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06/15/2007 11:38 7634791147 RASCO INDUSTRIES PAGE 02102
<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 at to be stored shall be as set Porth in this section.
<br /> Subd.2. Information required to be given individual.An individual asked to sul iply private or confidential data concerning himselfshall be
<br /> informed oft (a)the purpose and intended use of the requested data within the collecting a�stc agency,political subdivision,or statewide system;(b)
<br /> whether he may reftise or Is legally required to supply the requested data;(c)any known colrscqucncc arising from his supplying or refusing to supply
<br /> private or confidential data;and(d)die identity of other persons or entitia9 authorized by su a or federal law to receive the data.This 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 officer.
<br /> 1h9-z mpA18sjMAr of revaruc may Place the notice re91 fired u this g1ft` iOjpgin_the_indiAdual_incomc_tax_or vmocrty tax refund
<br /> jp=K4iggs Instead of on those forms.
<br /> Subd,3. Access to data by individual. Upon request to a responsible authority, n individual shall be informed whether he is the subject of
<br /> stored data on individuals,and whether it is classified as publ ie.private or confidential. U 'his further request,an individual who is the subject of
<br /> stored private or pubi ie data on individuals shall be shown the data without any charge to im and,if he denires,shall be informed of the content and
<br /> meaning of that data, After an individual has been shown the private data and infnrmcd o its meaning,the data need not be disclosed to him for six
<br /> months thereafter unless a dispute or action pursuant to this section is pending or addition data on the individual has been collected or created. The
<br /> responsible authority shall provide copies of the private or public dors upon request by th Indlvldual subject of oho data. The responsible authority
<br /> may require the requesting person to pay the actual costs of making,certifying,and comp iling the copies.
<br /> The responsible authority shall comply immediately,if possfble,with any reque itmadic pursuantto this subdivision,or within five days of
<br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate eon lisnccisnot possible,if hecannot comply with the request
<br /> within that time,he shall so infbrm the individual,and may have an additional five days wit iin which to comply with the request.excluding Saturdays,
<br /> Sundays and Icgal holidays,
<br /> Subd,4. Procedure when data is not accurate or complete.An individual may ca ntmt the accuracy or dompleteness of public orprivate dam
<br /> concerning himself. To exercise this right,an ind ividualsholl notify in writing the responsiteauthority describing the nature orthe disagreement The
<br /> responsible authority shall within 30 days either; (a)correct die data found to be inaceu to or incomplete and attempt to notify post recipients of
<br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify th individual that he believes the data to be correct.Data in
<br /> dispute shall he disclosed only if the individual's statement of disagreement is included w th the disclosed data.
<br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
<br /> contested cases.
<br /> DATA PRIVACY D •ISORY
<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 furnish certain private or
<br /> confidential information.
<br /> You arc notified that:
<br /> I. The information you furnish will be used to determine your qualification for the permit or license
<br /> requested.
<br /> 2. You may refuse to supply data,but refusal may require •at 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
<br /> process the permit or license.
<br /> 4. If your requested permit 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 permit,
<br /> Michael Chris Ingemansen
<br /> First Middle Last
<br /> 207 Biscayne Lane
<br /> Address
<br /> Rockford MN 55373 (612)310-7706
<br /> City State Zip Phone
<br /> I understand my rights as stated above.
<br /> Signature
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