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Sec.13.0:RIGF3TS OF SIJB.TECTS OF D�TA Subd. 1. Type of daca. The righcs oE individual oo whom thc data is scored or to be scord sha11 be as set forth in this secaon. Subd.2. Information reqirired to be�ven iadividual. An individua!asked to supply private or confideaaal dara coacerniag himseif shall ba informed of: (a) the purpose and inc:aded uso of the requcs�dara within the collecdng�tac�ageacy,polirical subdivisioo,or sntewide ryscem; (b)wherher he may rfuse or is legalIy requi�d to supply the r.quesced daca;(c)any irnown coasequeace arising from his supplying or refusing to supply privace orcon,Zdendal dara;az:d(d)ch:ideadry of otherpersoas orenridcs auchorized by sta�orfederal law to receive the dara. Zhis requiremeatshall not apply whzn an individual is as3;ed to supply invesd�aave daca,pursuant to secdon 13.83, subdivision 5, to a law enforcemza�of�ccer. - 'Cha com^,.issioner of revenue mav otace tha nodce r_auir.d under�his subdivision in the individual income tax or orooem c3x refund inscrucaor.s insccad oE on chose forms. Subd. 3. Access to data by indirzdual. tipon rcquesc to a responsible au�horiry,an individual shall be informed whecher he is che subjecc � of scord dac�on individuals,and whechzr ic is elass��d as pubiic, privace or confidenaal. Upon his furcher requesc,an individual who is the subjecc of scored privace or public dam on individuaIs shall bt shown the dati wichouc any charge to him and;if he desires, shall be infocmed of the contenc and meaning of chat data. Aher an individual hbs been shown the privace data and informed oE ics meaning,the dara need not be disclosed to him for siz monchs tl:ereaiter unless a dispuce or acaon pursuan�to [his secdon is pending or addidonal data on the individual has been collect�d oc creared. The responsible authoriry shall provide copies of the privace or public data upon request by the individual subjecc of the data. 'Ihe responsible auchoriry may require the reques:ing petson to pay tha accual coscs of making,cerrifying,and compiling the copies. The responsible auchoriry shall comply immediately,if possible,wich any request made pursuant to this subdivision,or wi�hin five days oF the dace of che request,excluding Sa�urdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc wichin chat ame,he shall so inform che individuai,and may have an addiaonal five days wicfiin which to comply with the requesc,excluding Saturdays, Sundays and Legal hoiidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or compleceness oF public or pri�•ate data conceming hir.iselF. To exercise this ri¢hc,an individuai shall nori"ry in wridng the responsible authoriry describing the na�ure of the disagreemeat. The responsibi:au�horiry shall within 30 days either: (a)correcc che data found to be inaccurate or incomple[e and attempt to nodfy past recipien[s oE inaccun�e or incomple:e data, including recipiena named by the individuat;or(b)nodfy tha individual that he believes[he data to be correcc. Data in dispuce shall be disclosed only if the individual's s�cement of disagr:em:nt is included wich the disclosed data. 'Ih�decerminarion of the responsible au�horiry may be appealzd pursuant to the provisions of che admirusrrarive procedure act relaang to contestzd cases. DATA PRIVACY ADVISORY In accordance wich M.S. 13.0�, Subd.2, "Ri;hts of subjects of data", we would like to inform you tha[your request for a permit or license from the Ciry of Orono or any of its deparcments may require you to fumish certain private or confidencial informacion. You are notified that: - 1. The information you fumish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permi[ or license. 3, The informatioa may be shazed with other local, state or federal a;encies to the extent necessary to process ' the perniit or license. 4. If your requested permit or license requcres Council action to approve, some information may become public. 5. You have certain riahts under M.S. 13.04 (available upon re uest) to review private data on yourself. 6. Your full name is required to process this application or pe 'c. /"� �,� ��'�-� � Ficst bfiddla Luc �� .o�� ,� �i Addreu � �� �c o�--9 Z�'�l/�' � .�.�(�;`� � � Ciry Sate Z' Yhone I understand my ri�hts as stated above. Signacure