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� <br /> � � <br /> ,,��, <br /> Sec.13.04 RIGHTS OF SCfB.TECTS OF D�TA <br /> Subd. 1. Type of data. The righ[s of individual on whom[he data is stored or to be stored shall be as set forth in this�ecdon. <br /> Subd.2. Information required to be given individual. An individual asked[o supply private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of Ihe requested data within the collecdng'state agency,polidcal subdivision,or sratewide system; <br /> (b)whe[her he may refuse or is legally required to supply[he reques[ed data;(c)any known consequence arising from his supplying or refusing to supply <br /> priva[e or confidenrial data;and(d)the idencity of ocher persons or endaes au[horized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enfoccement ofFicer. <br /> The commissioner of re�enue mav place the noace required under this subdivision in the individual income tax or propertv tax refund <br /> insttuctions instead ot on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her ic is classified as pubiic, privace or confidendal. Upon his further request, an individual who is the subjecc <br /> of stored priva[e or public data on individuals shall be shown[he data wi�hout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of chat data. After an individual has been shown che private data and informed of its meaning,the data need no[be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person ro pay the actual costs of making, cenifying, 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 Saeurdays,Sundays and leeal holidays,if immediate compliance is no[possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addirional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pm�ate <br /> data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing[he narure of the disagreement. <br /> The responsible authoriry shalt within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correc[. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3. T'he information may be shared with other local, state or federal agencies 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 /> (. Your full name is required to process this application or permit. <br /> p�(l � C +�.��+,�J <br /> First M�ddle Last <br /> �3�5 �l 1 �-�, ir <br /> Address /� ' �f`�'�Z �y�,�3 Z� <br /> ' �I/I/S ���1 ,7 <br /> ��ty State Zip Phone <br /> I understand my rights as stated above. <br /> � �— <br /> Signature <br />