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rv oF oRONo � 61247305�0 o9�24/96 14:00 � :03/03 No�522 <br /> �. <br /> Sa-13.04 lt1GA'i'S QF SUBJ�CTS OF DATx <br /> Subd. 1. Type of daU. 'T6e d�bu of indlvidiu!oa v�hom the dara I�aeored or to be smced�hall ba ai sct fords In chis ues3on. <br /> Subd,3. InPonnatlae reqvdrW to b��frad Iadividuat. M tndlvidwl askad ro supply priwa or oonfidenria data�onosrning hinuelf,ihall <br /> ba lnto►med of; (a)tha purpoce and(ntaaded uu ot�he tequesce�0 d�a witt►!n�hc collcwdcsQ►nce�genoy.poUticxl aubdl�isian,or snrowide syunm: <br /> (b)whether M may mNse oT is leeally.rcqttired co supply the raqueseai daca:(c)�rry known consequenee ariting from htt�Upplyln�or cell�ting te supply <br /> privi�a or ooatidadda!d�a;and(d)�he ictenricy ef odie�person�ar endoes authocixed by sum or federal I�w m rrxaire d�e dara. Th�i ttqulremenc sdull <br /> ncu apply whe�4n lndividuN i�esked co mpply inve�rigadve daQ.purtutnt ro ceedon 13.62, subQivision S.to a I�w enforcemenc oiPicar. <br /> , <br /> a cp �i}sk�ne_r_ PQ�eve tL,ue mq� nlace du not{ce requircd under this su6divisf�n In�ft� indivfdual incotne tax or oroosm re�;ral�frid <br /> --`-� 1TlE�illcdont in�(on nc�ro ior�,�+ . — - - • „ <br /> SuEd, 3. Arcees to daka by tnd[vidual. Upnn r�ques�ro�rcspun�ible wtbo�ry,in indiYidual shall ba infonned wharher lu b the snbJmt <br /> of itorod dra on indlviduals.sad whtdter ic is classlfied a�publi�,p�ivaee or confldetuial. Upon his ft�[r!►er reques[,�u►i�ividual who ia the subj�t <br /> of uo�ed priruo or publlc dua nn individu�s shall be shoWn�he dan withouc ury char`e w him and;if he de�ires,�h■Il be infonned of the wnten� <br /> snd mMnlns of d�atAaa. Afur�n irali�idus!har beaa shown�he pd�au darA usd infomxd of iu meanins.the Wta deed twt ba discloud to him far <br /> �ix mondu tkeraaftar uiilcss a dispute or acdon punuanc m �his seedan is pendinQ or addirianal dan on the individud hat beea ootlec[ed or creatad. <br /> Tha tespnti�ible�uthQrity cfull pro�ide copia�(ehe prnrue or public dea upon reqvesc by rha individual a,bJec�of dro dan. The rerpons3te ausha�i�yr <br /> msy require due eequestin�person ro pry d�e aeaei cos�s af ma{cta;.eertifyin�.�nd compiilaa rhe cop»s, <br /> 7t�e Ksponcible surhoriry.�hali comply immadiatnly, if possibk.aidi a�roqu�sc mado purcuant w�his Yubdlvision,or.vithln fi�e days of <br /> �he date of ehe raquet�.excluding 9uutds►yt,Sundays rnd l�;d ho!ld�ys,if bsunedlace compltance ii not po�sibl�. If�Le caraioe comply wid�d�e reques� . <br /> wlthln thu dme,hv ahsli w it►form che Iadividual,and may h►�e�►.ddirioat!five d.ys wid�in which ro comply wiTh the requesc,excludlpg Sawrdoys. <br /> 51�n�l�yi�nd k�rl holtd�y�. <br /> Subd.4. Proeedur�wh�o doea�net oceunt�or eomplate. An tadlvidual mty co�►ms�the nccunay or wmpluenou of puMlC o�privua <br /> dia eoncorn�6imself. T'o axercise ihis right.an indiViduel shsN aotilyr in wridng dse respotu�bk wr►wci4Y ddr�iblit�dse na�uro of tho Ql�agceemenG . <br /> The ea�un�lble�u�horiry d�ell wi�►i�30 days eirher. (�)correec tfie dam found ia be inaccunte or inccm►ple�e�tnd�tiecnpt ta nodfy pue reciplena oE <br /> irniiewiate or fn,caroplete dpn, Includina recipfenu nam�d by�e individual;or(b)aotiPy du individual that he belleves the dus to be ootreet Dia <br /> ia dkpu�e ilfall be disclo�ad only if tha indlvidu�l's tn�ement of dls�t�eem�u fs tncladad with�he di9closed dara. � <br /> �1�e dotamunadon of�he rcspansiblo su�horiry maY bo appealed pursuan�w rh�pro�isbns ol rhe admtnicrndve pmcedum act rel�rir►`co <br /> wn�dsrod ca9es. <br /> � pATA�YACY�l,�VI$ORY � � <br /> !n accordsnca with M.S. 13.04�Subd.2, "Itlghcs of su6jects of daca", we would Iike co iaform you thet your rcquesc <br /> for a permlt or license from ihe City of Orono or any oR its depanmeats may nquhe you to [umish certain prtvate or <br /> confidential iaformation. <br /> You are natified that: - <br /> 1. The informattan you furnish wUi be used ta dccermine your qualifica�ion for�he permfic or licensa requosced. <br /> 2. You may rofuse to suppiy daca. bue refusal may requfre tha[ [he City deny the pctmlt or licctt�e. <br /> 3. The informatinn may be shered wich ot4�r local. srata or federal agenciea tn[he extent nexessary to process <br /> the permic or lkense. <br /> • 4. . Tf your requaeced petmit or licetue rtquirec Council seilon [o approve, some infarmatlon may become <br /> ' pubtic. . <br /> 5. You have certain righ�s under M.S. 13.04 (available upon request) to review private data on youra�lf. , <br /> 6, Ynur fult name is requircd to pr ess tbls application or petmit. <br /> . �� d — � � I <br /> ' r , � � `./ � . <br /> C1 . . - sn� zip Phona <br /> j 9�a �� ���� <br /> t•understan my rlgtits as :ca�ed . • / ��(/� <br /> (S� �7 <br /> 8ign <br />