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„a. <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data; (c)any known consequence arising from his supplying or <br /> refusing ro supply private or confidentiai data;and(d)the idendry of other persons or entities authorized by state or federal law to receive the data. <br /> This requirement shalt not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or orooem tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority, an individual shall be informed whether he is the <br /> subject of srored data on individuals, and whether it is classified as public, private or confidential. Upon his further request,an individual who <br /> is the subject of srored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed <br /> of the content and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning, the data need not be <br /> disclosed to hun for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible authority may require the requesting person to pay the actual costs of making, certifying,and compiling the copies. <br /> The responsible authority shall comply unmediately, if possible,with any request made pursuant to this subdivision,or within five days <br /> of the date of the request, excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with <br /> the request within that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legai holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individuai may contest the accuracy or completeness of public or <br /> private data concerning himse(f. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurate or incomplete and attempt to notify <br /> past recipients of inaccurate or incomplete data,including recipients named by the individual; or(b)notify the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The deteanination of the respo�vsible authority may be appealed pursuant to the provisions of the administrative procedure act relating <br /> ro contested 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 <br /> request for a permit or license from the City of Orono or any of its departments may require you to furnish certain <br /> private or 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 <br /> 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 other local, state or federal agencies to the extent necessary to <br /> process 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 yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �I�- L \ 1�.�/�"1� T <br /> C <br /> First Middle Last <br /> �� �� �� a <br /> Address �� n 1 {n , ' , 1 ��,{ �i n �� I I / J� <br /> �v '� �i� N �a, ��- � �a c� <br /> C��y State Zip Phone <br /> I understand y)rights,a stated abo . <br /> Signamre <br /> 6 <br />