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See.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.I. Type of data. The rights of individual on whom the data is stored or to be sWred shall be as set forth in this section. <br /> Subd.2. Infortnation requirod W be givp�individuel.An individual asked to supply private ot confidendal data conceming himself slmll be <br /> informed of: (s)the purpose and inunded use of the requested dam within the collxting sbte agency>political subdivision,or stetewide systwn;(b) <br /> wlxtha he may refuse or is legally required to supPlY the roquesoed data;(c)arry known consequence arising from his supptying or rcfusirtg to suPP�Y <br /> private or confidentiel data;and(d)d�e identity of other persona or entities authoriud by state or federat law to receive the data.This ra�uiremrnt shel l <br /> not apply when an individual is askod to supply investigative data,pursuant W section 13.82,subdivision 5,to a law enforcemem officer. <br /> The cortunissioner of revenue mxv plece the notice reauired under this subdivision in the individual income tax or pro tax rofund <br /> inswctions instead of on those forms. <br /> Subd.3. Acc�s to data by individual. Upon roquest to a responsible authority,an individuel shap be infortned whetlur he is the subject of <br /> stored deta on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is d�e subject of <br /> storcd private or public data on individuals shall be shown the data without any etarge to him end,if he desircs,shall be informed ofthe content and <br /> meaning of that data After an individual has been shown du private data and infocmed of its meaning,the data rxed not be disclosed to him for six <br /> months thereafter unless a dispuu or action pursuant W this section is pending or additional data on the individual has been collected or created. The <br /> responcible authority st�all provide copies of the private or public data upon req�st by the individual subject of the data The responsible suthority <br /> may requirc the requesting pe�son to pay the acwel co�s of making,certifying,and compiling Uu copies. <br /> 'Ihe responsible authority shaU comply immedietely,if possible,with any request made pursuant w this subdivision,or within frve days of <br /> the date of du request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possibla If he cancrot canply with the request <br /> within that time,he shall so inform the i�ividual,and may have an addidonal five days within which to comply with the request,excluding Satundays, <br /> Sw�days and legal holidays. <br /> Subd.4.Procedure when data is rrot accurau or complete.An individusl may coMest the accucacy a completeness of public or private data <br /> conceming himsel£To exercise this right,an individual shal I notify in writing the rcsponsible authority describing the nature ofthe disagreement.'i7ie <br /> responsible authority shall within 30 days either: (a)wcrect the data found to be ineccurau or incompleu and attempt W notify past recipieMs of <br /> ineccurate or incomplek data,including recipients named by dx individual;or(b)notify the individual that he believes the data W be comect.Data in <br /> dispute shell be disclosed only if the individual's statetnent of disagrament is included with the disclosed data. <br /> 71u determination of the responsible authority may be appeeled pursuant to the provisions of Uu administrative procedure act rolating W <br /> conusted caves. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we woutd like to inform you that yow 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 qualificaiion for the permit or license <br /> 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 extent necessary to <br /> process the permit or license. <br /> 4. If yors requested pennir or�icense requires Council actton to a�prove,some informatiorr rrlay become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> Y'c�. :c.�..z�r 1 �,�-- <br /> Firot Middk I.ast <br /> \ �(a 0 `�Lle r� I,`.� � � <br /> Addreu � <br /> �,�►.,1 a�.�-►4r�4- n�� 5S� 9 r 9S Z-�8 6-��o y <br /> City State Zip P6one <br /> I�a�lerstsad ruy ri s sta bov� <br /> Sigoature <br /> i „�� n�;�i I pl�tu <br /> , 32 <br />