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. * l <br /> Sec.13.04 RIGFiTS OF SLJB,TECT'S OF DAT.+► • � <br /> Satd. 1. Tyge of data. The righcs af individual on whom the dara is s�ored or ro be stcr:d shall be as sec forch ia this secrioa <br /> 5ubd.2. Iatormation reqinrrd to be givm indlriduaI. An individual asted to supQly privam or confidecdal dam conceraing hiauelf shall <br /> be ia.°oc.�:ed o,`: (a)Ihe purpase and incendcd use of the requcs�data wichin the eotIecdng��ce ageaty.poGacal suL+divisioa,or sramwide rys�m• <br /> (b)whecLe:he;..ay r_�us:or is.legally tequir:d to suPPiY.�e r_ques�d daa:(e)aay Icsawn eaas:quccce arisia3 fmm his suppiyiag or reFusing w suppiy <br /> privace or co;i:;der.csI daa;ar.d(d)�e iCeaary of ocherpersoas orecd3es au�oriz:d by snce ar f:ac^.':c::.o r_ceive�o d33. This r_qu'uc�eat s��.�l <br /> noc a�ply waea aa ir:dividual is asked to supply iavesriganve daca,pursuaac to s<cdon 13.82,subdivision 5,w a law enfarcement ofncer. . - <br /> T�e eenrnissiorter of tevenue mav otace the nodc- r�!ird und-r this subdivision in the individual income eiz or orooertv tiz refund <br /> instrucdons Lnsu_d of on those larms. . <br /> Subd.3. Access to data by iadiridual. Upon requesc to a respansibie auchodry,an iadividual sha11 be informed whe�her he is the subjecc <br /> ef sto�d dsn on individuaLs,and whe�her it is elass�ed as pubiic,privato ar eonF.dend�l. Upan hu furcher r_ques�,an iedividual who is[he subjc�c <br /> o[s;or.d priva;e or public data on iadividuaIs shalI be showa ehe daa wirhaut any eharge ta him and;if 6e desira,shali be infocmed of the eaacenc <br /> and meaning of that daa. Aher an individual his beea shown the pcivatY dae ar.d iafo�med of iu meaaing,the daca need not be d'uclosed oo him for <br /> siz monchs ther_afur unl:ss a dispuce or acdon pursuanc ta this se;don is p<nding or addidoaal dara on tfie individuaI has been colIecc:d or ereac:d. <br /> The tesponsibie autl:oRry shaIl'provida eopies of che privac:orpubiic daa upon request by ehe individual subjecc of che daa. The respocuible aucfioriry <br /> may rcquir_ �he cequesdng pecson to pay the acntal eostc ai making,eecdfying,and eompiling the eaQies. <br /> The cesponsible au�horiry shali eompfy imrtsediataty,if possibie,wich aay requat made pursuant to this subdivision,or wi�Fun five days of <br /> the dace o![he rcques4 ezciuding Saturdays,Sundays ar,d leg�l hotidays,if ir,unediace compliance is not possibte. ff he eaaaot compiy with the requesc I'� <br /> wichin that ame,he shalI so inform che individuaI,and may have an addidonal fiv:days wichin which to eomply wich the requat,ezduding Sacurdays, ! <br /> Sundays and legal hotidays. . , . � <br /> Subd.4. Procedure when data is not accuraeo or eomplete. An icdividual may eont�st the accuracy a�eomplet�neu olpablic orprivace <br /> data conceming tiimsetf. To exercise[his righ�,an individual shall naafy in wridn,�he responsibie au�horiry desrn'biag the nanire of the disagreemeac. <br /> The ccspoasible authoriry shall wichin 30 days ei�:er: (a)eorrect�he dara found to be inaccucat�or incompiete and atc:mp�to nodfy past racipiencs of <br /> inaccucate or incompiae daca,inctuding recipien�s narrsed by the individua.l;or(b}aoafy che individual thac he believes�he daa to be correcc Daa <br /> in dispuce shall be disclosed only if the individual's scater,senc of disagreem:nt is included wi�h th:d'udosed daa. <br /> . The decerminadon of the responsib(a aurhoriry may be appaaled purnsanc to the provi;ions of tha adminisaadve procedure act reladng to <br /> conc:s::d cases. � . • <br /> DATA PRIVACY ADVISORY � <br /> In accordance wich M.S. 13.04,Subd.2, "Rights of subjecu of data", we would like to inform you that your request <br /> for a permic or license from the Ciry of Orono or any of its departments may require you to furnish ceRain private or <br /> confidential information. <br /> You are notified thar. <br /> 1. The information you furnish will be used to determine your qualification for che permit or license requested. <br /> 2. You may refuse to suppty data, buc refusal may require that the City deny the permit or license. � <br /> 3. The information may be shared with ocher local, state or federal a�encies to the ettent necessary to process <br /> the permit or license. � <br /> 4. If your requested permit or license requires Council action to approve, sorne information may become <br /> . public, � � . . . . . , <br /> �5. You ha�e certain ri�hts under M.S. 13.04 (availabie upon request) to review private data on.yourself. . . <br /> 6. Your full name is required to process this application or permit. <br /> �Q1,�� ),�c, r� � - �.S-G �,�� . <br /> Fusc ) /� �tiddle �n / � Lasc • <br /> / 7.� ���C ✓ <br /> Addreu � > � . ��/�� _ 1�,��/ � <br /> c� <br /> Ciry Sate Zip Phone <br /> I understand my ri�hcs a,��ated ve. <br /> G� <br /> signacur� <br />