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� <br /> . . , <br /> Sea13.04 RIGHTS OF S[JB.TECTS OF DATA <br /> Subd. 1. Type of data. 'Ihe righcs of individual on whom the data is stored or to be stored shail be as set forrh in[his secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall <br /> be infarmed of: (a)the purpose and incended use of the iequested data wichin the coliecang§tate agency,poliacal subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the cequested data:(c)any Imown consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the idendry of other persons or endties authorized by srate or federa!law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigaave dare,pursuant to secaon 13.82,subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav vlace the norice required under[his subdivision in the individual income tax or propectv tax refund <br /> insnvcrions instead of on those forms. <br /> Subd.3. Access to data by indiridual. Upon request to a responsibte authoriry,an individuai shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public,priva[e or co�dential. Upon his further reques�an individual who is the subject <br /> of stored private or public dara on individuals shall be shown che data wi[hout any charge to hun and;if he desires, shall be informed of the contenc <br /> and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed w him for <br /> six months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible aurhoriry <br /> may cequire the requesting person to pay the actual costs of making,certifying,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 Samrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc <br /> within that time,he s6all so inform the individual,and may have an addidonal 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 completeness of public or private <br /> data concerning himself. To exercise this right,an individual shali notify in wriang the responsible authority describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found w be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, iacluding recipients named by the individual;or(b)noafy ihe individual that he believes the data to be correct. Dara <br /> in dispute shall be disclosed only if the individual's sretemenc of disagreement is inciuded with the disclosed data. <br /> The determinaaon of the responsible authority may be appealed pursuant to the provisions of the adminisuative procedure act relaang 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 its departments may require you to fumish certain private or <br /> confidential information. <br /> You aze notified that: <br /> 1. The information you fumish 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 City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the eztent necessary to process <br /> the pemut or license. <br /> 4. If your requested permit 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 /> 6. Your full name is required to process this application or permit. <br /> ��t� P�� t-�l�@K� <br /> F�n� ddle / Last <br /> �S� C� �,��r' �Q�-�l� � <br /> Address • <br /> �t Xr/���1Z�S �/Ll�/ S�'�� <br /> City State Zip Phone <br /> I underst n ed a ov . <br /> J . <br /> Signamre <br />