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� - � Sec.13.04 RIGHTS OF SVBJECTS OF DATA ' Subd. i. Type o!data. The righcs of individual on whom rhe daa is swred or to be stoced shall be u sec focch in this secrion. Subd.2. Intormation reqirired to be givea iadividual. An individual uked w supply private or coafidendal dam coacecning himself shall be infocmed of: (a)the purpose aad iatended use of the requuud dam wichin the collecdng�tatt agenry.goliacal subdivisian,or sacewide sysum; (b)whe�ec he taay retuse oti is.legally nquir_d to supply the rsquesced dsta:(c)aay imown coauqueace uising from his supplyicg or re[usiag to suppiy privace or confidenda!data;and(d)�he ideaary af ocher peaaas or enddes auchorized by st+re or tedecai law to receive che dara. This requiremene shaI! not apply when an individual is uked w supply iavesagadve daa,pursuaat to secaon 13.82,subdivisioa S,tn a Iaw enfac�emenc officer. . 'Che eecamissioner of revenaa mav ofacr che nodce r.auired under dlis subdivision in the individual income �c or provem taz refund inscrucaons insuad of on rhose forms. Subd.3. Aecess to data by iadividual. Upon�cquesc to a responsible authoriry,an individuaI shall be informed whether he it the subjecc of swred daa on individuals.and whecher ic is classiFied u pubGc,private or confidenaal. Upon his furcher request,an individual who is che subjecc of scoced private o�public dam on individuals shall be shown ehe dam wirhaut any charge to him and;if he desires,shali be informed af the coatznc and meaning of rhat data. After an individua!has been showa the privat6 data and iaforaud ot iet meaning,the daa need not be d'uclosed oo hira for six mondu thereafter unless a dispute or acrion pursuanc w this secdon is pending or addidonal dara on the individual has been eollecred or ereaced. 'Ihe cespoasible auehoriry shall'provide copies of the privam or public dara upon«quest by the individual subject of che dara. The responsible authoriry may require the cequesdng pecson to pay che aceual eosu of making,eerdfying,and eompiling the eopia. The cesponsible authoriry shall eomply immediacety,if possibie,wich any tequat made putsuant to this subdivision,or widun five days of the date of�he nquest,excluding Saturdays,Sundays and legal hotidays,if irsuaediate compliance is not possible. If he cannot comply with the request wichin rhat dme,he shall so inform the individual,and may have an addidanal five days within which to comply wich the request,excluding Saaudays, Surtdays and legal holidays. Subd.4. Proeedure when data ts not aecurate or eomplete. An individual may eontest the accuracy or completeness of public or private dam concerning himself. To ezerciu chis right,an individual shall aodfy in wridng the respoasible aurhoriry describing die nature of the disagreemenc The respoasible authoriry shall within 30 days either; (a)cocrect tha data found to be inaccuratt or incomplete and atumpc to norify past recipien�s of inaceurate or incomp[ece data,including recipienrs named by the individual:or(b)naufy the individua!thac he believes the dara to be correc4 Data in dispu�e shall be disclosed only if the individual's stacemenc of d'uagreemenc is included wi[h the d'uclosed data. The decerminaaon of the responsible auchoriry may be appealed pursuant to the provisions of the administraave procedure act relating to contesad cases. • DATA PRIVACY ADYISORY 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 peraut or ticense from the City of Orono or any of its depaztments 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 shazed with o[her local, sta[e or federal a�encies to the ectent 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 cectai.n rights under M.S. 13.04 (available upon request) to review private data on.yourself. 6. Your full name is required to process this application or permit. 1N tF-�a-�',' � �-�,,.. d-� �- F'usc �tiddle I.asc S�"1 � �-`��w�-r.� �L✓r� �lddreu Y�ti r�� V�^,�`'• �S3L� ��'��'3 .f Ciry Sace Zip Phane I understand my ri;hts stated bove. � . Sigrumce