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Sec.13.04 RIGFTTS OF SLJBJECTS OF D�Ta <br /> Subd. 1. Type of data. The rights of individual on whom the dara is stored or rn be stored shall be as set focih in this section. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself shall <br /> be informed of: (a)the purposa and inrended use of[he requesred data wichin the collecting�tate agency,polidcal subdivision,or srauwide rystem; <br /> (b)wherher he may retuse oY is legally required to supply the cequcsud data:(c)any known coauquence arising from his supplying or refusing to supply <br /> privace or confidenaal dara;and(d)che idenriry of ocher persoas or enrides au[horized by stats or federal law to receive the dara. This requirement shall <br /> not apply when an individual is asked to supply in�'esdgarive dard,pursuant to secdon 13.82,subdivision 5, to a law enforcemenc o�cec. <br /> The commissioner of re�enue mav pla- che nodce rewired under this subdivision in che individual income tax or propem raz refund <br /> insttuctions inscezd of on fiose forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be infoaned whether he is the subjecc <br /> of stored data on individuals,and wheeher ic is classified as public,private or confidenaal. lipon ivs further request,aa individual who is the subjecc <br /> of stored private or public dara on individuals shall be shown rhe data wiehout any charge to him and;if he desires, shal!be informed of the contenc <br /> and meaning of rhac dara. Afrer an individual hu been shown[he privace dara and informed of its meaning,the data need not be disclosed to him for <br /> six mon[hs[herea8er unless a dispute or action pursuanc to [his secdon is pending or addidonal dara on the individual has been collected or creaced. <br /> The responsible authoriry shall provide copies of die private or public data upon request by the individual subject of the dara. The responsible au[horiry <br /> may require che requesting person to pay the accual cosu of making.cerdfying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,wirh any request made pursuant to this subdivision,or wichin five days of <br /> the dace of the request,exciuding Sacurdays,Sundays and legal holidays,if immediate compliance is not possibie. ff he cannot comply with the requesc <br /> within rhac titne,he shall so inform[he individual,and may have an addidonai five days wirhin which to compiy wi[h the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shal!nodfy in wridng the responsible authoriry describing the nature of the disagreemenc. <br /> The responsible au[horiry shall within 30 days eicf:er: (a)correct the data found to be inaccurace or incomplece and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data,including recipienc�named by the individual;ar(b)notify the individual thac he believes rhe data to be correct. Data <br /> in dispute shall be disclosed only if che individual's stacement of disagreement is included wirh rhe disclosed data. <br /> The decerminadon of the responsible au�horiry may be appealed punuant to the provisions of the adminisaadve procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rights 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 ics departments may require you to fumish 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 permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry deny the permit or license. <br /> 3, The information may be shared with other local, state or federal a�encies to the extent necessary to process <br /> the permit 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 ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. <br /> (, Your full name is required to process this applica[ion or permit. <br /> �� �� �1�� <br /> F`�� � �1 t Last <br /> G833 f�uuis�3 . �o. <br /> aaa�s5�,t.e�+t�r�� N^'� �Z 3 ��Z"�4—9�7 7 <br /> Ciry <br /> /� State Zip Phone <br /> I understand my ri� s as stated ab e. <br /> Signa re <br />