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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 secrion� � <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or <br /> refusing to supply private or confiden6al data;and(d)the iden6ry of other persons or enciries authorized by srate or federal law to recei�•e the dara. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision�, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav nlace the no[ice reauired under this subdivision in the individual income tax or orooem tax refund <br /> instructions instead of on those forms. <br /> 5ubd. 3. Access to data by individual. Upon request to a responsible authority, an individual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or conf'idential. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the data without any charge ro him and, if he desires, shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafter unless a dispute or action pursuant ro this section is pending or additional data on the individual has been <br /> collected or created. The responsible authority shali provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesting person to pay the acrual costs of making,certifying,and compiling the copies. <br /> The responsible authority shal(comply immediately,if possible,with any request made pursuant to this subdivision, or within five days <br /> of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with <br /> the request within that time, he shall so inform the individual, and may have an additional five days within which ro comply with the request, <br /> excluding Saturdays, Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the�ature of the <br /> disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to noufy <br /> past recipients of inaccurate or incomplete data,induding recipients named by the individual;or(b)notify the individual that he belieczs the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinanon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relatine <br /> to 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 <br /> request for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You are notified that: <br /> 1. 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 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 <br /> � process the permit or license. <br /> (' 4. If your requested permit or license requires Council action to approve, some information may become <br /> J� <br /> A,��1)` ,,�.(� public. <br /> � �,�NN 5. You have certain rights under M.S. 13.04(available upon request) to review private data on yourself. <br /> 1�' � <br /> � 6. Your full name is required to process this application or,.permit. <br /> ������ ��Y��l� <br /> First 1 1 Middle Last <br /> l �Z��J I'l�� �1� <br /> Address � ,•�, r .�5/�/�( �J/2��(3"1j�7 <br /> �'���N -r � r�r� <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> �� � • <br /> Signature <br /> 6 <br />