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� , . <br /> 5ec.13.t1A RtGH1'9 pF'SUBJ�C'C9 UF llATA <br /> Subd.1. Type nf d�tr�. "I'ho righte nf individuul on whom the datn i�etored nr tn be rtnr�d nluill Ma�r�et forth in th�eedinn. <br /> 9ubd,2. Infr�rnution required to be given individuel An u►dividuet aeked ta euPP�Y p�'jvet�crr ooafidentisl data conceming huu.effeluill be <br /> it�'octned of: (n)the purpoee and intended uee of Hie reqneeted drtr within the cnllneting�t�te agenoy,pnlitirai eubdivisicm,or etatawide�yetem;(b) <br /> wAetha ho mry r�n or ie legally requireci to eupply ihe requoeteJ duttr;(a)any known coneoquence rrieing frnm hie eupplying or refueic►g tn eupply <br /> privata nr cunf'identirl d�ts;and(d)the identiry ofnther pemone or entitiee xuthorizeci by ehte nr federrl la�w W rouuive the dnta.'I'hie requirement e}uill <br /> nnt rpply when+u►individwl u detcad W eupply invertigative dau,pureuutt tn eection 13.82,eubdivwian S,to r law atforceateat officer. <br /> 'Ttie cn �rei��inn�nf reva+Le n�ny,�LcR�ha no`�ce raq��tl'8 i LHAd[L�L1N NLfIlVl6lbft L Lhtl L�AfV1tILI Lntltlriftl LX 11S_�(�j�'LY Ctlfli+lLl <br /> ieutruadnnd inMtesd of nn these fortne, <br /> 3ubd.3,Aeeeer tn data by individual.Upnn roqueet to e rerpen�ibla euthoriry,an individual ehall be infnrn�od whether ha ir tha rubj�ct nf <br /> etvc�d drta nn individuxl�,utd whethar it u cLeei£ied re publia,privrte nr crmfidentiel. Upon hie further requeet,an individual who ie the enbject nf <br /> etored privrte or publir d�tn nn individunlr shnil be shown the drta without rny ohnrge w him and,if he de�iree,ehrll be infnmted nf the contant and <br /> merning nf that dnu. After rn individual}ue bd�bhown thn pr'rvatn data end informed nf itr merning,tho data n�ed not be discloeed to him fnr ei�c <br /> mcmthe thereafler unlese e d'upute or ration puruunat tn thir�ection ie pending nr additional detx on the individusl hae been cnllected or croat�d. `fhe <br /> rerponeible ruthvrity ehrll providu ropia af tho privete ar pnblic datr upon requeet by the individu�l eubject of the dab, 'I'he rwpcmuiblo�nthority <br /> may t�equire the requeetittg persnn to pay the actual ooete nf makittg,cartifying,and compiling the copiee. <br /> 'I'he roepemeible authority elwtl nomply immedietoly,if poe�ible,with any roquedt made pureuiuttta thid eubdiviram,nr within frve dayr vf <br /> the date nf th�requ�ut,exoludin�Saturdayr,Sundnys xnd legal hnlidaye,i�immedi�tn�nmplirnca is notpo�sible.If hn cannnt comply with tho requeut <br /> within that time,ha dhrtt dn infnrm the individual,rnd may have m edditioml five dxye within which w armply with the roqueet,mcclud�g 3�turcLyr, <br /> Sunddy�und legol hnlidaye, <br /> Subd,4.PrncroBnre when drL i�not aeCurrte or oomploto. An individurl mny ranteet khe recuraey vr oomplet�nnee nf publio or priv#e deta <br /> conceming himeul�.7'n eacarcira thie right,�n individual eluall notify in wridng th�reepcmeible authnrity deeeribing the natur�nftha dibngreoment'1'he <br /> reepnneibte onthnrity eholl with�30 drye either� (g�CtliTOCI 1t18 tIB�FOlit1A 10�tl fNCCpIYI�tlt 11lCOtClpIO�B ItIfI NK61fIpt Ytl tlMl�QaA�f8C1p1C[I�l1 0� <br /> inurcueute nr incnmplata dnta,innluding renipiunla nnmad by the individusl;ar(6)nntify the individual thrtho beliovnr the deta tn be cerrrect.brt�in <br /> dieputd ehrll bo d'ucln��d cmly if'the inclividurl'e�tatanont nf diergreemdnt ie inoluded with the d'ualoeed data, <br /> 'I'he dote�mination nfthe roepnndibin authority mry be appo�lod punuant to tho pwvuione nf tho adminirtrrtivd prncvduro act mlating to <br /> cnntaetec!cuues. <br /> DATA PRIYACY ADVISORY <br /> In accdrdnnce with M.S. 13.04,Subd.2,"Itights of subjects df data",we wnuld like to inform ynu thxt ynur request <br /> fnr g pennit cn license from the City nf Chonn or any of its dapartments m�y require you to fiuni�h certain private nr <br /> cu�d�ntigl inform�tion, <br /> Ydu are ndtified tt�at: <br /> 1. 'I'h� infonnetion ynu fiunish will be used to detc�rmine your quelificatinn for th� permit ur license <br /> requested. <br /> 2. You may r��fiase to supply dats,but refusal may require th�t th�City deny the pe�nit or license. <br /> 3. 'I'he inforn�aticm may be sh�red with oth�r locel, state crr fecicral ugencies to the e�nt necess�y to <br /> proc�ss the pennit or lic�nse. <br /> 4. If ynur requ�sted permit nr lioen�e requires Cnuncil Bcticm tn approve,some infcmngtion mey become <br /> public, <br /> 5. Ynu t�ttve certain rights under M.S, 13.04(ttv�ileble upon reque�t)to review priv�te datn cm yourself, <br /> 6, Your full name is required tn process this epplicetion or permit <br /> �'Irrt Middle Lrrt <br /> �� b � ,�l �2 . �u � �- z� I <br /> Addnwr <br /> � � � D 7 %1'�'G�( J I • 'VW �GC+4� 1�4�0 ��a.�J , �,n� .S � y 4 b' <br /> Cky Btxta Zip Phnna 6 S�-�.1�-/-3 �l�/ <br /> t under�tand my rlght� rteted ebnve. <br /> ' � : 1 —//— Ci <br /> 'S11 ra <br /> Reset E'otm 32 <br />