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+ � <br /> Sec.13.04 RIGHTS OF Si1B.TECTS OF D�.T?. <br /> Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be scored shall be as set fonh in this secdon. <br /> Subd.2. Information reqirired to be given indi��dual. r1n individual asked to supply private or confidendal data conceming himself shall <br /> be informed of: (a) the purpose and in[ended use of the requested data within the collecting'state agency, political subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing ro supply <br /> private or confidenrial data;and(d)the idendty of other persons or enrides au[horized by srate or federal law ro receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdeadve dara, pursuant ro secdon 13.82, subdivision 5, ro a law enforcement officer. <br /> The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund <br /> instruccions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and whe[her it is classified as public, private or confidendal. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown rhe data wichout any charge to hun and, if he desires, shall be informed of the contenc <br /> and meaning of[hat data. Afrer an individual has been shown[he private data and informed of its meaning, the data need�ot be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuant to [his secdon is pending or additional data on[he individual has been collected or creaced. <br /> The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the actual costs of makine, certifying,and compiling the copies. <br /> The responsibfe authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding 5aturdays,Sundays and leeal holidays, if immediate compliance is not possible. If he cannot comply with the reques[ <br /> within that time,he shall so inform the individual,and may have an addicional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legat holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or comple[eness of public or pm�ate <br /> data concerning himself. To exercise[his rieht,an individual shall nodfy in writing the responsible authority describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to norify past recipients of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual that he believes[he data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Ri�hts of subjects of data", we would like to inform you that your request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the pemut or license requested. <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 other local, state or federal agencies to the ex[ent necessary to process <br /> the pernut or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> j. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> E. Your full name is required to process this application or permit. <br /> �v��v.i �� I L� } c�� � , -� -��, <br /> First �� le Last <br /> ���i 9�.s ��� 1( �,�� <br /> Address � � <br /> �.��, �� ; �, `< �� ����r �- "����, ����- y�s��y�=� <br /> Ciry ��State Zip Phone <br /> I u erstand my 'ahts as stated above. <br /> �� �� <br /> Signa[ure _/ <br /> II <br /> ! <br />