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. J <br /> . . I . <br /> 5ec.13.04 RIGF�'S OF SUB,TECTS OF DATA ' <br /> Subd. 1. Type of daca. The righcs of individual on wham the dam is scored or ro be stor.d shalI bc as sct forch in this secrioa � <br /> Subd.2. IaformaGon reqirired to be given iadiridual. An individual uk:d w supply privam oc confidendal daca concerning himseif shall I� <br /> be informed o,`: (a)[he purpose aad inrendcd use of the requessed dam wit4in the collecdng Zate ageaty,poliacaI subdivision,cr sra�widc rystm; � <br /> . (b)whec,`.e:he r.3y r.`use or is,legally tequir.d to supply,the rquesud data;(c)any Imawn caasrqucnce arisiag from his supplyiag oc refusing to supply I <br /> privace or con.=tdar.dal dati;and(d)ehe idendry of other per�oas orenddes au�orized by sc�ce or federal law co rrceive t�e daca. This r_quire�cac shall � <br /> not apply w�en an ir.dividual is asked to supply invesagadve daa,pursuanc ta secdan 13.82,subdivision 5,w a law enfatcement officer. . <br /> 'f�e ce_clmissioner of revenuc mav oia;e the nodc- r�uir-d und-r chis subdivision in the individual income eiz or orooem tax refund <br /> insrrucdans inscezd of on chose forms. <br /> Subd.3. Aecess to data by indiridual. Upon requesc to a responsible aurhoriry,an individual shall be informed wht[her he is the subject � <br /> of swr.d dan on individuals,and whecher ic is class�ed u public,privaee or conEdenaal. Upoa his furcher r_quesc,an icdividual who is[he subjecc � <br /> of scor.d private or public data on individuals shall be shown[he daa wichout any charge to him and;if he desires,shall be infocmed of[he eonten� <br /> ar.d meaning of that data. Aher an individual has been shown the pcivate daa and iaformed of ics meaaing,the dara aead not be disclosed to him for I <br /> six moncfu theceafcer unless a dispuce or acaon pursuanc to tivs secdon is pending oc addirioaal dac3 on the individual has been eolle:c:d or ereat�d. <br /> Tae resporuibie aud:oriry shall provide copies of che privam or public daca upon request by the individual subjcct of[he dam. Tha respotuibie autfiotiry � <br /> may requir_ �he r.quadng per�on to pay the accual eoscs oi m�king,eertifying,ar.d eompiling che eopies. <br /> The r.sponsible authoriry shall eomply immediaccly, if Qossible,wi�h any request made pursuant to this subdivision,ar wichin five days of <br /> the date of the request,ezcluding Sacurdays,Sundays and legal holidays,if immediace compliacce is notpossible. If he canaot comply with the request <br /> wichin that dme,he shal!so inform the individual,and may have an addidooal fiv:days wichin which ro comply wich the request,ezeiudiag Satuidays, i <br /> Sundays and legal holidays. . <br /> Subd.4. Procedure whea data is not accurate or eompiete. An individuai may conc:sc the accuracy or eompieceness of pubtic or private <br /> dam concerning tiunself. To exercise chis right,an individual shaIl noafy in wridng che responsble auchoriry dascribing dse naeure of the disagreemeac. <br /> 'Ihe respoasible auchoriry shall within 30 days eict;er: (a)correcc ehe data found co be inaccurac:or incomptece and attempc to nodfy past recipienc�of <br /> inaccurate or incamplece data, including recipieacs named by [he individual; or(b)nadFy the individual that he believos the data to be correc4 Dati <br /> in dispu�e shall be disdosed only if the individual's statcmenc of disagreemenc is included with the disdosed data. j <br /> The dtcerminaaon of the responsibla auchoriry may be appealed puc�uanc to the provuions of[he admuuscrarive procedu�e act mlaring to ; <br /> conmsud cases. . <br /> 4 <br /> DATA PRIVACY ADYISORY <br /> In accordance wich M.S. 13.04, Subd.2, "Rigbts of subjeccs of data", we would Iike to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualifica[ion for the permit or license requested. <br /> 2. You may refuse to suppiy data, but refusat may require that the City deny the permit or license. <br /> 3. The information may be shared wich ocher local, scace or federal agencies to the excent necessary to process <br /> 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 certa.in ri�hts under M.S. I3.04 (availabie upon request) to review private data on yourself. <br /> 6. Your full name is required to process this applicacion or perm.ic. <br /> l��)�-n.,�,�-� � ��n�� �-j� <br /> First �fiddle I.asc <br /> � � �J � � � � N �s� i� ✓J t,�.����� <br /> Addreu <br /> �y'1'��v,�...-7 a�r�'� �S� � � �� t-1 �7�:3- — � �- � c3- <br /> Ciry ( Sate Zip Phone —� <br /> \ ', <br /> I underst d m ri�ht9!as"stated al�o've. '� (, <br /> ��� ` / <br /> � � �/ <br /> Signacure <br />