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Sec.13.04 FtICTFiTS OE SLTBJE <br /> C7'$OF DATr1 <br /> S�bd. 1. Type uf d�td. �°n8hrs of individual on whom thc dau i5 stored ot to bc stnred sh.�ll be as scc fordt in this seca��sc,f snail <br /> I rivatz or co[�£'idenrial daca toncec'nin8 <br /> esiad datn withia che collecting Statt agcncy.political sub�livisloo,o�statewidc system: <br /> Subd_2. I�Pormation reqcored to be�ven indi'�dt1:�. ''`n i�dividuai�ske to s�P4 � o�YeCvsing co supplY <br /> c ,t osc aIId intcnded use of thc Rw � 1R �o�coo.scqucnce atisin3 f���s sfPP Y�S <br /> bc informcd�E_ (a) th P rP �e.� cs;ed dnm:( )� Y <br /> �b)�vhc4yer he may n�+se o'r is Icgally required to suPp�Y � sta�e oc fede�l Iaw co rcceive che data- This requuemcne s6 1 <br /> Iv invcso ative daa. pur���YO ;ecdon 13.92. subdiv�sion 5, rn a la�+citforeemenc officer- <br /> pnvuce or cenfjdcnti�l data;and(d)che idendry oF othcr perons oc endd�s autharizcd y <br /> no[apply �hen an indi�idual is asked �o �pp- 8 <br /> Zlt <br /> c commi5sioner of re�renuc mav Iace th� noricc re uired under this subdi�isi n in thc indiv'dual income,_ta�r vrov���u—tix-'T�" <br /> insttz<<;yns�nsCe3d of on cho c F2rms- . <br /> bd. 3. Access to datn by� a��,.;s furrbcr requcsc, aa individual Who is�'�e subject <br /> Su u,di�idual- UP°n rcqUese tn a responsible authenty.an individual shall be infocmcd whechec he is chc su 1 <br /> ec: <br /> �ichout anY chacge ro htm and.��5e�e dac.1 n,ed not b od v oscd roe h�ltf°r <br /> of s�orcd data ott indi�iduals, and whe�her it is classiftcd as public, privaee or confdenti�l• UP <br /> of stoeed pri v a te ot p�b��c data on individuals shsll hc sbow+ti rhe da�a. <br /> or addidooal dara on�e individu a l has becn collecmd or c;esmd. <br /> and mC�nB oE tbac ds'a. After an individual has been shown che p rivat_data 2ndulnfa by the indiv du�bject of rhe data, The respoosiblc au�ho�iry <br /> Sit mon�ls the[c2Eter unless a dis�ute oc acclon pursuant�o chis seccion is p�ndin� <br /> the accual cosu of rttal�ing. certiFying, and compilin8 the copies. <br /> Tne rosponsible au�harity shall pravide copiez of the privam or pubVic da�upon[�Q W,� ����Gucse <br /> may requirc rhe requesting pCrson to pay cdiaccl if ossibte, with anY rcquesc made pursuanc�o this s�bdivislon.or wichin fivc days of <br /> The tcsponsible auchoriry shall��mp�Y�� y' p t W���e rcqueSt,exc:udinS 5°'u�days. <br /> '.•' ual and may havc at�addicional E'ive days withtn whlch tv comP y <br /> �he datc of che ccQucst.excludl�g SatutdaYs•�undays and lcgal holidays, if immediate comp�i��e is not possible. If he canno�comp <br /> wi�hin rhat time.he shall so infot7n thc indi i , <br /> 5undays ancl lc¢af holidays. letencss of public or priyate - <br /> ��,�s onsib{e authoriq'desciibin��he naNr�of the disaS���c�C. <br /> Subd.4. Procedure when d�ta is not�ecurate or coatplete_ An individual maY�oneasc thc ac�tra�Y or co �S�reCipients of <br /> �a�cvnc�ming himselP. ?o czercise r1�is nght,an individual shall nodfy in wricing p�e i�fdividu�l 4`�t he bclieves the daea ro De correcc. Data <br /> 'ihe respor.sible nutnonrY shx��"'��in 30 days eiCher: (a)coct�ct riie data found ro bc inaccurare or incoeipletc ar,d ar.empt to noa P <br /> �n3C�u��o��n�ompleto daca. in�ludin8 cecipian� named by che individual; or(b) nodfy <br /> F the r�s onsiole authonry may be appealcd puFuan�to ch: provisions of she admsnistrative proc�dure act rclaan� �o <br /> in dispute shall be discloscd onty if chc individual's statcmenc of disagretmcctt'ts includcd wi;h the diselosed aca. <br /> Tlte de�ertnination o P <br /> contes:ed eases. �Tjs R.Y <br /> DATA R�ACY AD <br /> " we would li�:�to iriform You that your requesc <br /> of O�ono or any of ics departments may require you tu furnish certain private or <br /> In accordanee with�.5. 13.04, Subd.2, "Rights of subjects of data , <br /> fo� a pertnit ot license from the City <br /> confidential information,. <br /> Xou are no�ified that: <br /> o furnish will be used to deternline yout qualifieation for the permit oz.license requcst� . <br /> re uirc that the City dcny tYtE ���t or license. <br /> �, The inforznation y u to rocess <br /> �, You may refuse to suoply daca, but refus3l maY �1 encies to the eztent necessary P <br /> 3. <br /> The inforrnarion tnaY be shared with other loc�l, state oc federal ag b�comE <br /> t�,e pertnitq r lice Pe• uixes Council action to approve, som� info�nation maY <br /> 4, If yaur te uested ermit or license req <br /> public. <br /> 5 Xou have c <br /> ertain zights under M.5. 13.04 (available u�onee�est) ro revie�v privaCc data on ynuzselr. <br /> 6 Xour ;ull name is zequired to process thi.s applicatton or p <br /> _.---- <br /> �-� Las <br /> �►1� e vtiddl� --------' <br /> First � ��_ <br /> ----11�! -` SSYY �-�- sv�s� <br /> Addross phonc <br /> -- Statc Z�P <br /> C" �� . . <br /> t undc � my ric as sta��bove. r <br /> � ,,,�, ._._..___--�._—•— <br /> ;- —_ <br /> ��g ture <br /> l�6-a Z�Q/ZO.; d F9E-! 919y°�ZZ561 oN0a0 �� ,lll�-we�� weEO� ll l�OZ-lG-,10N <br />