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a� � <br /> r <br /> Sec.13.04 RIGHTS OF S[JB.TECTS 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 fonh in this section. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or co�denrial dara concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting"state agency,political subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply <br /> priva[e or confidential data;and(d)the identiry of o[her persons or enriries authorized by state or federai law to receive the data. T'his requirement shall <br /> not app(y when an individual is asked to supply invesrieadve daca, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public, privace or confidendal. Upon his further request, an individual who is the subject <br /> of stored private or pubtic data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be informed of the con[ent <br /> and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hun for <br /> six months thezeafter unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the ac[ual cosu of making, cenifying, and compiling the copies. <br /> The cesponsible authoriry shall compiy immediately, if possible, with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immedia�e compliance is no[possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, <br /> 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 private <br /> data conceming himself. To exercise this right,an individual shall norify in wriang the responsible authoriry describing the nature of the disagreeme�t. <br /> The responsible au[horiry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienu of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act reladng to <br /> 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 request <br /> for a pernut or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the pemut or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. <br /> 3, The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the pernut or license. <br /> 4. If your requested pernut or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> 6, our full name is required to process this application or permit. , <br /> � , S�, ���rs� <br /> � u � <br /> First Middle Last <br /> .����� � �s�� P� ; hfi �a <br /> Addre � ��7 j��� �• <br /> �/� , a � f� YI/I . �.53�1/ � <br /> City 3tate Zip Phone <br /> ��I unders and my rights as s ed ve. <br /> �� � � <br /> � <br /> gnature <br /> � <br />