2001-P03876 - new home - Laserfiche WebLink

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Sec.13.0,t RIGHTS OFSUBJECTS OFDATA Subdivision I. Type ojdal¢ The rights ojindividua!on whom the data is stored or 10 be stored sha11 be as set forth in this seclron. ' ' Subd 2. Injormation required to be given individual An individual asked�o supply private or confrdential data concernrng himselj shall be informed of (a)the purpose and intended sise of the requested data wrthin!he collecting state agency,political subdivrsian,or statewide system;(b)whether he may refuse or is legally required lo supply rhe requested data;(c)any knotivn conseguence arising from his supplyrng or refusrng to supplyprivate or confidentral data;and(d)the identity ojother persons or entities authorized bystate orfederal!mv to receive the data. Thrs requirement shall not apply when an individua!is asked to supply imestigative data,pursuant to section 13.82, subdivrsion S, to a Imv enforcemen!o�cer. The commissioner ofrevem�e may place the notrce required under thrs subdivision in the individual income!ax or property tax refund inslruclrons rnstead oI on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individi�al shal!be informed whelher he is the subject ojstored dala on individuals, and whether it is classified as public,private or confrdential. Upon hrs further request,an individua!who is the subject of stored private or publrc data on individua(s shal!be shown the dala�vithoirt arry charge to him and, if he desires,shall be informed of � the content and meaning of�hat data. Ajter an individua!has been shotiyn 1he private data and rnformed of its meaning, the data need not be disclosed to hrm for srx months thereajter unless a dispute or action pursuant to this section is pending or additiona!data on the indrvrdual has been collected or created. The responsible authority shall provide copies ojthe private or pt�blic data t�pon request by the individual subject of the data. The responsible aulhority may requrre the requesting person to pay the actua!costs oJmakrng,cert�rng,and compiling!he copies. The responsible authorrty shall comply immedrately,rfpossrble,with any request made pursuant to this subdivisron,or wrthin frve days ofthe date of the request,excludrng Saturdays,Sundays and lega!holidays,ijimmediate compliance is not possible. Ifhe cannot comply with the request tivithin that time,he shall so in1'orm the rndividual,and may have an additional frve days lvrthrn lvhich to comply with the reqtrest,excludrng Saturdays,Sundays and legal holydays. Subd.4. Procedure when data is not accurate or complete.An individual may conlest the accuracy or completeness oJpublic or privafe data concerning himselj. To exercise this right, an individua!sha!!notrfy in wrrtrng the responsible authority descrrbing the nature of!he disagreement. The responsible authoriry shal!tivithin 30 days either: (a)carrect the datajound to be inaccurate or rncomplete and a�tempt!o notify past recipients of rnaccurate or incomplete data,including recipients named by the individual;ar(b)not�the indrvidual that he believes the data to be correct. Data in dispute shal!be disclosed only rf the individua!'s statement of disagreement is included with the drsclosed data. The determination of the responsible authority may be appealed pursuant to the provrsrons of the adminrstrative procedure acl relating to contested cases. DATA PRIVACYADYISORY In accordance ivith M.S.13.04,Subd.2,'Rights of subjects oJdata",tive tivould like to inform you lhat your reguest for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or confidentia!injormalion. You are norifred that.• 1. The informatron you furnish wil!be:�sed lo determine your qualrfrcatron jor the permil or license requested. 1. You may refuse to suppfy data,but refusal may require that the City deny the permit or Ircense. 3. The injormatron may be shared ivith other local,sta(e or federa!agencies to the extent necessary to process Ihe permrl or license. 4. Ifyour requested permrt or license requires Counci!aclion to approve,some injormation may become public. S. You hme certain righcs under A�1.S. 13.04(see folloiving page)to revietiv private data on yourself. 6. Your full name is required to process this applicatron ar permit. PLEASE PRINT �c� t�obk-f /�� ren na ,. � ��l� f�-v.�.�--� }-��.e,r-5 Frrst Middle Last I� �� /1�1:�N C,�,�f �3I��P . Address ��A�a�� /j1V �5�S 39 � Crty � State Zip Phone ��j �j/76 'S�q Cr l:o derst ry ri :1s a s�ated above. ( ignature 10