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�� OF OR�NA � b��47305�0 09/24I96 14:00 �1o03lO3 �OeSZ� <br /> . . <br /> Sac.13.04�l�ii'P��F�UBlEC1C3 OF DA'P•a <br /> Subd. 1. 'Typ¢aP duta. YRe el$h�s of individutl o�s�hom the�a�Is-smred oe to ba sro�cd sha➢1 be as ut fonh in ehis eeetian_ <br /> Subd,d. FnPo�atlen roqudrAdlo ba�l��n indi�iduzt. An Individual asked[o supply privare or oanfidendal data cancarssing hitnself,�halt <br /> bs InPo�ited oft (s)d�a Qucpose and intended use of dte Pequesarl d��within ehe eolleednQ etate age�oy,pntldeal subdivisian,or srateuride syatem: <br /> (m3�rherher ho may refuse oi is legally required m supply the e�quesied daea:(c)ar9y knoum�onsequeace ariaing from his euppl�tng or iefUsing to supply <br /> privace or ooeflden[in!dara;and(d)�he idendry u!odie�persons or endoes aud�orized by su�e or iedar�l 1Aw en e�enive rhe da�a. Th�requiremeac shull <br /> �rot tpply whe0 en lndividuel 1�asked[o supply Invesdg4dve da�,pursuan[eu 6eedon 13.82,subdivision S.to a law enforcemenc olPfcer. <br /> ,. � <br /> �]�c,�r�isa{oner aP revamae mu� GISCe fhC P10t1Gt RQulfEd UtldCi is subdivisinn in �he indtvidual income �ax or oroesrtv c�x�reI{ind <br /> . • �1161[faGilQtli�,�BL�i14�4�611 t�1090 f4t'�4f6. „ <br /> SuEd.3. A�ceas eu data by 6�d[vido�al. Upon eequest to a respnnsible authonry,en lndi�idurl shall ba infoimed whather 6t ls the s�ibJecs <br /> ot�tored drra on andlvi�uals.and whe�hor ic is class[Fed a�pubiie,p�ivue or canfldential, Upon his tUrrl►er rcques�,an individual who i9�he subject <br /> �f stored prirece or Nubiic dau an individuals shall be 9hown�he data wirhouc any chaeae w him and;if he des(rea,shail be infotmed of the conCenc <br /> ofld an�aning of d�as d�tu. Ahet�n individusl hts been shoWn ohe pcivete ddra end iaforrrtad of iv meaning,the dats naed ewt be diaclased to him for <br /> a{s�ondu thereaftar unleai 9 dispute ar acrion pursuant m oltis seeaaa e�pendins or addirionrl dara on the individual has been oollecced Qr creared. <br /> �a tsaponaible authQriry thill pro�ide copies oP rhe privi�e or public daa upon requeas by�he individual subjec�of�+e dara. 'ITie re�ponsible autAo�iry <br /> �sy requira rho roqueatin�pmesen ro pay d�e a�tual cosu�f making,csrtifyinv.aed eompfUag rhe ropi�e, <br /> 17te rssponsible authoriry.shall comply immediusly,if possib[e,wi�h aap roquese muie pursuattt s��his subdivision,or wi�hln five days of <br /> �e date af ehe requeac.xxc[uding Suuedays.Sundays end legd halldays,if immedlaee compllancc is not po9sible. If'he cattnot comply with the reques� . <br /> within thac clm�,ho ahall ea infotm eha tndividus�l,and m�y ha�e an addlcional fiveJdoys wichin whicb m comply with sh�request,oxUuding Saaudays. <br /> S�nd�ya ind legai holldaye. � <br /> Subd.4. �saeeduea arh�e dn�a is net aceurata or eompl¢te. An indlviilunl m�y conoes�iha accurscy or complereno�of publ[c or privuca <br /> dva concem�bimselP. `Po exercise ihis right.on indi'viduel shal)uoaPy in wridng�he respunsible�urhudry desezibing d�re�ura oF the d(sagreamenc. . <br /> 'fhe�sapenplble authoriey d�ell within 30 days eieher. (a)eotracc�ha dam found�a bo uuccucate or incwmptece and eaempt te nodfy p�ae reeiplencs oE <br /> inaeeurnte or in.eamplete dpra, Inctudin�recipien�named by d�e indivtdual;ar(b)noaPy rhe indivulual thec he belleves rhe dam co bo comace. Data <br /> ip d�epute ahall be diacloaod oaly if the uullvidusl's su�ement of dlsaareemenr is includad with�he dieclosed dera. <br /> �'he do�erminntion oP ehe respansibla au�lioriry may bo appealed pursusnt co 9ho pro�isionc o[ehe adminiswdve pror.eduee aet relarins m <br /> sonu+eted cases. . <br /> � pATA PRYVAC�VI�Q,R�I - " <br /> !n accordanc� with 1bf.S. 13.04,Subd.2, "Aighu of su8]ecta of data", we woutd like to inform you that your requesc <br /> for �permit oc license frem che City of Orono or az►y of its departmencs may sequlro-you to fuenish cer[ain private or <br /> confidentlal information. <br /> 'You are �atffied th�t: <br /> 1. The inform�tion you fu�nish wtli be used to detersnine your qualificacion for the permic or tieeasa requcsted. <br /> 2. You may refuse co supply daza, bue rcfusal Ynay require tha[ [he City deny the permlt ar lice�ise. <br /> 3. 'I'he infarmation msy be shattd with oth�r loeal, state or fedetal agencie� to the extent neccssary to procoss <br /> the p�rmit or license, <br /> � 4. . 1f your cequeeted permie or lioease requires Council aetlon ro appeove, some infarmation may become <br /> ' public. <br /> 5. You have certain righcs under M.S. 13,04 (available upon request) to review privata data on yourself. , <br /> 6, Ynur full neme as required to process_,thls applfcation or permit. <br /> . �,/).'C'O` � �._� — <br /> , F� .�` ° .� �'` <br /> ...��s.,� � ��c �1� <br /> d , . ., . , � � a .3 , <br /> Cl�y . � �nr�a 2ip Phonv <br /> ; <br /> ' I•ued�rst d tny right� �s ta d above. <br /> sign r+e <br />