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Sec.l3.at RIGF3TS OF SL'BJECTS OF D:�Ta ' <br /> Subd. 1. Tvpe of data. 'I�e righc�or icdividual on whom[he dat�is s:o;:d or m be scnred shail be as set for�h ia chis secrioa <br /> Subd.'_. Information reqirired to he�vea individual. �.n individual uk:d co supply private or confideadal dara conceraing himself shaIl <br /> be inforaed of: (a)the purpose and inrended use of ctre tzquested dam wichin the collecdng 3ti`a,eary,polidcal subdivision,or scimwide rystm; <br /> �b)whe:her he tnay refitse or is le3afIy cequird co st:pply the cequested data;(c)aay I�own coas��ueace arising from his supp(yi.^.g or refusing ro supply <br /> privam or conr.dendal dara;ar.d(d)che id�adcy of ocherpersoas orenades auchociz�bY sia�or fed�ral law[o re�eive che dac. "Ihis requir.men�s5a11 <br /> not app[y wF.zn an individual is asked to supp(v ia��esdgadve dan, Qursuant to sec_on 13.83, subdivision 5, m a law eniorteW:ac officer. <br /> The comr.ussioner of r:•enLe nav vi�:: the nocce reauired under this subdivision in the irdividual income ttx or orooem taz tefur.d <br /> ins:rucaans ins;z=d of on chose forms. <br /> Subd.3. access to data by iadividual. lipon requesc to a responsibia au�horiry.3n individual shall be informed whecher he is the subjecc <br /> of s�r_d data on individuals,and whe:�er it is classifed as public, private or con:.�_::dal. i:pon his further reques�an individual who is the subject <br /> of stor:d privace or public dan on indir•iduals s;�all be shown�he daa wi�hout any caar3e co hia and,-if he desires,shall be intormed of[he conc:r.c <br /> ar:d meaniag oi chat dacs. Aher an individual has Eeen shown che privace data and iniormed o�ics meaning, �he dara need noc be disclosed co hira for <br /> siz mon�s d:erafte�unless a dupute or acrion pu:suanc w chis secrion is pending or addido�l data on che individual 6as brea collecud or crear�d. <br /> The cesponsibla au[horiry shall provida copies of�ha privam or public data upon c:quase by the icdividusl subjecc of�f:e daca. Tae r:sponsible auchoriry <br /> may rquir_che requesring person to pay the acwa!cosc�of making.certifying.ar•d compiling rhe copies. <br /> The rsponsible au�tsoriry shall comply ir.u::edia[ely,if possible, wi�h a:.y r.quest s3d�pursuant co this subdivision,or within five dsys oi <br /> the dam of�e requesc,ezcluding Sanirdays,Sundays and legal tiolidays,if immeC�=:e compliacce is no�possible. If he canao�comply wich[he requesc <br /> wichin�ac cme,he shall so inform che individual,u:d may have an addidoaai five days within which co comply wi�z[he requst,excluding Saturdays, <br /> Sundays and legsi holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An ir.dividual may concest che accuracy or compleceness of public or pri�•ate ' <br /> dara cor.cerning himseif. To exer:ise c�is righc,an individual shall nod"ry in wridag u:rspoesiole auchoriry describing rhe nacu:e oi che disagteemeac. . <br /> 'Ihe responsibla au�horiry sh�ll wichin 30 days ei�`.er. (a)correcc[he data found ro t=inaccu��or incomplece and aaempc to nod.`y past r•cipiencs oF <br /> ir.accura:e or incomple:e dan, including recipien¢named by [ha individual; or(b)codfy tF: individual[ha�he believes rhe daci to be cor�ec Da� <br /> in dispure shail be disc!osed only if[he individu�l's saccmenc of disagreemen�is i^:luded wiL`�[h�disciosed daca. <br /> 'Ihe de�e:minadon of[ha rosponsiole au�horiry may be appealed purn.:�-c ro che provisions of cht admuuscr3rive pro.edure act reladng to <br /> con[es:ed cases. <br /> DAT� PRIVACY �D`'ISOR�' <br /> In accordance wich M.S. 13.04, Subd.2, "RiQhcs of subjecu oi data", w•e wouid like to inform you that your reauest <br /> for a permic or license from che Ciry oi Orono or any of its depz�.mencs nay require you to fumis� certain private or <br /> confidencial information. <br /> You are notified that: <br /> 1, The information you fi:rnish will be used to determi^-your quzlitication for the permit or license requested. <br /> ?. You may refuse to supply daca, buc refusal may reouire that the Ciry deay the permic or license. <br /> 3, The information may be shared with ocher local, sca��or federal a�encies co the exteac necessary to process <br /> the permit or license. <br /> .�. If your requested permit or licease requires Council action to approve, some informacion may become <br /> public. <br /> �, You have cena.in riQhcs under �1.S. 13.04 (availabl� unon request) to review private data oa yourself. <br /> 6. Your full name is required to process chis applica�:oa or pe:mic. <br /> Firsc �tiddle Lasc <br /> Add::ss <br /> Ciry Sa� Zip Phaae <br /> I underscand my ri;hcs as sta�ed aoove. <br /> ,�_�,l� <br /> Signacur_ � <br />