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TY OF ORONO � 6124730510 09/24/96 14:00 �1 :03/03 N0:522 <br /> . . . <br /> Sse.13.04 RIGI�TS OF SIIBJ�C'rS OF DA1'.1 <br /> Subd. 1. Type of dsts. 'fAe riydts of indlvidud on whom ths data I�srored or ro be scorcd shall ba u see fordi!n thu ucoan. <br /> Subd.3. infoRaatinn riqtdnd to ba�1►en iadloidaal. M individual asked ro supply priwa or con�idendel d�a concerning hiteaelf shall <br /> be(nfonped of: (�)dte purpose and inunded uu of the�equesced dan Withiu rhe oolleednQ lnue agenoy,polldcal aubdivision,or snro�vide sy�tem: <br /> (b)wfiether la may refuse ot i�legWy required co supply rhe roquesnx�dau;(c)�uty knoum consequence atising from his supplyln�or reA�sln�ro svpply <br /> privata oc coalidend�!dsta;and(d)�he idennty of od►e�persom or endoes aud�onzed by sum or federai!�w sn rGeeive rhe daia. Thi�m�utreme�c shull <br /> noc appiy wheo an individunl is esked[o mppiy inretrigadve daa.pursutm to ceedon 13.B2,subdivirion S,to a I�w enforcemenc otffcer. <br /> '��i sgne*^�M� nue ma� alace che noejce c�wiced under 's s bdi�ision►n ihe individu�l income �az ar orooem mx,ro�ind <br /> -� ` jpEuucdon�i�a�uf on�w}e forms. <br /> SuDd. 3. A�eese to data br iadl�tdu�l. Upon rcquest ro a rcspan�ibie sutho►iti,�n individual shall be informed wherher ha u tbe a�b)ees <br /> at norad dau on i�dividuals,and wh�thar it is clissified�9 public,pdva�e or conPklen[iai. Upon his}1lrther rcques[,an individu�l who i�rhe rubjact <br /> �f uorod pri�ue or public dwu nn individu�ls shall be sho�►rn rhe dara widtout sny ch�r�a W him and;if he desliroa,she11 be infortned of ihe wntenc <br /> u�d�r�nL�a of d��t daa. Afur on i�xli�idua!da�bean shown the pd�ata dara�nd iafornxxl of us meaning,the dea aeed noc bs diulo�d to him far <br /> d:anondu thersafur uale�a dispute or action pursuattt m �his:eedoa i�pendlna or�ddidonsl dua on the iltdividud hat been eoUected qr created. <br /> 11�e mponiible�uthpriry ah'll pro�ide copies�f du prirzm or public de�upon requesc by�he individua!subjee�of d+e dara. The ro�pon�ble iuchoriry <br /> auy requite the mquesdn�person ro pay d+e ucuel cos�s of making,certifyino,aad compiling rhe wpia. <br /> The Ksponaible sudwriry.�hall comply irtunadlatnly, if possibk,with aay nquest made pursuant m this:ubdivision,or ai�hln fl�e days of <br /> �he date af the raqueet.excludir►a 3amtdays.Sundays ond le�d holldays,if immedlaee eompltance is not po9sibla Ihhe cannoi comply wid��he roques� <br /> altl�in�ha[�Lm,ho�ha11 ea inform�he lndividud,and may hs�e�n nddlrion�l flve d.ys wi�in which co cornply whh rlie roquest,excludlag Saardays, <br /> Sund�ye and le�pl holldaye. <br /> Subd.4. PtoeMure wheti dnta is net aceurate or enmpltte. An indi�i�uvl m�y eomes��he accurrcy or complercnos+of publk or privue <br /> dia eoneern�nR himself. To exercise rhis Nght,sn individuel shsll ao6fy in wridno che responsble eurhurit,y desetibl��d�e necuro of�ho diasroemenc. <br /> The teapecalble authoriry sl�ell wid+in 30 days ei�her. (a)correcc the dam found�o ba inaaurare or inc�tnplea and stoempt te nopfy pta recipfena of <br /> iaaaunte or incaroplete dpa, includin�reoipienu named by d�e individud;or(b)eodfy rhe individual�hec he belleves the daa co be co�rece. Da�a <br /> ia d�tpu�e shall b�diacloaad only if the individusl's sdart�nt of disa4reemenc is includod with�he di9cloaed da�a. ' <br /> '�'he detemninntion oF�he responsible.utboriry may bo appealed pursuani eo th�pro�isionc of dte adminisemrive proeedure act rrl�ring to <br /> aonmsted ci�es. , <br /> ' A�TA PRYVACY ADVI$QRY <br /> !n accordance with M.S. 13.04,Subd.2, "Righu of sutijects af da�a", we would like co inform you that your requesc <br /> for a pefmu or Itcense from the City vf Orono or any of its depanments may nquire you to furnish cer[ain private or <br /> confidential information. <br /> You are notified that; <br /> 1. The infoctnation you furnish will be used to decermine your qualificacion for the pernnic or license requesced. <br /> 2. Yuu may refvse to supply daca, buc refusal may �equire thac che City deny the petmi.t or license. <br /> 3. The information mey be shaced with otdCc loeal, state or federal agencies to the eatent ncc�ssary to process <br /> the permic or license. <br /> � 4. . Yf your requeated permit or liceuu requires Council action co app�ove, some infarmation may becomc <br /> ' public. <br /> 5. You have certain rights under M.S. 13,04 {available upon request) to review prfvate data on yourself. <br /> 6. Ynur futl aazne is required co process this applica�ion or permic. <br /> � � r�..— �a �� . <br /> , FircT dls �� Laa. <br /> L�ao .�n� S�-} �a�` <br /> � . � � � �sa� c . c�ou�- <br /> c,ry sb� z� r�oa. <br /> " t•unde tand my dgh stat abova <br /> s�dn.an <br /> D,.,,_ ....] mf. n n. � �nn�r n. . � �n� .. .. . , ....... <br />