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Sec.13.0a I2IGI�TS OF STJBJEC'TS OF AATA ,� Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secuon. Sl�bd.2. Information requized to be given individual. An individual asked to supply p�vate or co�denaal data concerning himself shall lx informed of: (a) t4a purpose aad intended use of the requested data within the collecting state agency, poli[ical subciivision, or statewide system; (b) whether he may refuse or is legally required to supply the requested data; (c)any Vmown consequence arising from his supplying or�efusing to supply private or confidential data;and(d)the idenriry of other persons or enddes authorized by sffiu or federal law to receive the data. This�equiromenc shall not apply when an individual is asked to suppiy invesdgadve data, pursuant to section 13.82, subdivision S, to a law enforcement ofFicer. 'Rze commissioner of revenue mav place the nodce required under diis subdivision i71�ha individual income qx or propercy tax refund insauctions instead of on those fonns. Subcl. 3. Access to data by irtdividual. Upon request to a responsible aud�oriry, an individual shall be informed whether he is the subject of smnxi dan on individuals,and whether it is classified�s�ublic,private or confidential. Upon his further request, an individual who is the subject of srored privare or public data on individuals shall be shown the data wid�out any charge to huu and, if he desires, shall be informed of the content and mcaning of that data. After aii individual has been shown the private data and informed of its meaning, the dara need not be disclosed to him for siz months �heceafcer unless a disppce or acdon pursuant to chis secdon is pending or additional data on the individuai has been collected or created. The responsible authority shaU provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require thc requescing person ro pay the actual costs of making, cercifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible,with any mquest made pursuant ro this subdivision, or within fiva days of chc clate of d�e request,excluding Satutdays,Sundays anci legal holidays, if immediate comptiance is not possible. [f he cannot comply with the request within that dme,he shall so inform ti�e individual, and may have au additional five days wi[hin which ro comply with the request, excluding Satunlays, Suci�ays arid legal holidays. 3ubd.A, Procedure when data is not aceurate or complete. An inciividual may contest the accuracy or completeness of public or private da[a conceming himself. To exeroise this right, an individual shall nodfy in writing.the responsible authoriry describing the nature of the disagreement. The responsible aud�ority shall wi�tiln 30 days eirher. (a)correct the data found to be inaccurate or incomplere and attempt to notify past recipients of inaccurace or incomplete data,including recipients named by the individual;or(b)notify tha individual that he believes the data to be correct. Data in dispuce shaU bc disclosed only if dte individual's statement of disagreement is included with the disclosed data. The detenninarion of the�esponsible authority may be appealed pursuant to the provisions of the administrative procedure act relatuig to contcstcd cases. DA'1'A PRIVACX ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we wnuld like to inform you that your request for a permit or license fzom the City of Orono or any of its departments may requize you to furnish certain private or confidential inforznation. You are notified that: 1. The infonnation you fiirnish will be used to deternune your qu�lification for the pernnit or license requested. 2. You ma}� refiise to supply data, but refusal may require that the City deny the �erznit o� license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the pemut or license. - 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.0� (available upon request) to review private data on yourself. 6. Your full nazne is required to process this application or penmit. ��.�� .10�' .� .� First � { Middle� Last — �/U . Address , �/I � � / _ S��{ Ciry State Zip Phone [ underst my rights as stated ve. � . na e 1�