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Oct 10 2006 9: 29RM HP LRSERJET FRX 612-825- 1900 p. 4 <br /> Sec.13.04 RIGHTS OF SUBJECTS OF D TA <br /> Subd. I. Type of data. The rights of indrvidual on whom the data is stored or ta bc stored shall be as set farth in this sccHon. <br /> Subd.2. Information required to b given individual. An indiv idual asked to supply private or con6dential data concerning himselfshall be <br /> informed of: (a)the purpose and intended usc ofthe nequested data within thc collecting slate agency,political subdivision,or stalewide system;(b) <br /> whecherhe may refuse or is tegally rcquired to suppiy the requested data;(c)any known consoquence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identi of other persons or entities authorized by state or fedeta)law to receive the data. This requireroent shall <br /> not apply when an individual is asked to sup y investigative data,pursuant to section 13.82,subdivi�ion S,to a law enforcement ofFcer. <br /> c o v I i <br /> instrucrions instead of on�ose forms_ <br /> Subd.3. Access ro data by individ al. Upon request to a rosponsible aut6ority,an individual shall be infortr�ed whether he is the subject of <br /> stored date on individuals,and whether it is ci ss�ad as public,private or confidential. Upon his further requesk an individual who is the subject of <br /> stored private or public data on individuals'sh 11 be shown the data without any charge to him and,if he desires,shall be infortned of the contenc and <br /> rneaning of that data. After�n individual has en shown the private data and informed of its meaning,the data nced not be disclosed to him for six <br /> tnonths thenafter unless a dispute or action p uant to this section ispending ar additianal data on the individual has been collected or aeated. The <br /> responsible authority shall provide copus of t e private or public data upon requast by the individual subject of the data. The responsible authoriry <br /> may require Ihe requesling person to pay tha tual costs of making,certifying,and compiling the copies. <br /> T6e responsi6le suthority shal l co ply immedielely,if possibl e,with any reguest made pursuant to this subdivis ion,or wrthin 5ve days of <br /> the date�f the reques�excluding Saturdays,S ndays and legal holidays,ifimmediate compliancc is not possible. Ifho cannot eomply with the requast <br /> within that qme,he sball so inforro the individ 1,and mey have an add itional five days within which to evmply wit6 the request,excluding Saturdays, <br /> Sundays and legal bolidays. <br /> Subd.4 Procedure when dats is n t aeeurate or oomplete. An individual may contestthe accuracy or completeness ofpubl ic arprivatedeta <br /> concernine himself. To exercise this right,an i dividual shall norify in writing the responsible autltority dcscribing the nature of the disagreement. The <br /> responsible authority shall withm 30 days ei er: (a)correct the data found to be inaccurate or incomplete and attempt ro nodfy past recipients of <br /> inaccurate or ineomplete deta,including recipi nts named by the individual;or(b)notify the individual that he believes the data to be coaeck Data in <br /> dispute shaq be disclosed only if the individu 's statement of disagroement is included with the disclosed date. <br /> The determination of the responsi le authority may Ix appesled pursuant to the provisions ofthe administrative procedure act�elating lo <br /> contestod 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 fumish certain private or <br /> cunftdentisl information. <br /> You are notified that: <br /> 1. The infomtation you furnish will be used to determine your qualification for the permit or license <br /> reyuested. <br /> 2. You may refuse to su ply data,but refusal may require that the Ciry 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 icense. <br /> 4, If your requested pe it or license requires Co�mcil action to approve, some information may becorae <br /> public. <br /> 5, You have certain righ s under M.S. 13.04(available upon request)to review private data on yourself. <br /> 6, Your ful)name is req ired to pracess this application ar permit. <br /> Firct NORTHRUP RO FING �ODELING L�ct <br /> 4400 NICOL £7 AV�NUE SOUTH <br /> Addreas (61 )825•3353 <br /> Cily Strte Zip Phooe <br /> I understand roy rights as stated a ove. <br /> Signature <br /> � 1 I�r P��u•ii li I i Xn�.�.ne il t�y Ci'� -..c. <br /> . 4�A �,, . �{7. <br />