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� Sec.13.04 RIGHTS OF SUB.TECTS OF D�TA Subd. 1. Type of data. The righLs of individual on whom the data is stored or to be stored shall be as set fonh in this secdon. Subd.2. Information required to be given individual. An individual asked to supply privace or co�dendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, polidcal subdivision,or statewide system; (b)whether he may refuse or is leeally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or co�denaa!data;and(d)che identiry of other persons or enaties auchorized by state or federal law to�eceive the data. This requirement shall not apply when an individual is asked to supply investigadve dara, pursuant ro secrion 13.82, subdivision 5, to a taw enforcement officer. The commissioner of revenue mav place [he norice required under this subdivision in the individual income tax or propem tax refund instrucdons inscead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuais, and whe[her it is classified as public, priva[e or co�denrial. Upon his fur[her request, an individual who is the subjec[ of stored private or public data on individuals shall be shown the data without any charge to hun and, if he desires, shall be informed of the co�tent and meaning of that data. Afrer an individual has been shown the private data and informed of irs meaning,the data need not be disclosed[o him for six months thereafter uriless a dispute or action pursuant to this secdon is pending or addirio�al data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requescing person to pay the actual costs of making, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is no[possible. If he cannot comply with the requesc within that titne,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall notify in wriung the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomptete and atcempt to nodfy past recipients of inaccurate or incomplete data, including recipiencs named by the individual; or(b) notify the individual that he believes che data to be correct. Data in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data. Tne determinacion of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relacing to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Riehts of subjects of data", we would like to inform you that your request � for a pernut or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal a�encies to the extent necessary to process the pernut or license. 4. If your requested pernut or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. • —_ _� _ � , `-�.�= j -<' (r � � ' L ( �� --�!j t �,�c� ,� First Middlz Last ,� .�� Address 1 ) � � �� � �/�1 � ��5�� /'��-'/ Ciry l i State Zip Phone � ) I understand m�y�ghts as state�above. ,- i '� "`�'�'/'�l �----_ �-�� Si ture j �