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� � . <br /> Sec.13.04 RIGHTS OF SLJB.TECTS OF D�TA <br /> Subd. 1. Type of data. The righ�s of individual on whom the data is stored or to be stored shall be as set fonh in this secdon. <br /> Subd.2. Information reqirired to be given individual. M individual asked to supply private or confidendal dara concerning hicnself shall <br /> be informed of: (a)the purpose and iatended use of the requested data within the collecang"state agency,polidcal subdivision,or sratewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the idenrity of other persons or enrides auchorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrieauve dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or pro�ertY tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by indi�idual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject <br /> of stored data on individuals, and wherher it is classified as public, private or confidenoal. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown[he data wirhout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of rhat dara. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acaon pursuan[to [his secdon is pending or addiaonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual coses of making, certifying, and compiling the copies. <br /> The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> [he date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is no[possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with[he request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic or pri�•ate <br /> data concerning himself. To exercise this righ[,an individual shall noafy in wridng the responsible authoriry describing[he nature of the disagreeme�t. <br /> The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, inciuding recipients named by che individual;or(b)nodfy the individual that he believes the data to be correcc. Data <br /> in dispute shail be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible aurhoriry may be appealed pursuant to the provisions of the administradve procedure act relaring 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 City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1, The information you furnish will be used to deternune your qualification for the pemut 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 pemut 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 /> (, Your full name is required to process this application or permit. <br /> �nn�Gt"� C�c'r� �� �jvG���50.tJ <br /> First Middle Last <br /> Lf Z Z S —�.'c'�� %s4�i� �i-r�� <br /> Address �_�U.vJ �-(/" SS36�� �.SZ / 7Z �����i <br /> C% <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> .% <br /> Signa[ure <br />