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� •� Mar 03 04 09: 02a DavidSchweichConstruction 952 469 3920 p. 3 ' SecJ 3.04 RIGfII'S O�SUB�EC7S OF DATA Subd.1. 7ype at data The righis of individual on wtwm the dala Is storcd or to be stored shall be as set fort6ln this rxction. Subd.2. l�rformsdar required�o be�lven individual. M lndividuaf asfaed to supply private or ca�fide�lal deta coxerning hinsdf shall he infortned of: (a) tbe purpose and iMended use oF Ihe requested data vrithin Ihe odkding s�le agenc.Y, P�dca! s whether he may retuse or ls legally required lo supply the requested daia; (c)anY laiovm oonse9�nce from�� a� stalewide system; N) ivafe or corddentlal dala;and d Ihe Idenfi of other �� PPh'�8 or refi�sing to suppiy Pr ( 1 ly pe�sons or e�rtities sut6orised by state or federal law to reoeive fhe dala. This requiremmt af�all no1 apply wtien an individual is asked fo supply inveatlgalive dala,pursuaM lo sation 13.82,subdivision 5,lo a faw en(oroement olfloer. lhe oommissioner af nwenue mav nlace Ihe notice reauired under thia subdivision in fhe individual income tax or oroneriv lax refwid instruclions inslead of on liase tortns. '"" Subd. 3. Aocess to data by I�Mividual. Upon requesl to a responsible authodty,an individual shall be irdormed whelher he is tde subjed of stored data on Individuals,and whelf�er 11 is dassifled as public,private or confideiRial. Upon his turther request,an individual xfio is the subJect oi aeored privsle or public data on indlviduals sFiall be slaxm Ihe data wilhoul any diarge to him and, if he deslres,shall be lafornied ot tfie content and mea�g � that data. Aiter an individual has been ahuwrti the private data and Wom�ed of Ns meaning, Ihe data need not be disdosed lo him far six montls thereafter unless a dlspute or acfion pursuaN to this section is pending or addiUonal dala on lhe uidividuat has been collecled or created. 'flie responsible authaity shall provide cwpies of Ihe privale ar public dala upon request by U�e Individusl subject oF the data. The responsible authmily may require Ihe �B P��lo pay the actual aosts of malring,cerl�ying,and wmpillng t6e oopies. The respons�ble authwity ahall rnmply irtpnedialely, if poas[hle,wilh ;my requesl made parsuanl to Ihis subd(vlsion, or wlUdn 6ve days ot the dale of the request,excluding Saturdays,Sundays and le�l holidays, 'rf irtunediate compliance is nof possible. It he cannol compy wilh Ihe request wilhin thal lime,he shall so inf�m the (ndividual, and may ha�an addlllonai five days witl�in ufiid�to com�y with the request, exduding Saturdays,Sundays and IegaT holldays. 5ubd. 4. Prooednre wl�n data is not accurate or camplete. M lndivldual may cantest the accurary or completeness of pubUc or prhrate data conaerning himself. To exerd9e this rlght� an individual shall notl[y in wr9ting the responaibk auttwrity describi�Ihe nature d ihe dlsa�eemeM. The respoRsible auUwrity shail within 30 days eilher. (a)ca�ei.t tlee data found to be inao�wale oc inooaipkte and attempt to notiiy p�at redpienls of ineccuraie or incomplde data.indudh�g reclpie�rts named by the ind'wldual� or N) na�Y Uie individuai ih� he belleves lhe d�to be corred. Dats in dispute atiall be disdased only if!he indivldual's slateme�of d�sagrse�nenl is induded with the disdosed dsGti 'flie delertnination of ihe respaaibk authority may be appeale� pursuant lo IMe provisions of the administrative procedure acl relating fo conlested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request for a permit or ticense from the Ctty of Orono or arry of its deparhnents may require you to turnish certain private or confidential infomiation. You are nobfied that: 1. The infortnation you fumish will be used to deterntine your quali8cation for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City derry the permit or ficense. 3. 'lhe infortnation may be shared with other local, state or federal agenaes to the.extent necessary to prooess the permit or license. 4. If your reqaested permit or license requicea Council action to apprave, some information may be�ome public. 5. You have certain rigMs under M.S. 13.04(available upon request)to review pmrale data on yourself. 6. Your full name is required to process this appllcation or permit. ��C� ��n f,��-��/1 ��Y1S`�..1��? U� ��l'� l � �!��-�C•I� �,�a.,vu.� �� '��.ez �� Q e l�-trv ��1=t u �Sa —��i -3 ZZ Z Cily State ZIp Phane I unde ta my ts as stat abo Signa ure ' .