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,Aua-13-2�02 10:31am From-CITY OF ORONO t9522494616 T-820 P.002/D02 F-448 <br /> �ec.13,0a RIG�"CS OF SUBJECTS OF D�,Tl� <br /> Subd. t- Type of d�ta• 'Yh�ngh�s or individuai oa wham�a dau is swrcd or[o br scored shAll be as sec for�:u Wis secrio:x. <br /> Subd-2. Iatoraauttoo req�nsed to be pren iadividuol. An i�dividu�l askcd co suppiY privaw oc co�deaaai dsta coacerniag birnsalf shall <br /> be infocu�ed of: (aJ the Purpose ar�d uucnded use of d�e rectucswd dap wirhin ihe collecd�suu�►scoer.poliDcal subdivisioa,or stacewide rysrem: <br /> Cb)whothes he may refuse or is iogally tequir�d�o supply�he eequesced Qara;(c)any 1�wwn con�equence srixing tmm his:upplYing or re!5►s�ng w suppty <br /> pnvrca or confidcnf�l dat�;usd(d)the idenary ot a�er penocu or enudes aucherized by:e��e or fedcrrl[aw io rcceiva the dats. This requiremnoc shall <br /> noc aQpiy whert an individua!is asked to supply invesogaove data.pursuant te secdnn 13.82,subdivision S,co a law anfoccemer,c offfcer. <br /> Ttte commi341one"of tl�enue mav isce the nedce r ir d under[his suDdlvision in ihe inCivi ual ' e or m e tsx rtfUnC <br /> in5� c:ions scraII o ea thcfsa forms. <br /> Subd.3. Aocsas to dota by usdividual. Upoa requcxc eo a rosponsible ruehonry,xn individust xhall be informed whcthcr he'ts d�n subjtcc <br /> o�stoad daw on uxiividsals,u�d w5e�her ic is classi�cd as public,pri��u or confidcndal. Upon dis!ur�ur requssc,Aa iadividuaT wno is[he subjea <br /> oP scoretl private or public d�a on individusis shell bt sCo�tha da�a wichouc any eharSc w hioa and.�if he daira�,tbali ba i,nfocrned of che contern <br /> and tntanins oP th�:dam. AFar an individu�l tsas bnen shown the priva�da�a anA infarmcd of irs aieaainC,[�e data oted noc be aiscloseS co�ijn lor <br /> six mondis�hnrr,cfnr unlCss a d'upu�e or acdon pur�ac eo eltis secoon is pcndirig or aaaidonal dau on�bc indirid�aE hu been co:lec�i or cr�aue. <br /> TTe ccsponsible aufiori.y xhnll provida eopies of the priva�or puDlic data upon rcquesc by che ir.d'svidual subjec�of:he da�a. The r�spansibta aushoriry <br /> may requir e.he raques:ing person w psy rhe ara�!csscs of mskinB.ccrrih'inS.and eompiliag t�a copies. <br /> 'The cesponssble au[h�r,ry shatt comply immed;a�ely,if possible,with say requess madt pursuxnt ro�is subdivisioa,or vn�hin five days of <br /> the daz of rhe rcquesc.ezcluding S�tu�ays,Sundays and Zeg�i holidaYs.if imrt�cdiau compliancc is aoc pocsibie. Tf he canno[comply wi�2t tl�a tequest <br /> w•i�in�hac timt,hc shall sa inlornt�hc individual,and may havt an add'uioa�i five days wid�in wlsicA to comply wi�iha reqves�,cxcluQing S�turdays. <br /> Sundays and lcSul holid�ys, <br /> Subd.4. Prvicedure�heo datA is not accur��e or complese. An individual may concese che accuracy cr:omplctcnesi of publit o[p��a« <br /> dau concerning himealt. Ta ezercise chis riSht.4n individual sRall notity in writin8�ho responsible audwriry dcscribing the nawro of rho disugreemcnr <br /> The responsible authority snail wirhin�0 da3•s eichoc; (a')comect the daw found to be inaecusacc or incomplete and aaempt co eu�dfy pa�Y recipicnu of <br /> inaccurace ae incampleK ds�, inaiuding rccipieav rrer-ted by ihe individusl;or(b)naii4y the individual[hsu he balieves dec 3aca co ba coirect. Deta <br /> in disp��o sha1S be diu:losed ot�1y if thc inQividwtt'a sracer�scr.t of disagroemen�is incfuded wich�he duclosad dsa. <br /> The dacermin��ion of d�e r:sp�nsible�a�hoRry may be app<sled pursuaas�:o rhe prov�s�ons of�i+e a4minism►rive procedurc a�e reladnx� <br /> COR�bBICd r.ff4C3. <br /> LaATA p�AC1��DVISORY <br /> In accnrdance with M.S. 13.04,Subd.3, "Righis of subjects of data", we would like�o info�n you chac your request <br /> for a parmic or lieense from ih� Ciry of Orone or any vf ics depar�ments may require you to furn:sh cenain private or <br /> confidcntia3 information. <br /> You are nocifted chat: <br /> �, 7he informa�ion you furr�ish will be used to decenxune your qualification for ihe permit or iicense requested. <br /> 2, 'You may sefuse �o supply data. but tefuSal may require th2t the City deny the perAut or license, <br /> 3, 'rhe informa�ion may be shfired wi�b ocher loeal, state or federal agencies co i.he ex�ent necessacy co prxess <br /> th� permit or liceAse. <br /> a. If your requesctd peraut Or licease requires Couttcil action to approve. some inforsaacion ivay become <br /> pablic. <br /> 5, You have cenain nghcs under M.S. 13.04 (available upoa reqnes;) to review privare data on yourseif. <br /> 6. your full name is required co proetss thi� application or peruuc. <br /> J� � �esSc n <br /> Firs[ <br /> Middle Last <br /> a��� � � <br /> Address _ �� ��Oyi/ �i����/a�Q <br /> .—�� ,�, 7 / <br /> �� 5ua Zip Fhone <br /> I uude:st rt�y righu as stat�d abova. <br /> -- . <br /> Si ► <br />