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fe6-DT-200� 02:blpm fro�-CITY OF ORONO +8512484616 T-480 P 0071�p9 F-588 <br /> , Sec.23.0A RIGRTS OF SilBTECTS OF DATA <br /> Subd. t. Iype oP dats. Thc rigAb of i�ulividual on whom the dara is s�nred or w be storcd shall bc as sct focrh in this xction. <br /> Sl�bd.2. Iafoematioa roquieed to be givee indivld+uil. An individusl asked ro supply privau or co�fidcnrixt dam coneeming himeeif <br /> stu11 be i�ormcd of� (u)�he puepose and ineended use of rhe requasud d�u wi�hin�hc collecring su�i agency,poii[ieal nibdivision,or sucewida <br /> system:(b)Whzther he may refuie or is lagatty roquired to supply tfic rcques�ed dan;(c)any lauwn consequence arising from Ais sapplyir�or <br /> refusing to supply pnvs�e or confidendal dau;and(d)ihc idenriry of�ther persons or anrities aqiho�izcd by suu or icdcrai law[o rccoivc thc dr�. <br /> This requiremtnt shal!noc appfy when en i�ividual is asked to suppiy invcstigacivc data, purzuane m see�ion 13.82,subdivis;on S,m a law <br /> enforccmcnt o�cer. <br /> ThG CMl�rt+l�iintur nf rtvtTlu!rt1pY j1]8C fI1G M1UL![�COUI/EfI l4RA�f flll���Ihtliviaiqn i!1 Iltie individyy�inCllrtlt(Hz(1f PfOrertV ta7C_f6lSl� <br /> instn�cri�n.inaead�f nn tho6e fetms. <br /> Subd.3. Aecess to duto by Indiv(Aual. Upon request to s rcsponsible tuthoriry,nu individunl chall be informed wherher he is the <br /> subjecs of seorcd data on individuzls,and wherher i�is classifiod a�public,privute or confdenriaf Upon his funher requesr,an i�ividunl who <br /> is the�ubjcct of Stored ptivare or puDlic daa on individtuls shall bc shown the dnra widiout any clurge[o him�nd,it he desims,shall be informcd <br /> of thc con�en[and meaning of that dra. Afcer sn individuel hti bcen ihown fie priva[e dacx atui inforad of its meaning,che data ne�d oot be <br /> disclosed m him for siz montt�s ehere4Rec unlcss a di�pu�e or accion pursuant co[!us section ix ponding ot adQitiomt dAa on Nc icMividua!has been <br /> colltered or creaad. "Ilu responsible oud�oriry shalt provide copiec of the peivate or public dR�a up��n rcqucee Ey rhe individunl suhjecc ot rhe dara. <br /> The responsible suthoriry may require the reques[ing person to pay[he setupl costs of mukir�,certifying,and compifing she copies. <br /> 'Ilu rwpnnsible au�horiry sYull comply immod'u¢ly,if possibte,w;d�nny requesr made pursuint co chis u�bdrvision,or wiMin five days <br /> of rho da�c of ihe rrquesc,excluding 5ewrd�ys.Sundsys and teg�l hofidnyr.if immediate complirncc is rwe possiblc, li hc conno�comply wirh <br /> �he reques[widun diac dmc,hc shuJ1 so inform ihe individuni,and may havc an addiuonal fivc dnys wieh;n wh�ch m comply with r!u nquess, <br /> axctuding Sacurdays,Su�ays and lega!hol;days. <br /> Su6d.4, ProceeJure when data Is not aceurate or complete. An�ndi�idual may cen�es�du accuracy or comple�eness of public or <br /> pmaec dacs coneerning himselY. To exarcise�hie righe,an iadividual shall notify in wrlting tha nsponsible suchoiiry dcacribing che inture of[he <br /> diwgreeman�. 'Ilie responsiblc au@wriry clv�l wi�hin 30 days eithar. (a)cotrect du dau found m te inaceurnee or incomplere aed oerempt w nocify <br /> pase recipierus of inaccucsa or incompteoe dau,ineluding recipienes tumed by rhe individual;or(e)mt�ty rhe irtdividu�l�[he believes the da� <br /> �o ba corrcc�. Dau in dispuro shsll be diu}osed only if rhe individusil'c cmremen�of dis�greemEn[�s includcd wi[h thc discloocd deu. <br /> 71+e deterntinadon of 1he rssponsible au[horiry may be appealed pursu�nt[o the provisions of tAc�dministrative proczdure ace reluing <br /> w concrsted cases. <br /> DATA PRIVACY AnViSORY <br /> ln accordaaee with M.S. 13.04, Subd. 2, "Rights of subjects of data", ae would like to inform you rhat your <br /> requesc for a pi:rmit or license fzom che�i[y of Orono or any of i�s deparcments may require you to furn�sh eertain <br /> private or confidential informa�ion. <br /> You are rwtified[hat: <br /> 1. Tne intormation you furnish will be uud to determine your qualification for cht permit or license <br /> requested. <br /> 3. You may refuse to supply data, bu[rcfusal may require that the Cicy deny�he permit or license. <br /> 3. The information may be shared with ocher local, scate or federa! agencies to ihc extent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requites Council accion to approve, some information may become <br /> public. <br /> 5. You have certain righcs under M.S. 13.04(ava'tlable upon requc:st)to review private data on yourself. <br /> 6. Your full name is required to process this application or perm�t. <br /> ��Ct �C� `-- �AUV Ll <br /> Z1d r�p ��,Aee . �.�C�.in3�. L � <br /> Addr��,� r��� ��.� � ���-a3� <br /> c�� � sa« z�v pn�� <br /> 1 sighcs as stared above. <br /> S�gnaNre <br /> 6 <br />