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A� <br /> Sea 13.04 RIGHTS OF S[JBJECTS OF DATA <br /> Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set forch in rhis section. <br /> Subd.2. Information reqirired to be given individual. An individua!asked to supply private or confidenaal data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecdng�tate agency,political subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply[he requested data:(c)any faiown consequence arising from his supplying or refusing W supply <br /> private or confidential data;and(d)the idenriry of other persons or endaes autharized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdgadve dara,pursuant to secaon 13.82, subdivision 5, to a law enforcemenc ofFicer. <br /> The commissioner of revenue mav p(ace the nodce required under this subdivision in the individual income tax or vropertv tax refund <br /> instmcdons 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 whecher it is classified as public, private or confidendal. Upon his further request,an individual who is the subjecc <br /> of stored private or public data on individuals shail be shown the data wichout any charge to him and,-if he des'ues,shall be informed of the content <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 to him for <br /> siz mont!►s thereafter unless a dispute or acdon pursuanc to [his secaon is pending or additional data on the individual has been collected or created. <br /> The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person ro pay the'actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possibte,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 addidonal five days within which to 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 himsetf. To exeicise this right,an individual shall nodty in wridng the responsible authority describing the nature of ihe disagreement. <br /> The responsible auchoriry shall within 30 days eithe�: (a)correct the data found to be inaccurate or incomplece and aaempt to nodfy past recipients of <br /> inaccunte or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shail be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinadon of the responsible authority may be appealed pursuant to the provisions of the administradve procedure act relating to <br /> contesred 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 are notified thar. <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 City deny the permit or license. <br /> 3. 1fie 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 permit or license requires Council action to approve, some information may become <br /> public. <br /> g, 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 /> SS� �C.19 ctLCftx�-� -�'�sP� <br /> First Mid e ` � st <br /> �S'a� -�2_��lc �ccr � � t9K �7 <br /> Addre��,�� ,e c ,�.�r s�?�S� �� ���- 7��"/ <br /> Ciry S�� Z�p Phone <br /> I u tand my ri s te ove. <br /> Signamre <br />