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� <br /> 5cc.13.0� RIGI-ITS OF SUBJECTS OF DATA <br /> Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> SuUd.2. (nformation required to be given individual. An individual asked to supply private or contidential dataconceming himselfshall be <br /> inforaied of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide systein;{b) <br /> �vhether he may refuse or is legally required to supply Nie requested data;(c)any known consequence arising ftom his supplying or refusing to supply <br /> private or confidential data;and(d)the identity ofother persons or entities authorized b��state or federal law to receive the data. This requirement shall <br /> no[apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or r�operry tax retund <br /> instructions instead of on those fonns. <br /> Subd.3. Access fo data by individual. Upon request to a responsible authoriry,an individual shall be intormed whedier he is the subject of <br /> stored data on individuals,and��hether it is classitied as publ ic,privace or confidentiaL Upon his further request,an individual who is the subjcct of <br /> stored private or public data on individuals shall be shown the data�a�ithout any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the private data and inFormed of its meaning,the data need not be disclosed to him for six <br /> months thereatter unless a dispute or action pursuanc to this section is pendin�or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon request by the individual subject of d�e data. The responsible auchority <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible aud�ority shall comply immediately,if possible,with any requesc made pursuant to this subdivision,or a�ithin tive days oF <br /> the date ofthe request,e�cluding Safurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply witl�the request <br /> within that time,he shall so infonn the individual,and may have an additional tive days within which to comply with the request,e�cluding Saturdays. <br /> Sunda��s and leoal holidays. <br /> Subd.4. Procedure when data is not accurate or complefe. An individual may contest the accuracy or completeness of public or private data <br /> concerning himseff. To exercise this ri�ht,an individual shall notify in�vriting tlte responsible authority describing the nature of the disagreemen[. The <br /> responsible authoriry shail within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notit;v past recipients of <br /> inaccurate or incomplete data,includin�recipients named by the individual;or(b)notify the individual tha[he Uelieves the data to be correct. Daca in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included�vith[he disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the adminisVative procedure act reladng tD <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.0�4,Subd.2,"Rights of subjects of data",we would like to inforn�you that your request <br /> for a pecmit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential infortnation. <br /> You are notified that: <br /> 1. The information you furnish wilf be used to dete�7nine your qualification for the permit or ficense <br /> requested. <br /> 2. You may refuse to supply data, but refusal n�ay require that the City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the e�ctent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some inforn�ation may becoilie <br /> public. <br /> 5. You have certain rights under NI.S. 13.04 (availablz upon request)to review private data on yourself. <br /> 6. 1`our full name is required to process this application or permit. <br /> `���J t"� � `_�)/1�l�'vl fi.�.16 S <br /> First �'fiddic Last <br /> �i�1�.� �LYi�1'S►�tir-1- ,•4.�j ` S . <br /> r�ddress <br /> j(d o r�1 - {'�ni �S`{Z o �'-I_�2_ - � �s�s-3 7 � ( <br /> Cil} State "/_ip Phone <br /> I under nt1"rr v ri hts �ted a <br /> Sign.�tun� <br /> Reset Forrn �2 <br />