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, � Sec.13.04 RIGHTS OF SUBdECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in diis secaon. Subd.2. Information required to be given indiridual. An individual asked to supply private or confidential data coacerning himself shall be informed of: (a)the purpose and intended use of rhe reques[ed data within the collecdng§tate agency,political subdivision,or sratewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the identiry of other pecsons or enaries authorized by state or federnl law to receive the data. Ti�is requirement shatl not apply when an individual is asked to supply invesdgative data,pucsuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revernie mav vlace the nodce required under this subdivision in the individual income taz or propertv tax refund instcucuons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as pubiic,private or confidendal. Upon his further request,an individual who is the subject of stored private or public dara on individuals shall be shown the data wirhout any charge to hun and, if he desires, shall be informed of the content 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 six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addiaonai data on the individual has been collecud or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The iesponsible authoriry - may require the requesting pecson to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request tnade pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply wiih the request within that time,he shall so infocm the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or priva[e data conceming himself. To exercise this right,an individual shall nodfy ia writing the responsible authority describing the nature of the disagreement. 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 inaccurate or incomplete data, including recipienu named by the 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 wirh the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 aze 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 City deny the permit or license. 3. The information may be shared 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 fuYl name is required to process this application or permit. ��r�c_.. �Y �l��c[��-�o��J Firs[ � Middle �s� ; �o � �nA ��.��E � 2 ► Address � /J,7�,/ � Il1�—t'(Lf�. l�� `7 .7 6��`5 —�� State Zip Phone City I de tand rights s above. Sig wre