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TY OF ORONO � 6124730510 09/24/96 14:00 (�7 :03l03 Na:522 <br /> Ssc.13.04 R1C,IfiTS OF SUHJ�CTS OF D�TA <br /> Suhd. 1. Type of data. 'Tlte dydts of inQividud oi�Whom ths daa i�scored or�o be scomd shall be as see forrh in thls seceian. <br /> Subd.1. Ielonuatloa rpudr�d to ba�Iv�n indfMduai. M Individud nsked ro�upply privsu or oonfideed�l dza concsrning 6imaelf Rhall <br /> be fnfo�oft (a)d�e purpose�nd intende�use oP�he requescaJ d�n wirhin�hc cotleedna 1�u�genay,polidcal aubdlvi:ion,or sdrewide sycu�m: <br /> (b)wfie�her h�may n(use or i�legally required co supply rhe roquesud dau:(c)any knoum conaequaiu:e ariring from his supplying or retl�sing to supply <br /> priva�a or coalldenif�!data;and(d)�he idenriry of od�e�person�or enddes aud�odzed by su�e or federal IAw m n�aire�he dara. Th�requlremaa�shull <br /> nol apply when on Individual i�nsked�o �upply tnvesrig�dve daa,pursuani eo�eedon 13.82, subdivision S.to�I�w enfurcement otPfcec. <br /> '�►a cum��,:9nec�f tov_e�ue ma� place ihe not�ce re uir¢d under is subdi�isic�n in ihe individu4l income �ax or oroDsttv r��;nl�lind <br /> j�cucdona ins ud u�on�►o�c ior�+�. " <br /> Subd, 3. Aeceu to data by tndlvidtul. Upon rcques�to a rcspansible authonry,an Iadi�idual shall be informed whother 6�le the s�ibJee� <br /> ot�corod data on individuals,and whefiar it is cl�ssified a�public, p�ivue or canlM1depual. Upon his tUrrher rcquest,an individual who is rhe subjtct <br /> of sarod pri�ua oc public daw nn indivirluals slull be shown�l+e dau wi�hou�any chuae u�him snd;iF he deairaa,9he11 be infonned of the wnten� <br /> rnd maantng of diAt da�. After an individusl hu been shown�he p�i��u clara and iaformcd of i�mesning,the dan naed mc bs dixclosed w him for <br /> da e�ond�s thersatter unlet� n dispu[e or�ctiun pureuant m this seedon is pendina or addirionrl dan on 1he individual has been oollecced or creatocl, <br /> 11�s rs�puniible�uthpriry ch�ll pro�ide copies of rhe privare or public dara upon requeu Ay�he indlvidual cubject of d�e dara. The reypansible iutho�iry <br /> m�y requife the requestin�penen ro psy d+a xctuel cos�s oP mak[ng.csrtif�rino.u�d complling rhe eopi��. <br /> The risponeible auth�riry sh�ll comply immadiotely, if possible,wfch any reques�made pureuant u►d�is s�,bdivision,or withln fi�e days of <br /> �he dtte of the rayuesc,excludina Satutdays.Sundays ond legd holldoys,if irtunedla�e rompliance is not po9sihle. IFhe cannoi comply with the reques� <br /> wlwln cha[clme,ho ahall w inform rtw individual,and m�y ha�e An ad�ileanal flve d�ys wld�in which ru comply wi�h the cequesc,eaeluding Saa�rdays. <br /> SunJ�ye And le�wl holldaye. <br /> Subd.4, Ptotedu�e wh�n dn�a is net oceurats or eomplete. An iruJlviduvl mry conms�rhn aecu�aay er complercnoaa of public or priv�ce <br /> d�u coneern�n`birrwelf. To exarcise ih;s right,on indi'viduel shal)nouly in wriiinp�ho reapunsible su�hudry deacribl��d�a newro of�ho dicagreemcnc. . <br /> The texponelble ou�horiry dtell wirhin 30 d�ys ei�her: (4)coRec�the data found�o be inaccutate or incomple�e And�aompt to nodfy p4a reciplenes oE <br /> ie�aunte or in.camplete dpra, Includin�recipienu named by d�e individurl;or(b)nodf�r rhe individual thet ho belleves the dam co be cotrece. Data <br /> la dbtpwe iAall be diecloaad only if tha indlvidusl's sn�artune of dlpQreemnne is includsd with rhe di9closed dara. ' <br /> �'he dotertninntion of�he respansiblo,u�horiry m�y bo appealed pursu�n►to th�p►o�isionc o[�he adminirwdve proeedure act reloring w <br /> con�esrod e�ees. , <br /> ' pATA �,R,jVA�Y ADVI�QR�I <br /> ln sccordance with M.S. 13.04,Subd.2, "Righcs of su6Jects of data", we would like co inform y�u that your request <br /> for a permit or licensa from the City of Orono or any of its departments may requira you to furnish certain private or <br /> confidential information, <br /> You are nntified cher. <br /> 1. The informetion you fumish will be used to decermine your qualificacion for�he permi�or iicense requosced. <br /> 2. You mey refuse to supply data, buc tefusal may cequire that the City deny the permlt or license. <br /> 3. 'I'he information may be shared with oth�r loeal, state or fedetal agenciea to the extent neccssary to pmcoss <br /> the permit or license. <br /> � 4. . 1f your requeeted permi[ or license requires Council action to approve, some infarmatlon roay becomc <br /> ' public. <br /> 5. You have cenain righcs under M.S, 13,04 (avulable upan request) to review private data on yourself. <br /> 6, Ynur full name is required to process th[s application or permic. <br /> . �0.ro� � <br /> . � ��"�..� � g�+� ��- �-�.� a�� u�t. <br /> �s . �l 95 �f� Oy�- <br /> Cl�y 8oua Zip Phon� <br /> ' t�understand my dghts as ataced above. <br /> 8ienoa� — - <br />