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N��g-2?-Z001 08:23am From-CITY OF ORONO +g522494616 T-685 P.003/003 F-617 <br />� <br /> ` � . <br /> Sec.13.o4 RiGiiTS OF SC.lB.TEC7's OF DaTA <br /> Subd. i. Type of data. Thn dgku o!iadividual oa wbow sAe d�a is uoRd or ro be scored shal!bc as sct for�h in dus section. <br /> Subd.3. Informatioa req+ssrcd to be�;ivea iadividw3t. Pui iadividual asiccd to supply privaa or confidaadal dat�coaccroing himsctf sdall <br /> be informed of: (�the purpose and farended use o!fLe nqvesrsd dan widiio die collecriag S�sce agracy,policical subdivisiosr,or sncewide sysrem; <br /> r,b)wbac6er he►suy refusc ot is legaUy nqui�sd eo supply�Le:eqnemd dan:(c)any l�wn eonsequeace arisiag t�vm bis supplyiag or refus�g eo supply <br /> privsre or wuiidentr+l dac►;and{d)ehe ideaacy of oiherporsons orendaes authorized by s�u or fednrel!sw to►ticeive ihe dsta. This tequiremea[shsIl <br /> not apply wh¢n an iridividual is astied to supply invascguive daa,putsvsnc to secrion 13.83,subdivision S,w a faw snPorcemea�officec. <br /> 'T'he commissioner of_ 'enue mav oface the nocce reaui�eci anQer deis subdivision in the individual ome mx or arooem ux refarxl <br /> inse�uctions insT _ of on chose Po�ms. <br /> Subd.3. Access to data by iadividvsl. iJpon requesc to s responsble au�ocip�.sn ind+vidu�l shall be informed wbe�her he is ehe subjeca <br /> oF scored dara on individu�ls,and whc�bcr i�is class'�ied ss pubIic,pnvaa or eoafidendal. 11poa his futsher rcquesc,aa iadividua!wdo is tfu subject <br /> of srnred priv�u or public dara oQ individuals shall be ahown e6e dan.widiout aay charge�o him sad;if he desirea,sEall be informed of ine contenc <br /> and mrattiag ot�lfa[da�. Afur an individuaJ bss beea s6own du pri�ate dan xnd itttorraed af irs moaciag,du dan Aeed not be disclosed ao hisu for <br /> six mondis d�ereafur unlcss a d'upuu or udon pecrsaanc�o shis secaon is pendieg or sddicoa�l dan oa che individua!6ss bern collccted or crzased. <br /> T3e caponsible suthoriry shatl p�ov�Qa eopies pf the privare or pt,blie aaa apon ceqursc by che iadividtta!subject of�he dan. The responsible surho�iry <br /> may rcquire d�e nqucsdng parson to pzy du acnL�!cos�of malv�g, ccrdfyi�,and compitin6 tbe eppies. <br /> Thc�esponsible aurhoriry shall compty imme�iately.if possible,wid�aqy nques�made pursuant w rhis subdivision,or wishin five days of <br /> �he dau oP rhe requa�exctuding Saattdays,Sundaya and legsl holidays,if iiucnediate compliamca is noc possibk. If he wmo�comply widt d►e requesc <br /> wi�hin�}tu tima.he shall so inform tha ir,dividvaf,aad may lfave sa adJt�oaai hve days wirhin which to cocnply wieh�he nquess,excludiag Saturdays, <br /> Sundays and legal hoiidays. <br /> Subd.p. proexduie whqs data is aot accurate or complete. An individusl any tontes�t1u acc�uacy u�eompleceaess oP pubiic or pri�aQ <br /> daa eocieemins himself. To exeeeise td"u right,an indiridual shall noc�ty in wridag the responsible authoriry describing ehe nsn,re of rhe disagreea�en� <br /> T!:e cr,yponsi6le au�horiry sbatl wirAin 30 dsys ei�er: ts)cortcct du aaca tound ro be insccurate or incomplets and'acmpi to notiTy Dast�ecipienrs of <br /> inaccwaic or incomple�c data, including recipieaa nsmed by�e iadiviAvai;or(b)no�ify�hc individual that he believes d�e daw w be corisec Dan <br /> ia dispuce shall be diselosed only if du adivideui'S sneement of disagroemenc is included with the disclosed daffi. <br /> Thc daerminadon of tha responsible suchoriry may be apX.��led porsuauc�o rhe provisions of du admuusaacive procedure ac�nl�dng w <br /> concesxd cascs. . . . <br /> DATA PRI�ACY ADVISORY <br /> In accordanCe wich M.S. 13.04, Subd.2, "Rig�ts of subjects of data"�we would like to inforax yoa that your requcst <br /> for a permi� or liccnse from the Ciry of Orano or aay<�f iu departmears may require you to fumish cenain priva�e or <br /> confidential informatioa. <br /> You are no�ified that� <br /> 1. The inforinazioa you furnish will be used to�iecermine your qualification far the permic or license requested. <br /> 2, You may refuse to supply daca, but rcfusal may require that the Ciry d�ny the permi� or lieense. <br /> 3, The infotuiation may be shared wich other tocal, scate or federal agencies to the ex�ent necessary co process <br /> rhe permit or Iicense. <br /> 4. If your requesced permit or iicenst requiras Council action to approve, some informauoa may become <br /> pubIic. <br /> S. You have cer�ain rights under M.S. 13.04 (avaiiable upon request) �o review private dars on yourself. <br /> 6. Your fuil t�ame is rtquired to process thii application or permic. . <br /> � \ <br /> Amz�'�c�.6c<_�G.Cc�n..�Crr�ck�. ���c� (Q1cM w s�U.c � <br /> '�'�` o _� ` t 2d �f bo ^ �� <br /> �i(� � �t�c. <br /> _,�. <br /> �'S ,�lU ��`I a,��a� �'��5� ' - <br /> �r��i�1 I� <br /> Ciry Snre Zip pnone <br /> I uriderstaztd my righu as scased above. <br /> �'�'C,` �J W��_ <br /> Signsiurc <br />