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Sec.13.Q;RIGHTS OF SLB.7ECTS OF D:�TA Subd. I. Tyge oE data. The ri�h�s of individual on whom c��data is stor:3 or to bz scor:d shaIl be as set focth in this sccaon. - Subd.2. Information reqtrired to be pivea indicidual. An individuaI asked ro suppty private or confidzndal cL.ra conceming himsetf shaIl be informed of: (a)ch�purpose acd incend:d use of the rquu�da�wirhin the colle:an;Ytat�ageacy, poiiacal subdivisioa,or secewide rystem; (b)whe��er he may rfuse or is le3aIIy requipd to supply the rquested data;(c)any Imown coasequence arising from his supplying or refusing to supply privar or con:;denaal dara;ar.d(d)che idenary of ocher parsoas or enddu auchorizad by stacz or federal law ro receive the data. This requiremeac shall not apply when an iridividu:l is asked to supply invesrisaave daci,pursuan�co secdon 13.82,subdivision 3, co a law enforcemenc ofr;cer. - 'Ihz comm.issioner oF tevenue mav olace the noace r_auird und�r chis subdivision in the individual ir.corae tix or orooertv taz tefur.d insrrucdor.s ulscead oE on chose focros. Subd. 3. Access to data by inditizduaI. lipon requese to a tesponsible authoriry,an individual shall be infocmed whe�her he is[he subject � of scord daci on individuals,and wh��hzr ic is classified as public,privace or co�denaal. Upon his further requesc,an individual who is the subjec� of scored privac_-or pubtic daca on individuaIs shali be ahown n4e dara wi�houc any charge to tiim and;if he desires,shalI be informed oF che concenc and meaning of that data. Ahtr an individua!has bten shown the priva�.data and informed oE its meaaing,the daa need not be disclased to tum for six moncas tf:ereaner untess a dispuce or acdon pursuznc to this secdon is ptnding or addidoaal data on the individuaI has been collect�d or creared. T'ne r.sponsibt�au�horiry shall provide copies of[he privace or public data upon requcse by the individual subjecc of[he daca. 'tiie respocuible auchoriry may tequir che requesdng pe�son to pay che accual coscs of making,eerrifyin„and compiling the copies. Tna responsible auchoriry shall co�ply immedia�aly,if possibte,wich any request made pursuant to chis subdivision, o�wichin five days of the date of che requas�,excluding Saturdays,Sandays and legal holidays,if immzdiate compliance is not possible. If he cannot comp(y with the request ' wichin�hat cimz,he shaIl so inform che individual,and may have an addiaonal five days wirfiin which to comply wi[h the requesc,exctuding Saturdays, Sundays and legal holidays. Subd.4. Procedure r�hea data is not accurate or complete. An individual may contesc the accuracy or compieceness af public orpri�ate daca cor.ceming hir,iself. To exercise chis ri¢h�,an individual shall noa"ry in wriang che responsible au�horicy describing the nature of the disagreemenG The responsibte authoriry shall wichin 30 days either: (a)correcc the dara found to be inaccurate or incomplece and accempt to noafy past recipieacs of inaccurdte or incomptece data, including re:ipien�s named by the individuat;or(b)nodfy the individual that he btlieves the data to be correcG Data in dispute shait be disclosed only if the individual's scacement of disagr:erttent is indudtd wich the dudosed data. The dececminadon of the tesponsible auchoriry cnay be appealed pursuant to the provisions of thz adminisetadve procedure act reladn� to contestcd cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�ts of subjects of data",we would like to inform you that your request for a pernut or license from the Ciy of Orono or any of its deparcments may require you to fumish certain private or confidential information. " � You are notified that:� 1. The informa[ion you furnish will be used to determine your qualification for the per�nit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared wich ocher local, state or federal a�encies to the eztent necessary to process ' the permit or license. 4. If your requesteci permit or license requires Council actibn to approve, some information maq become public. 5. You have certain riQhts under M.S: 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. • � '�►V2�ICL: 42�c�-+�2-� t�/�l oL5 AT!-�E Y� Firsc �fiddle Lasc � �g� CAt�.� C�o�D Address ►XL��S�� , I�� `a�3 31 4--� � � � �3 4_- Ciry State Zip Phoae I understand my ri�hts as stated above. �►�t a 0_.ltic�2 I� � I l —.— , Signan:re