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.�• <br /> � <br /> . <br /> Sec.13.04 RIGHTS OF SLBJECTS OF D,�Ta <br /> Subd. I. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as sec forth in[his section. <br /> Subd.2. Information required to be�ven indi�idual. .�n individual asked to supply private or conndenaal dara conceming himself shall <br /> be iniormed of: (a) the purpose and incended use ot[he requested data wi[hin the collecdng"state a2ency, polidcal subdivision, or stacewide rystem; <br /> (b)whechzr he may refuse or is leeally required to supply cfie requested data:(c)any k�own consequence arising from his supplying or refusing to supply <br /> priva[e or contidendal data:and(d)the identicy ot o�`:er c�rsoas or entides au[horized by state or federal law ro receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesn�sdve data, pursuant to secnon 13.82, subdivision�, to a law enioremen[oificer. <br /> The commissioner oi re�erue ^ia� olac .'r odc rcwired under 'his subdivision in ��e individual ir.come taz or oropem taz rerund <br /> instructians instead of on rhose rorms. <br /> Subd. 3. ?,ccess to data by individual. L?oon reques[to a responsible authonry,an individual shall be inYormed whether he is the subject <br /> of stored data on individuals, and whe�her i[is classided as puolic, pnva[e or contidennal. lipon his [urther request, an individual who is the subjecc <br /> of s[ored private or public data on individuals shall be shown [ne data wichout any charee to hun and, if he desires, shall be informed of the concen[ <br /> and mzaning of that data. After an individual has been shown[he pnvace data and informed of ics meaning, the data need noc be disciosed ro hun for <br /> six months[hereafter unless a dispu[e or accion pursuanc co chis secnon is pending or addido�al data on the individual has been collected or crea[ed. <br /> The cesponsible authoriry shall provide copies or[he pn��as,or pubiic data upon request by[he individual subject of the data. The responsible authority <br /> may require the requesting person ro pay �he actual costs of ma}:ing, cemfying, and compiling che copies. <br /> The responsible authonty shall comp(y immedia[ely, if possible, with any request made pursuant to this subdivision, or wirhin five days ot <br /> che date of the reques[,excluding Saturdays,Sundays and le�al holidays, if immediate compliance is not possible. If he canno[comply wirh the request <br /> wi[hin tha[cime,he shall so iniorm the individual,and may have an additional five days wirhin which to compty wi�h the request,excluding Sa[urdays, <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 concemine himself. To exercise rhis ri�h[,an individual shall notify in wncing the responsible auchoriry describing the c�ature of the disagreemenc. <br /> The responsible aurhoriry shall within 30 days either. (a)correct the data found ro be inaccurace or incomplete and attempc to nodfy past recipien[s oi <br /> inaccurate or incompizte da[a, includine recipienes named by the individual; or(b) noti"ty the individual that he believes the data to be correcc. Data <br /> in dispute shall be disclosed only if che individual's sta�emen[of disaereemenc is included wi[h che disclosed dara. <br /> The de[ermina�ion oT the responsible au[honry may be appealed pursuanc ro �he provisions of the admuustranve procedure act relating to <br /> contesred cases. <br /> D:�T:� PRNACY ADVZSORY <br /> In accordance with�I.S. 13.04, Subd. �, "Riahts of subjects of data", we would like to inform you that your request <br /> for a permit or license from the Ciry oT Orono or any oT i[s depanments may require you to furnish certain private or <br /> confidential information. <br /> "iou are ^o�ified cr.a�: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply daca, but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared wich o[her local, sta[e or federal aaencies to the extent necessary to process <br /> the pemut 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 cenain riQhts under �4.5. 13.04 (available upon request) co review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �-�� ,r�c` f��j� �7`� <br /> First ( '.i:ddle Last <br /> 7lQ C> ��� G-"�S�D� �_ G'/] — <br /> Address <br /> S"r �ui S .�.� .G/�' �� S�/� d��-�3��5�� - <br /> �ity Srate Zip Phone <br /> I understand my rights as stated above. <br /> � ,�..�--�.�'c��_ <br /> Signacure <br />