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� <br /> Sec.13.04 RIGHTS OF SiJBJECTS OF DATA <br /> Subd. 1. Type of data. 'Che rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or co�dential data 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 or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing ro supply <br /> private or confidential data;and(d)the idenciry of other persons or entides au[horized by state or federal law to receive the data. This requiremen[shall <br /> not apply when an individual is asked to su�ply im•esdganve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of reveru mav place the notic•� required under[his subdivision in the individuai income tax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether ic is classified as public, private or confidential. Upon his further request,an individual who is the subject <br /> of siored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hun for <br /> six months rhereafter uniess a dispute or action pursuant ro this secnon is pending or additionai 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 authority <br /> may require che reeuesting person to pay the ach:at costs of making, certifyine, and compiling the copies. <br /> The responsible authoriry shall comply 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 immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so infocm the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal hoiidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may co�test the accuracy or completeness of public or private <br /> data conceming hicriself. To exercise Lhis right,an individuai shall nodfy in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsibie authoriry shall within 30 days eiL4er. (a)correct the data found to be ivaccurdte or incompiere and attempt to notify past recipients 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[he disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 permit 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��ill be use�to determine�our qualification for the pernut 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 othe:loca:, state or federal abencies to the extent necessary to process <br /> the pemut or license. <br /> 4. If your requested permit 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. Your full na.*ne is required to process this application or permit. <br /> �� � � �x ��I�- _ -�._�: ,. ,_ <br /> First Middle Last� <br /> f � � � � � 1. l�� <br /> Addr � -- �/ <br /> �� � I��� �`�� ��\.� .� �/ �\.I / ,Ll i � '- J ) /N1 . <br /> ,yR�A. � s <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> - � / � . <br /> ;, <br /> S�gnature " <br />