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� � 4 Sec.13.04 RIGHTS OF S[7BJECTS OF DATA Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information req�rired to be�ven individual. An individual asked to suppty private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data wi[hin the collecting 3tate agency,political subdivision,or stacewide system; (b)whether he tnay refuse oY is legally mquired to suppiy the requesud data;(c)any known consequence arising from his supplying or refusing to supply private or confidenaal data;and(d)the idendry of other persons or enaries aurhorized by state or federal law to roceive the data. This requirement shall not apply when an individual is asked to supply invesagarive data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of revenue mav alace the nodce required under this subdivision in the individual income tax or prooertv taz refund insttucaons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible aurhority,an individual shall be infocmed whether he is the subject of stored data on individuals,and whether it is class�ed as public,private or con6dendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,-if he desires,shall be informed of the content and meaning of that dara. After an individual has been shown the private dara and informed of iu meaning,the data need not be disclosed to him for six months thereafur unless a dispute or acaon pursuant to this secaon is pending or addiaonal data on the individuai has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individuat subject of the dara. The responsible authority may require the requesting person to pay the actual costs of making,ce�tifying,and compiling the copies. The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediau compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal five days within which W comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of public or private dara conceming himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccunu or incomplete and aaempt to nodfy past recipients of inaccurate or incomplete data,including recipients named by[he individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disctosed data. The deternunadon of the responsible authoriry may be appealed pursuant to the provisions of the administraave procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2, You may refuse to supply data, but refusal may require that the Ciry deny the permit or license. 3, The information may be shazed with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6, Your full name is required to process this application or permit c-��_ / G� �� I.ast F /�/ ��`/ / iddle — f� S � i Address �� (/� �'�,�_ 35' ,�� i%t/f 7 Ciry Smte Zip Phone I under my rights as stated ve. � Sig mre