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.� <br /> Sec.13.04 RIGH'I'S OF SiIB.TECTS OF D�TA <br /> Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. r1n individuai asked to supply private or confidenaal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested dara within the collecting"state agency,political subdivision,or sratewide system; <br /> (b)whether he may refuse oi is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply <br /> private or co�dendal data;and(d)the identiry of ocher persons or enriaes authorized by state or federal law to receive the data. This requirement shali <br /> not apply when an individual is asked to supply investiearive dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the ❑odce reauired under this subdivision in the individual income tax or propercv tax tefund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority,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 confidenaal. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown che data wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. .4fter an individual has been shown che privace data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acaon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shalt provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of making, cerafying, and compiling the copies. <br /> The responsible 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 Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addirional five days within which[o comply with 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 conceming himself. To exercise this rieht,an individual shall noafy in wridng the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, inciuding recipients named by che individual; or(b)notify the individual tha[he believes the data to be correct. Data <br /> in dispute shali be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinarion of the responsibie authoriry may be appealed pursuan[to the provisions of the administradve procedure act relaang to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri�ts of subjects of data", we would like to inform you that your request <br /> for a pernut 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 deternune your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested pernut or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> (. Your full name is required to process this application or permit. <br /> l��lv ��Vvd't12� �'S I J�2� <br /> First ` M�e �� Last <br /> `���,,__.�--c v✓l��1 �S��� <br /> Address <br /> ti ,ti��t ' � �� � (� (z � 1_`�ZS_� <br /> Ciry State Zip Phone <br /> I und st my nghts as state above <br /> � <br /> /' /C��L ' - <br /> Signa re <br /> � <br /> / <br />