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f � <br /> . � 7 <br /> • • � � <br /> + <br /> Sec.13.04 RIGFiTS OF SZ(B�TECTS OF D:�Ta <br /> Su�d. 1. Type o[data. The righcs of individuai oa wham the dara is smr.3 or w be scnr.d shall be as sec focch ia this secdon. - <br /> Subd.2. Intarmaaoa required to be givea individual. An iadividual uked to suppty pcivate or coafidenaal dam eoaeerang himself sbaIl <br /> be iePormed of: (a)tht pucpose aad inrended use of che requesL-d daca withia the collecdng Staue ageaty,polidca!subdivuion,or sac-wide rystem; <br /> (b)whaher he may refuse or is le3ally requir_d to supply the r:quesc:d daca:(c)any lmowa coasequeace arisiag fromhis supptyiag o�refusing to suppiy <br /> pcivar_oreon.'4dendai data;u:d(d)the idendry o(asher pecsoas orendries aachocized by snte or fedaral law ro receive the dam. This tequiremeat sball <br /> �r.ac appty when an individu�i is asked to supply invesrigadve dan,pursuaac co secdon 13.82,subdivision S,co a law eafoccemen�ofFicer. — <br /> '[tte commissiona of reveaue mav vlace the nocce t=auir:d under this subdivision in the individuaI income tax or orooem taz tefued <br /> insttucaor.s ins�exd of an chase faRns. <br /> Subd.3. Access to data by iadividual. Upon request w a resporuible au�horiry,aa individual shall be inforraed wh:�t:ec�e is the subject � <br /> af smrd daca on individuals,and wh:�her ic is class�:d as pubtic,privac-or co�dendal. Upon his tur�her requesc,aa individual who is the subjeec <br /> of scor.d privace ar public da�a on individuais shal!be shown the daca wichouc any chuge to tiim and;if he desires,shall be infocmed of the eon�eat <br /> aad meaning o[chat dara. Afcec an individu3l h�been shown the priva�.dara and iaformed of iu meaaing,che dara need not be d'uclosed to hica for <br /> six mon�hs chereah:c unless a dispuce or acaon pucsuanc to chis secdon is pending or addidonal data on the individual has been coile:�d or ereated. <br /> The r.sponsible au�horiry shall provide copies of the privare or publie da�a upon req¢est by the iadividual subjecc of the dan. The responsible anthociry <br /> msy require rhe requesang pecson to pay the accual cosu of making,cecdfying,aad compiling the eopies. <br /> The responsible auchoriry shall eoc:�piy immediacely,if possible,wich any request made pursuanc co this subdivision,o�wiehirt ftve days of <br /> the dace of che requesc.ezcluding Satu�days,Sundays and legal holidays,if immediate compliance is not possibte. If he eaaaot compty with the tequest <br /> wirhict that dme,he shaU so inform che individual,and may have an addiaonal five days within wEuch ro compty wich the requesc,exc[uding Saaudays, <br /> Sundays and legal hotidays. <br /> Subd.4. Pracedure Khen data is not aecurate or complete. An individual may eoatesc the accuracy or eompleteness oEpublic orprivate <br /> daci concerning tiir.uetf. To execcise chis righc,an individual shall noafy in wriang the respoasible au�horiry desccibing the naare of the disa;reemeaG <br /> The raponsibie authoriry sh�lt wichin 30 days eithec: (a)correcc the daca faund w be inaccunce or incomplece and attempt to nodCy past recipieau of <br /> inaccunte or incomplece daca,inciuding recipiencs named by�ha individual;or(b)noafy the individual that he believes ehe data to be eoaect Data <br /> in dispute shalt be disctosed only if the indir•idual's statemsnt o[disagroement is included wi�h rhe disetosed dae. <br /> The dececminadon o!the responsible authoriry may be appealed pursuane to rhe provisions of che adminiscrarive proceduce act nladng w <br /> eontesced easas. <br /> DATA PRIVACY ADVTSORY � , <br /> In accordance wich M.S. 13.04,Subd.Z, "Righ,ts of subjects of data",we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confidential informacion. y <br /> You aze notified that:• <br /> � 1. 'Ihe information you furnish will be used to determine your qualification for the permit or license requated. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with ocher local, state or federal agencies to the exteat necessary to process <br /> ' the p�rmit or license. <br /> 4. If your requested permit or license requ�res Couacil actibn to approve, some information maq become <br /> public. . <br /> 5. � You have cenain ri�hts under M.S. 13.04 (available upon tequest) to review private data on yourself. <br /> 6. Your full name is required to process this application or permic. <br /> G o�,�'� y � _ .� �-� Y o�. � . <br /> Fust /� / / � r✓�fiddle �� <br /> �, � m� ,� ; � ,� �� <br /> Address M y� y�L � !�v G� O' v ! /✓v �� �/� / / / ����" �/ <br /> ��/ Y7 ��� <br /> Ciry State Zip Phone <br /> I uaderstand my 'ghcs as stated above. � _ <br /> � �� �������� _ ��� C%��=�-�� <br /> signan:re ' <br /> . � � � <br />