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1 <br /> Sec.13.04 RIGFiTS OF SLtB.fECTS OF DATa <br /> Subd. 1. Type of data. The righcs of individual on whom che dara is stored or to be scored shall be as sec fonh ia this secrion. - <br /> Subd.2. Informaaon reqirired to be given iadividual. An individual asked to supply private or confidendal dara conceming himself shali <br /> be iaformed of: (a)the pucpose and inrended use of the requuud data wichin the colleccing 3tace agency,polidcai subdivision,or sratewide rystem; <br /> (b)whether he may refuse or is legally requiced to supply che rsquesud data:(c)any Irnown coasequence arising from his supplying or refusing to supply <br /> private or con8denaal data;and(d)che idendry of other persoas or enddes au�hocized by state oc federal law to ieceive the daca. This requiremenc shall <br /> noc app(y when an individual'u asked to supply invesri¢adve dan,pursuanc to secaon 13.82,subdivision 5,to a law enforcemenc ofFicer. - <br /> The commissioner of rcvenue mav place the nodce rauired under this subdivision in the individual income tax or vrooem taz refund <br /> inscrucdons instead of on�hose fortns. <br /> Subd. 3. Access to data by indiridual. Upon request to a responsible auchariry,an individual shall be informed whether he is the subject � <br /> of scored dan on individuals,and wheeher it is classified as pubiic,private or confidentiai. Upon his furcher request,an individual who is the subjecc <br /> of scored private or public dara on individuals shalt be shown che data wichouc any charge to tiim and,-if he desires,shall be informed of the contenc <br /> and meaning of chat daca. Aher an individual hu been shown ehe privare data and informed of iu meaning,the data need not be disclosed w him for <br /> six monehs chereaiur uniess a dispute or acrion pursuanc co chis secaon is panding or addidonal data oa the individual has been collecced or creaced. <br /> The responsible au�horiry sha(1 provide copies of ehe private or public daca upon request by the individual subjecc of che dara. The responsible auchority <br /> may require the requesting person to pay the accual coscs of making,cerrifying,and compiling the copies. <br /> The responsible au[horiry shall comply immediately,if possible,with aay requesc made pursuant to this subdivision,or wi�hin five days of <br /> the dace of rhe requesc,ezciuding Samrdays,Sundays and legal holidays,if immediate compliance is noc possible. If he canaot comply wich the request <br /> wichin[hat time,he shall so inform the individuai,and may have an addiaona!five days wi[hia which to comply wich the request,excluding Saturdays, <br /> Sundays and legai holidays. <br /> Subd.4. Pcocedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic orprivace <br /> dan conceming liimself. To exercise chis righc,an individual shall nadfy in wriang the nsponsible aurhoriry describing the nature of the disagreemeac. <br /> The responsible au�horiry shall within 30 days eicher: (a)correcc[he daca found to be inaccurnte or incompiete and aaempt W nodfy past recipieau of <br /> inaccurate or incomptece dara, inciuding recipiencs named by the individual;or(b)nodfy the individuai that he believes che data to be correct Data <br /> in d'upute shall be disclosed only if the individual's sratemenc of disagreement is included wich the disclosed da[a. <br /> The decerminadon of the responsible auehoriry may be appealed pursuanc to the provisions of the administtarive 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 Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. <br /> You ue notified that:• � <br /> i. 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 perm.it or license. <br /> 3. The information may be shared with ocher local, state or federal agencies to the ezcent necessary to process <br /> � the permit or license. <br /> 4. If your requested pernut 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 permic. <br /> ,�o . � �er�r �u o����c%� <br /> First �tiddle 1-�� <br /> lfJDB Pv'�l�i'U �'�v�� <br /> aaa«1,ss/ , ��7 `.��l� � <br /> W�?CQy1�4 dl, <br /> Ciry Sate Ztp rnone <br /> I underst my ri ts stated above. , <br /> ignature <br /> l.._. <br />