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� y Sec.13.04 RIGH'TS OF SLJB.TECTS OF DATa Subd. 1. Type of data. 'Ihe righc�of individual on w6om the data is s[ored or w be stored shall be as set forth in this section. Subd.2. Informaaon reqirired to be giren iadividual. �1n individual asked to supply private or confidendal dara concerning himself shall be informed of: (a)[he purpose and in[ended use of rhe requesce�data within�he collecdng i�te agency,polidcal subdivisioa,or sracewide rystem; (b)whe[her he may refuse oY is legally required to�uppty the requested data:(c)any known coasequence arising from tus supplying or refusing to suppty privau or confidendai data:and(d)the idendry of ocher pecsoas or entioes authorized by srare or federal law to receive[he data. This requiremenc s6a11 not appiy when an individual is asked to supply invesd¢adve data,pursuanc to secdon 13.82,subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav pla� the nodce rewired under this subdivision in the individual income tax or aropertv raz refund instrucdons instzad of on those forms. Subd. 3. Access to data by individual. Upon request ro a responsibte auchority,an individual shall be informed whether he is the subjecc of scored data on individuals,and whe�her it is classified as public,privace or confidendal. lipon his further request,aa individual who is the subjecc of stored private or public data on individuals shall be shown rhe data wichouc any charge to him and,�if he desires,shall be informed of the content and meaning of[hat data. Afur an individuai has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six monrhs thereafter unless a dispute or acrion pursuant to chis secdon is pending or addidonal dara on the individual has been collected or created. The responsibie au[horiry shall provida copies of fie private or public data upon request by[he individual subject of the data. The responsible authoriry may require the requesring person to pay[he acaal cosu of making.certifying,and compiling the copies. The cesponsible authoriry shall comply immediate(y,if possible,with any request made pursuant to this subdivision,or within five days of the dace of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possibie. If he cannot comply with the requesc within rhat time,he shall so inform the individual,and may have an additional five days wi[hin 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 pri�•ate data conceming himself. To exercise[his right,an individual shall nodfy in wri[ing the responsible au[horiry describing the nature of the disagreement. The responsible auchoriry shall within 30 days eit2:er: (a)correcc[he data found to be inaccurate or incomptete and attempt to nodfy past recipienu of inaccurate or incomplete data,inciuding recipiencs aamed by the individual;or(b)nodfy the individual that he believes the data to be comct. Data in dispuce shall be disclosed only if[he individual's statement of disagreement is included with[he disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to conresred 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 fumish certain private or confidential information. You are notified that: 1, The informacion you furnish will be used to detemune your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the Ciry 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. �, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. Fint �id�z Last Address City State Zip Phone I understand my ri�hu as d above. S�gnacure