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Sec.13.04 RIGHTS OF StTB.JECTS OF DAT?, ' <br /> Sutd. 1. Type oC data. The righct af individual on whom�he daa is srored or co be stnrod shall be as set forch in this secdon. <br /> Subd.2. Ia.Formation reqirircd to be givw iadiridual. �1n individual asYed W supply privam or confidendal dara conceining himsalf shall <br /> be infora:ed o,`: (a)[he purpose and intended use of the requuud dara wichia the eollecang 3tate ageaty,poliacal subdivision,or sramwide rysum; <br /> (b)whecher he may r:vse or is_legaily requir_d to supply the c:quesud dan:(c)aay iaiown coasequeace arisiag from his si:pplyiag or refusing to supply <br /> privace or connder.�sl data;and(d)[he idenory of o�ha persons or enrides aurhorizcd by suce or fedaal law to receive c�e da�a. This requiremenc sha!I <br /> not app[y when an ir.dividual is asked to supply invesdgarive data,punuant to setdon 13.82,subdivision 5, to a law enfoc�emeat o�cer. <br /> 'i�z eer.tmissioner of revenue mav piace che nodc- r�uird under this subdivision in the individua! income rax or orovertv taz refund <br /> inscrucaons inscead of on chose forms. <br /> Subd.3. access to data by individuaI. Upon requcs�to a responsible au�horiry,an individual shall be informed whecher he is che subject <br /> of stor.d daa on individuals,and whecher it is classified as public, pmate or conFdenaai. Upon his furcher r_quest,an individual who is the subje:� <br /> of stored private ar public dara on individuals shall be shown ehe daa wi[hout any charge to him and;if he desires,shall be infocmed of the eontenc <br /> and meaning of rhat dara. Afrer an individual has been shown the privac.dan and informed of ics meaaing,the dara need not be disclosed ro him for <br /> six manths thereafter unless a d'upute or acaon pursuane to this secdon is pending or addidoaal daa on the individual has been eollected or creat�d. <br /> The respocuibie authoriry shall provide copies of the privam or public data upon request by the individual subjcct of[he dam. 'Iha tesponsible autfioriry <br /> may requiro che requaring person to pay che accual cosu oi makin¢, cerrifying,and compiling che copies. <br /> 'Ihe responsibla au�horiry shall comply immediately, if possib(e,wi�h any request made pursuant to this Subdivision,or wichin five days of <br /> the date of the requesc,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he canaot comply with the tequesc <br /> wichin that ame,he shall so inform the individual,and may have an addidonal five days within wluch to compiy wi[h the request,ezcluding Sacurdays, <br /> Sundays and lrgal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or completaness of public or pri�•ate <br /> data conceming himself. To exercise this right,an individual shail noafy in wriang the responsible au�horiry dascribing the nature of the disagreemenc. <br /> 'Ihe responsible auchoriry shall wichin 30 days ei�:er: (a)correcc cha data found to be inaccura�,or incomplece and aaempc to nodfy pasc recipiencs of <br /> inaccurate or incomp[e�e data, including recipien�s named by the individual; or(b)nodfy the individual ihat he be(ieves the daca to be correct Data <br /> in dispuce shall be disclosed only if the individual's sta�emenc of disagrcem:nt is included wich the disclosed data. <br /> The decerminadon of the responsible au�horiry may be appzaled pursuan[to the provisions of tha adminisaarive procedure act relaang to <br /> contesc:d 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 depar�ments may require you to furnish certain private or <br /> confidencial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to decermine 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 licease. <br /> 3. The information may be shared wich other local, stace or federal a�encies to the ettent necessary to process <br /> the percnit 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 ri;hts under M.S. 13.04 (available upoa request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permi[. <br /> �'J � <br /> ��"',�''��'M �-r' I�l t,�,✓ ���c���"�� �._ <br /> Firsc �ddle � Lasc <br /> � �ZCP-�P�yCP S �v� � - <br /> Address <br /> � G�l �( �(�� � �- �2�l�d <br /> Ciry� Sace Zip r !-� <br /> I underst my ri;hts as stated above. <br /> � <br /> Signs <br />