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� t . Scc.13.0:RIGHTS OF SUBJECTS OF DATa Subd. 1. Type oF data. The righcs oF individual on whom the data is stored or to be s�or:d sba11 be as se[forth ia this secdon. " Subd.2. Informatioa reqirired to be givea individual. An iadividual asked to supply private or confid�ndal data concerning fiimsetf shall ba info�med of: (a)the purposo and inr:nded use of[he rtquess�dara wi[hin the collecdng§tat�a;eacy,poliacal subdivisioo,or sacewide ry�m; (b)whe[her he may rfuse or is legally requir.d to supply[he rquesced data;(c)any Fmown coasequence arisin3 from his supplying or refusing to supply private or confidenrial data;and(d)th_idendry of ocher pacsoas or enades au�horized by se�ee or federal law to r:ceive the dara. This requucmenc shall not apply when an individual is asked to svpply invesdgadve data,pursuant to secaon 13.82,subdivision 5, to a law enforcemznt ofricer. - Tha commissioner of rever.uo mav place tha noace r_auir.d under this subdivision in the individual ir.come �x or orooem tax refued inscrucrions inscead of on chose forms. ' Subd. 3. Access to data by individual. tipon requesc to a responsible au�horiry,an individual shall be informed whe�her he is the subjecc � of scored dact on individuals,and whechtr it is ciassified as pubtic, privace or confidenrial. Upon his furcher request,an individual who is the subjecc of scored private or public dara on individuals shall be Shown che data wi�hout any charge to tiim and;if he desires, shall be informed of the eontent and meaning of that dara. Afcer an individu�!has been shown[ho privac�data and informed of ics meaaing, the dara need noc be diseiosed to him for siz monrhs thereaiter unless a dispute or acdon pursuanc to chis secdon is ptnding or addidoaai dat�on the ir.dividual has been collected or crearr.d. The responsibie authoriry shall provid�copies of the priva[�or pubiic data upon reques�by the individual subje:c of che data. Tne responsible auchoriry may requir the requesring person to pay the accual coscs of making,cerafying,and compiling tfie copies. The responsibla au[horiry shall comply immediately,if possibfe, with any request madz pursuant to[his subdivision,or wichin five days of the dace of tht request,excluding Sacurdays,Sundays and legal holidays,if immedia�e compliance is not possible. If he canaot comply with the requasc wirhin that time,he shall so inform che individual,and may have an addiaonal Five days wichin which to comply with the requesc,excluding Saturdays, Sundays and legal hotidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest cha accuracy or completeness of public orprivate dan concerning himself. To exercise chis ri¢hc,an individual shall noa'ry in wriang che responsibie auchoriry d:scribing the nantre of the disagreemeac. The responsible authoriry shall wi�hin 30 days eicher: (a)corrcc che data found to be inaccurate or incomplece and aaempt to nodfy past recipiencs of inaccurate or incomplete data, including recipien�s named by che individual;or(b)nodfy the individual thac he believes che data to be correcc. Data in dispum shall be disclosed only if the u:dividual's s��emenc of disagreement is included wich che d'uclosed da�. The decerminarion of the rzsponsible auchoriry may be appealed pursuant to the provisions of che 2dmirus[radve procedure act reladn� to contesced cases. DATA PRiVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Riohts of subjects of data", we would like to inform you that your request for a pernut or license from the Ciry of Orono or any of its departments may require you to fumish certain;private or confidential information. You are notified tha[:� 1. The information you furnish will be used to determine your qualification fo:the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permi[ or license. 3. The informatioa may be shared wich ocher local, state or federal a�encies to the excent necessary to process ' the permi[ or license. 4. If your requested permit or license requcres Council action to approve, some informa[ion may become public. �. You have certain rights under M.S. 13.04 (available upon request) to review private data onyouurself. 6. Your full name is required to process this application or permic. l� �a-�,��.. �P��,��- ��t�s _ First Middle Lasc ��`'Z-L-<.� �S„l L4�/c�'J- CfTUL-� � Addcess �V�u �' �Y� ��+�1 �� ` ��- Ciry _� Sate Zip Phone I understand my rights as stated above. Signa�ur