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. , <br /> ^ Sec.13.04 RIGHTS OF SGBJECfS OF DATA <br /> Subd.l. Type of dom. The right�of individuel on whom the data is stored or to 6a stored sha[1 be as set forth in this section. <br /> Subd.2.Information requirad to be g[ven individual.An iedividual a�ked co supply private or confidendai data conceming himselfshall bo <br /> informed of: (a)the purposc and Intended use oP the requ�data within thc collecting smte agcncy,political subdivision,or slale�ride system;(b) <br /> whether he may retbse or is legal ly required to supply the requested dam;(c)airy known co�equcnce arising fi'am his supplying or retLsing to supply <br /> prlvate or confidentiel data;and(d)the idenciry of other persons or entities authoriatd by slate or fedaral law to rer.aive the dam.Thia requirement shall <br /> net apply when an individnal is asked to supply investigetive date,pursuant to section 13.8Z,subdivision 5,to a lew enforcement ofFiccx. <br /> Tho commissioner of revanne mav place the notice reauired under this su6division in the individual income ta�c or uronartv tax refimd <br /> instructio�s i�tead of on those formmc. <br /> Subd.3_Access to data by individual.Upon request tn a responsible authority,an individual shall ba infoime3 wHether he is the sub}ect of <br /> stored data on individuals,end whathar it is classified as public,private or confidential.Upon his further request,an individuul who is the subject of <br /> stored prlvate or public deta on individuuls shaN be shawn the data wilhout any charge to him and,if he des'ues,ahal!be inEormed of the content and <br /> mcaning of that data. After an indivtdual has been shown the private data and infortned of lts meaning,ttie dats need not be disclosed w him for six <br /> months theceafter unlass a dispute or action puisuant to this se�tion Is pending or additio�l data on die individual has been collected or crenu:d.The <br /> reaponsible authariry shal I provide copies of ehe private or public da►a upon request by tha individual subject of the data. The respansible authority <br /> may requ'¢e the requesting person w pay the actual cosrs of muking,certifj�ing,end compiling the copies. <br /> The responsible authoril;shall comply imrnediately,if possible,with any request made pursuant to Ihis subdivision,or within five days of <br /> �e date of the request,escluding Sanudays,Sundeys and legat holiduys,if immediete complience is not possble.If he cannut comply with the request <br /> within that ame,he shal l so inform the individual,and may have an additiorial Ilve days within which to comply with the requPst,e�ccluding Satvrduys, <br /> Sundays and lega(holidays. <br /> Subd.4,Procedure when data is not accurate ar complete.M individual muy concest the accumcy or completeiress oFpublic m private data <br /> eoncxrning himself.To e�reise this right,an lndividual shall noflfy in wriang che responsble m�thority describing the muure of the disagreemenc.The <br /> responaible authority shall within 30 days eithar: (a)correct the daia found to be inaxurate or incomplete and sut�npt w noliFy past recipientc of <br /> inaccurate or incomplete data,including recipients nomed by the individuul;or(b)notify the individual that he believes the data w be wrrecc Deta in <br /> dispute shall be disclosed only iF the individuaPs statemen[of disagreement is included with rhe disclosed data. <br /> The detertnination ofthe�nstble authority may ba appealed pursusnt to tde provisions of�he administrative pracedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> Jn accordance with M.S.13.04,Subd.2,"Rights of subjccts ofdata",we would like to inform you thatyour request <br /> for a permit or license from the City of Orono or any of its deparhnents may require you to fumish c:ertain private or <br /> confidential information. <br /> You are notified thaG <br /> 1. The infocmation you futnish will be uscd to detern►inc your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permil or license. <br /> 3. The information may be shared with other local,statc or federal agencies to the extent necessary to <br /> proc�s the permit 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 yovrself. <br /> 6. Your full name is reyuired to pcocess this application or permit. <br /> �t��\�--- � �S"" <br /> Fhsf Middle I.ast <br /> ���' 4.� 'Z�r� �c � - - <br /> Addrevs <br /> ���'fi v� 5 t�ti ���� <br /> C��y State Zip Phoae <br /> 1 understand m righ as stat bo e. <br /> . Sigoatnre <br /> Reaet Form 32 <br /> Z •d e0Z �0T GO EZ I�C <br />