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� <br /> Sec.13.04 RIGHTS OF SLBJECTS OF D�T� <br /> Subd. l. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as se[for[h in this section. <br /> Subd.2. Information required to be�ven indicidual. .-1n individual asked to supply private or conhdenrial dara conceming himself shall <br /> be informed of: (a)the purpose and intended use o[the requestPd dara wi[hin the collecang"state agency, poliacal subdivisioo, or statewide system; <br /> (b)whecher he may refuse or is le¢ally required to supply the reauested da[a;(c)any Imown consequence arising from his supplying or refusing to supply <br /> private or confidendal data:and(d)the idendty of ocher persons or enndes authorized by srace or federal law ro receive the data. This requirement shall <br /> not apply when an ir.dividual is asked [o suppty invesn�an��e dara. pursuant to secnon 13.82, subdivision 5, ro a law enforcement o�cer. <br /> The com�nissioner of re�e ue mav olac� c'r od-� roauired under this subdivision in the individual income taz or oropertv tax refund <br /> ins[ructions instead uf on rhose forms. <br /> Subd. 3. .-�ccess to data by individual. L'pon reaues[[o a responsible auehonry,an individual shall be informed whether he is the subject <br /> of srored data on individuals, and whether i[is classuieci as puolic, pnvate or coruidendal. Upon his fur[her request, an individual who is the subjec[ <br /> of stored private or public data on individuals shall be shown �Ze da[a wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. .-�frer an individual has been snown che pnvace data and informed of is meaning, the data need not be disclosed to hun for <br /> six monrhs thereafter unless a dispute or action pursuan�tD this secnon is pending or additional data on the individual has been collected or crea�ed. <br /> The responsibie auchoriry shall provide copies of the pri�•are or public data upon request by[he individual subject oi the data. The responsiole au[horicy <br /> may require the requesting person to pay the actual costs oi makine, cemfyine, and compiling the copies. <br /> The responsible authonry shall comply immedia[ely, if possible, with any request made pursuant to this subdivision, or wichin five days of <br /> [he dare of[he request,excluding Sanirdays,Sundays and legal holidays, if immediace compliance is no[possible. If he canno[comply with the request <br /> within that time,he shall so inrorm che individual,and may have an addidonal five days within which to comply wirh the request,exduding Sanirdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this neh[,an individual shall nodfy in wri[ing ehe responsible au[honry descnbing the nature of the disagreement. <br /> The responsible au[hority shall within?0 days ei[her: fa)correct the data found to be inaccurate or incomplete and attempt to norify past recipiencs of <br /> inaccurate or incompiete data, includine recipien�s named by L5e individual; or(b)nodfy the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individuai's s[acemenc of disagreement is included wi[h the disclosed data. <br /> The determination of the responsible au�horicy may be aopealed pursuanc to the provisions of the admuusrradve procedure act relacing to <br /> con[ested cases. <br /> D:�T:� PRIVACY �DVISORY <br /> In accordance with M.S. 13.04, Subd. �, "Riah�s of subjects of data", we would like to inTorm you[hat your request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> ':ou �;e :o�i;ed that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license requested. <br /> 2. You may rer'use to supply dara, but refusal may require that the City deny the permit or license. <br /> ;. The information may be shared witn ocher local, sta[e or federal agencies to the extent 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 certain rights under �1.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this applicacion or permit. <br /> �ti %/�,-�, ✓� �,/<<S <br /> Firs[ ` ^ , titiddle ��� // / Lasc <br /> �/4 � � ��� ''�' t@"�_r /r;0i <br /> Address 7 <br /> � � 1 �� �� �i///�v S�� `i i �7/ -� 7/� <br /> ��ry � State Zip Phone <br /> I understand � rights,, st ec� above. <br /> �/ '' <br /> C( `' /� <br /> Sienature <br />