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�Y OF OR9NA � b��47305�0 09/�4I9b 1�:00 �1003/03 ��e-5�� <br /> . <br /> Sac.13.04�IC,ii'i'S�F SIJH�JEC'�5 mF P�A'P•a <br /> �ubd. 1. 'Tyge oP aista. `�Ae el�hts of individumi o�s whom the�ats Is scored or to ba stomd shapl be�.s set fonh in ehis�eedan. <br /> Subd.3. I�Par�atlon roqssd�rad cu ba�Ir�n indi•(duat. An(ndividud asked to suppiy privare or oonfidendal data canccecilng bitnaelf,�hall <br /> be Infotined of; (o)die purpose at�intended use of�J1e qeques�ul d�m withia ehe eotlecdny Bhtt agenoy,polidcal subdivisian,or statewide rysmm: <br /> (�)whethor ho may cePuse oT is tegalfy requieed eo supply the Yequ�sied d0u;(c)any knoa+n eonseqneate ariaing from his eupplytng or refUsing to supply <br /> privaca or coc�iden[ia!dara;and(d)�he idenriry of ocrie�persons or endries auchorized by s�a�c or feder�l!�w en e�eeive[he data. Thit requlremeoc shull <br /> �ot�pply whe�an individual 1�esked�o supply invesrig�dva da�,Pursunnt e�secdon 73.82,su�sllvision S,eo�law enforcemenc oPPfcer. <br /> ,.� <br /> o �ummi�signer Q�revenue m � �nlace the no�,a r�cuired under this subdi�isi� in �tee indfvtdu�i income �ax ar orooem r�x�rel�ind <br /> � , sdons iq� ac�u�on�090[�rrng. " , <br /> Subd,3. Areee�eo data by 60dl�fd�ai. llpnn eeques[to a respunsible au�hariry,en 1aai�iau�shau ue i�formea wne�n�r ha le�he s��nJ�cc <br /> ot uwted drn on indlviduals.amd Whe�hme ic is classified as public,p�ivace or canfldepdat. Upon 6is tUrrher rcques[,an individual who is�he subject <br /> of icored pri�ate or�ublio d�u en individuals shall be shown the dan withou�sny chae`a w hi�nnd;if he dea{rea,ahatl be infotmed of the content <br /> and�aning of�hAc da�. After an individusl ha9 been shoWn ahe pd�au d4ra nnd[nformed of ics mesning,the dan need ewrba diaclased co him far <br /> a{a�nnrha thereafter unleu 9 dispu[e ar acrion pursuanc eo ohis seeaoa is pendinB or addirionrl data on lhe individual has been oullected qr creared. <br /> 11�s tsspunaible�uthpriry ehill pro�ide copies of rhe priYi�e or public da�upon requese by�he individua!subjacc of dro dara. The responsible au[ba�ry <br /> q�sy requiro cho raqueadn�pmeson ro�my rhe actual coscs ef maJcing,cattif�iny,and eompiliag�he oopiea, <br /> The nesp�naible suthoriry chall eomply immediately,if possib[e,with any request mede pursuant sq Wis subdivision,or wii!►In five days of <br /> d�e date of ehe eaquea[.xxcluding 9amrdays,Sundays and leg�l halldays,if immedla�e compllsncn is not possible. If�he cattna�somply with rhe eeques� <br /> wirhin chac cime,ho�hal1 eo inform cha Individual,and may have an addl�ional Five days widiin which m comply.with che requese,exeluding Saa�rdays. <br /> 9�andtya and le�wl holldaye. <br /> Subd.4, &�roeeduea whQti do�a is net accurata or eompl¢te. An indfvufunl mey contss�the accuracy or complereno�a of publ[c or privace <br /> daa coneorn�himself. `Po exercise rlus right,on indi'viduel shall no6f�r in wridng ehe respunsible�uehoc{ry daciibl�g dw eantea oP the dltegreamcni. . <br /> Tht teapenalble outhoriry Sl�ell withi»30 days either. (a)correc�the data found ro be u�ccucate or incomplece and aaempt ta noafy p�i�reeiplenes oE <br /> inaeeucnto or in.camplete dara,Includin�roaipien�s nanud by d�e indivfdual:or(b)notif�r thc indivirlual that ho belleves the daw co bo cotrae� Data <br /> ia d�Cpu�e ehsll be diaclosed a�ly if tha i�ufividusl's sa�ement�f dlsagreemnne is includad wirh�he di�cloud dara. ' <br /> 3'he detemnination oP�he ersppnsible auVioriry m�q bo appealed pucsvem eo 9ho pro�isionc ol qhe adm�nisesadve proeerlure act relarinB� <br /> wnte9ted crees, , <br /> � p,�TA PRY'VAC�_ADVI�QRII - <br /> i�ascordance with 1!/t.S. 13.04,Subd.2, "Righcs of sul'sjecta of da[a", we would like co inform you that your requesc <br /> for �permit or licensa feom the City of Orono or any of its departments may requlra-you to furnish certain private or <br /> confidential information. <br /> �'ou are notifted th�r. <br /> 1. The inform�tton you furnish will be used to decermine your qualiftcacion for che permic oriicense requosced. <br /> 2. You may refuse co supply daca. bur tefusal cnay require tha� the City deny the permlt or licotlse. <br /> 3. The information may be shared with othCr loesl, state or federal agencies ro the extent necossary to pmcoss <br /> thc p�rmit or licensa <br /> • 4. . Yf your requeited permit ar license requires Council aetion to ap��ove, some infarmation may become <br /> ' public. <br /> 3. Yuu have certain rights under M.S. 13,04 (availa6ie upan request) to review private daea on yourself. <br /> 6, Ynur ful! name as required to roces5.,thls applicz�ion or permic. <br /> � �_���� . <br /> "� � � 0 � : �"'� d'. S-�-e. �-Z�\ " <br /> r �� � ' V � LL/v 1� <br /> cicq - �mrm e^.ip Phona <br /> � <br /> ' t•u erstand �ny righ • seaced ubove. <br /> nnN�e <br />