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� <br /> � .. <br /> Sec.13.0:RIGHTS OF SLJB.TECTS OF D�.TA <br /> Subd. 1. Type of daca. The rig��s of individual on whom[he dan is storcd or to be s�ord shalf be as set forth in this secdon. <br /> Subd.2. Iaformaaon reqirired to be given indirzdual. An iadividu�l asked to suppiy privare or confideaaal dara coacerniag himself shall <br /> ba informed of: (a) [he purpose and ia[�nded use of che requesr�daa withia the colle:dng stac�ageacy, polirical subdivision,or statewide ryssem; <br /> (b)whechcr he may r_fuse or is le3ally requird to supply che r.quest:d dsca;(c)any Irnown coasequeaco arising from his supplying or refusing to supply <br /> privace or eonndendal dara;and(d)the idendry of other parsons or enada au�horized by sc�te or federal law to receive tfie dam. Ttiis requiremeot shall <br /> not apply when an u:dividual is zsked co supply invesri�adve dara,pursuanc to secaon 13.82,subdivision 5, to a law enforcemen�officer. - <br /> Thz com^�ssioner of revenut mav place the noace rauird und-r this subdivision in the individual ir,come tax or orooem taz refur.d <br /> instrucdor.s insLead of on�hose forms. <br /> Subd. 3. Access to data by indi�idual. lipon request to a responsibte auchority,an individual shall be informed whether he is the subject � <br /> of s�or_d dac�on ir.dividuals,and whecher it is classified as pubiic,privace or confidenoal. Upon his furcher requesc,an individual who is the subjecc <br /> of scor:d privace or pubiic dat3 on individuals shall be shown the dati wichout any charge to him and;if he desues, shalf be informed of the content <br /> and meaning of chat dara. Aft�r an individu�l has been shown the privac-data aad informed of its meaning,the data need not be disclosed to him for <br /> six monchs cl:zreacc-r u:iless a dispute or acdon pursuzac to chis secaon is pcnding or addidoaal data on the individuai has been collecced or created. <br /> 'Ihe rsponsibl�authoriry shall provide copies of[he privace or public data upon tequesc by the individual subjecc of[he data. The responsible authoriry <br /> may requir the requesdng person to pay the acnial cosu of ma3cing,cecafying,and compiling the copies. <br /> 'Ihe responsibte auchoriry shall comply immediacely,if possiblc, wich any request made pursuant to this subdivision,or wi�hin five days of <br /> the da�e of cha requesc,excluding Sacurdays,Sundays and legal holidays,if immediace compliance is notpossible. If he canno[comply with the rcquesc <br /> wichin[hat tima,he shail so inform che individuai,and may have an addiaonal five days wi[hin which to comply wich the request,exctuding Sacurdays, <br /> Sundays and legal hoiidays. <br /> Subd.4. Procedure vchen data is not accurate or complete. An ir.dividual may contest the accuncy or completeness of public or pri�•ate <br /> data conceming hirself. To exercise chis right,an individual shall nod"ry in wridng�he responsible auchoriry describing che na[ure of the disagreemen[. <br /> The responsible autY:oriry shall within.i0 days eithec: (a)cocrecc che data four,d to be inaccurdce or incompiete and attempt to nodfy past recipienrs oF <br /> inaccurate or incompiece data, inciuding recipiena named by the ir:dividual; or(b)nodfy the individual thac he believes che data to bo cocrecG Data <br /> in dispute sha(t be disclosed only if the individual's s�temenc of disa3r:err;ent is included with the disclosed data. <br /> 'Ihe dececminarion of the responsible au[horiry may be appealed pursuan[to 4`�e provisions of[he adminiscraave procedure act relatiag to <br /> contesced 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 reques[ <br /> for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. J <br /> You are notified thar. � <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. The information may be shared with ocher local, state or federal agencies to the ex�ent necessary to process <br /> ' the permit or license. <br /> 4. If your requested permit or license requires Council actibn to approve, some informa[ion maq become <br /> public. <br /> S. You have certain riQhts under M.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �/�i/�� � nl�% .,/='! <br /> First �fiddla Lasc <br /> ����1 11/��r/ - <br /> Add�ess f , - , , ,� . <br /> , '��;� ��'��, K /'��/ �� '. �.. . �� .��_ <br /> , �' <br /> Ciry Snce Zip Phone <br /> I understand my ri�hts as stated abov��j � <br /> ;' ��.__/"- <br /> '1 �' <br /> Signa�ure <br />