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. ' Sec.13.04 RIGFiTS OF SUBJECTS OF DaTA ' Sutd. 1. Type of data, 'Ihe rights of individual on whom[he data is sroced or to be s�ored shalI be as sec forch ia this secaon. Subd.2. Iatormation reqirired to be given indiridual. An individual askcd to supply privam or confidendal dara concerniag himself shaIl be informed o;: (a)[he purpose aad iatcnded use oE the requesced dara wi[hia the collecdng�tate ageaty,polidcai subdivision,or smccwide rysum; (b)whetfier he taay refuse or is_legally requir_d co supply[he r:quesud data:(cj any icnown coasequeace arisiag from his supplying or tefusing to supply privsce or conitdendal dara;and(d)the idendry af ocher pecsoas or eaddes au[horized by sc�te ar federal law to rec:ive che data. This requiremenc shall noc apply w;en an ir.dividual is asked to supply invesagadve daa,pur�anc ro secaon 13.82,subdivision 5, co a Iaw enfoccement officer. "I�e eenmissioner of revenue mav olace che nodce r�uir_d under this subdivision in [he individual income tax or orovem taz refund instrucaons inscead of on[hose forms. Subd. 3. Access to data by iadividual. Upon requcsc to a responsible au[hority,an individual shall be informed whether he is the subjeu of stor:d daa on individuals,and whecher it is classifi:d as public, privace or conFdenaal. Upon his fucther request,aa iadividual who is the subje:c of stor.d private ar public dam on individuals shall be shovm the dara wichouc any charge to him and;if h�des'ues, shall be infomied of the concanc and meaning of chat dara. After an individual has been shown[he private daci and informcd of ics meaaiag,the dara ne�d not be d'uclosed to him for siz monrhs theroafter uriless a dispute oc acaon Pursuane to this secaon is pending oc addidoaal daca on the individual has been collecc�d or creaced. 'Ihe rtsporuibie authoriry shall p�ovide copias of che privat.:or public data upon request by the individual subject of the data. The responsible autfioriry may cequir the tequesdng person to pay the accual cosu o[makin¢, cetvfying,and compi�ing the copies. 'Ihe responsible auchoriry shall comply immcdiattty, if possible, wieh any request made pursuanc to this subdivision,ar wichin five days of the dace of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply with the request wi�hin that ome,ht shall so inform the individual,and may have an addidonal five days within which to compiy with the request,ezcluding Saturdays, Sundays and Icgal holidays. Subd.4. Pracedure when data is not accurate or eomplete. An individual may contest the accuracy or compteteness of public or pri�•ate dara conceming himself. To ezercise this right,an individuai shall noafy in wridng ehe respo�sible auchoriry describing the naatre of the disagrtemea� The responsible authoriry shall within 30 days eitt:er: (a)correct[he data found co be inaccurat�or incompiete and aaemp[to nodfy past recipien�c of inaccurate or incomple[e data, including recipienes named by the individuat; or(b)nodfy[he individual that he believes the data to be correcc. Data in dispuce shall be dis:losed only if the individ�al's sta�emene of disagrcement is includtd wirh[he disclosed data. The de�erminadon of the responsible auchoriry may be appzaled pursuant to the provisions of tha adminis�arive procedure act telaang to contesud cases. • DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hcs of subjects of data", we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to decermine your qualification for the permit or license requested. 2. You may refuse to suppty data, but refusal may require that the City deny the permit or license. 3. The information may be shared wich other local, state or federal agencies to the e�tent necessary io process the permit or license. 4. If your requested permit or license requires Council action to approve, some informa[ion may become public. 5. You have certain ri�hts under M.S. 13.04 (availabie upon request) to review private data on yourself. 6. Your full name is required [o process this application or permic. vJ � s� �'� Firsc �fiddle Last .S-t�S" �c� o�� 13 L��r� Addreu Yl�a v�N � YYv�r� �5.3 � t� � Ciry Sate Zip Phone I understand my � hts as sta ed above. � . Sign�are