed only if�:e individual's sncemenc of disagr::m:nc is�:luded wi��[he disclos�d dara. <br /> 'Ihe C:ce:miradon of�k;e rsponsiole auc.horiry may be appealed purn:�-�ro the provisions of the adminis�arive procedure act reladng to <br /> contes:ed c�ses. <br /> D?,T:� PRIVACY �D�'ISORY <br /> In accordance wich�i.S. 13.04, Subd.2, "Ri�hts of subjecu oi data", ��e would like to inform you that your reauest <br /> for a permit or lice:lse from che Ciry of Orono or any of its depz.men[s nay require you to fumisa certain private or <br /> confidencial information. <br /> You are notified that: <br /> 1. 1he information you fi:raish will be used to detecmiy�your qualification for che perm.it or license requested. <br /> '�. You may refuse to supply daca, buc refusal may re�uire that the Ciry deny the permit or license. <br /> ;. The informacion may be sbared wi�h o�er local, s�ac�or federal agencies to the extent necessary to process <br /> the permit or license. <br /> .�. If your requested perait or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have cena.in riQhcs under �1.5. 13.04 (availabl� upon request) to review private daca on yourself. <br /> 6. Your full name is required to process this applica:ion or pe:mit. <br /> L-�-;�,�� � Sr--�'�-`� <br /> Firn �tiddle Luc <br /> �C�S G��n,`f" �v Ti � ST�2�.�-'� <br /> Addr_ss <br /> �� � ��� �sy� s <br /> ciry saL zip Pr.oaa <br /> I understand ny ri�hcs as staced above. <br /> �� � <br /> Signacur <br />