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� � Sec.13.Q4 RIGHTS OF SUB,fECTS OF DaTA ' Subd. 1. Type of data. 'Ihe righcs of individual on wham the dara is srorcd or to be scarcd shall bc az set forch in this secaon. Subd.2. InFormation reqirired to be givea indiridual. �1n individual uY:d to supply private or coafideadal dara conceraing himself shall be inform:d o,`: (a)che purpose aad incended use of che requesud dam wichin the colleccing�a�e agency,polidcal subdivision,or statewide rystm; (b)whect:e:he rtsay r.;vse or is_legalIy requir.d to supply ehe cequesud data:(c)aay lmown caasequence arisiag from his supplying or refusing eo supply private or connder.ria!data;and(d)the ideaary of other per�oas orenodes au[horizcd by sc��e or federal law to teceive the dara. 'Ihis tequiremenc shall noc apply when an ir.dividual is asked to supply invesdgarive daa,putsuaa�to secdon 13.82,subdivision 5,to a law enforcemeat officer. 'I�e ce^imissioner of rcvenue mav oface �he nodc- r_auir.d und:r chis subdivision in the individual income cax or orooem taz refund instrucdons inscead of on those forms. Subd.3. Access to data by indiriduaI. Upon request to a cesponsible authoriry,an individual shall be informed whether he is the subject of scored daa on individuals,and whe�her ic is c[assifi:d as pubiic,privace or conFdenaal. Upoa his fursher requesc, an icdividual who is che subjecc of stoced private or public dara on individuals shall be shown che dara wichout any charge to hun and;if he desires, shall be infocmed of the coacenc ar.d meaning of that daa. After an individual has becn shown che privace dac�and informed of ics meaning,[he data need not be disclosed ro him for siz months thereafter unless a dispute or acdon pursuanc to this secdon is pending or addidooal dara on the individual has beea eollecc:d or erea[:d. 'Ihe responsiblt authoriry shall provide copies of the privam or public data upon tequest by the individual subject of[he dara. 'I�e responsible autfioriry may requir the requesang person to pay the accual coscs oi making,cerdfying,and compiling the copies. The responsiblt auchoriry shall compiy immediately,if possible, with any request made pursuant to this subdivision,or within five days of the date of the cequesc,exctuding Sanirdays,Sundays and legal holidays,if immediate compliar.ce is not possible. If he canaot comply with the requcsc wichin[hat dme,he shall so inform the individual,and may have an addinonal five days wichin which to comply wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate oc complete. An individual may contest tht accuracy or completeness of public or private data conceming himself. To execcise this right,an individuai shail nodEy in wridag ehe responsible auchociry describing the nature of[he disagreemeac The responsible authoriry shall within 30 days eitFer: (a)correc[[he data found to be inaccura�,or incomplece and aaempc to noafy past recipiencs of inaccurate or incomplece data, including recipien�s named by [he individual; or(b)nodfy the individual thac he believes che data to be correc� Data in dispuce shall be disclosed only if the individual's statemertc of disagreem:nt is included with the disclosed data. The decerminaaon of the responsiblz auchoriry may be appealed pursuant to the provisions of tha administrarive procedure act relacing to contesud cases. � DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Righcs of subjects of data", we would like to inform you that your request for a permit or license from the City of Orono or any of ics departments may require you to fumish certain private or confidential information. You are notified that: i. Zhe informa[ion you furnish will be used to determine your qualificatioa for[he permit or license requested. 2. You may refuse to suppty data, but refusal may require that the Ciry deny the perm.it or license. 3. The information may be shared with ocher local, state or federal a�encies to the e�tent necessary to process the permit or license. 4. If your requested permit or license ;equires Council action to approve, some information may become public. 5. You have cenain ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this applicatio❑ or pecmi�. ��{l� � c �-� �' �� l� �'-�� S 0 l� Firs� �j ��.� C n L�s �iddle �� .a5� 7� V'� �� Address L�� (S {^�P l � ��! V� J =7 .�� .� J �T� Ciry Sate Zip Phone I understand my ri hts as stated above. ,�-�L . / L, s�g��,«