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. - <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 secrion. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or co�dential data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the col►ecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is Iegalty required[o supply the requested data;(c)any known consequeoce arising from his supplying or <br /> refusing to supply private or confidential data;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data. <br /> This requirement shall 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 place the notice required under this subdivision in the individual income tax or vrooertv 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 stored daca 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. After an individual has been shown the private data and informed of iu meaning,the data need not be <br /> disclosed ro him for six months thereafter unless a dispute or acdon pursuant to this secoon 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 authoriry may require the requesting person ro pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediacely, 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 dme, 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 legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private dara concerning himself. To exercise this right, an individual shall notify in writing the responsible authority describing the nature of the <br /> disagreement. The respo�vsible authority 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. Da[a in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The deterntinarion of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating <br /> to 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 �ity 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--.-,,, v.�. a � O r� L � f-1 A iC-S� �2 E ►2 <br /> F t i Middle Last <br /> � � �7 c( �- F�c(� � 1 � Lc: y- 0�IJ E <br /> Address <br /> f7 \ c� L- r4K � VV� N SS.3S 6 �v ( ;�� �173 7b'i��Z <br /> C��y State Zip Phone <br /> I understand my rights as stated above. <br /> � �� <br /> S�gnature <br /> 6 <br />