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, <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA ° ' <br /> 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 this secdon. <br /> S�bd.2. Information required to be given individual. M individual asked to supply private or confidential data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising fmm his supplying or refusing to supply <br /> private or confidential data;and(d)the identiry of other persons or enaues authorized by state or federal law to receive the data. T6is requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the notice�eauited under ihis subdivision in the individual income tax or propertv taz refund instn►ctions <br /> instead of on those forms. <br /> S�bd.3. Acxess to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of <br /> stored data on indivicivals,and whether it is cL�ssified as public,private or confidential. Upon his further request, an individual who is the subject of stored <br /> private or public data on individuals shall be shown the data without any chazge to him and, if he desires, shall be informed of the content and meaning <br /> of that data. After an individual has been shown the private data and informed of its meaning, the data need not be disclosed to hun for six months <br /> thereafrer unless a dispuoe or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible <br /> authority shall provide copies of the private or public data upon request by die individual subject of the data. The responsible authoriry may require the <br /> requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> 'Ihe responstble authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the <br /> date of the request,exduding Sauudays,Stindays and legal holidays,if unmediate compliance is not possible. If he cannot comply with the request within <br /> that time,he shall so infom�the individual,and may have an additional five days within which to comply with the request,ezcluding Saturdays,Sundays <br /> and legal holidays. <br /> S�tbd.4. Procedure when data is not accurate or cromplete. An individual may contest the accurdcy or completeness of public or private data <br /> co�eming himself. To exercise this right,an individuai shall notify in writing the responsible authority describing the nature of the disagreement. The <br /> responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipients of inaccu�ate <br /> or it�complete data,including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall <br /> be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinadon of the responsffile authority may be appealed pursuant ro the provisions of the administradve pmcedure act relating to contested <br /> 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 aze notified that: <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. The 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 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 permit. <br /> D�NJ�1lS �,�j��1 1�R U/�J/� <br /> First Middle Last <br /> Z�� u sTi���4 y l� . <br /> Address <br /> /�1.4-�t� Pt.�4i�c/ M�cl� �S3S9 -¢73 —7 S`3 Fl <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br /> 10 <br />