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� Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Typc of dafa. 'Iha rights of individual on whom the data u atocrd a W bc atorod shall be as ect forth in thi+section. <br /> Subd.2 Infomulion ecquircd lo bc givcn individual.M individual askcd to supP�Y Pm'ate or co�dential data conceming himaclfshall bc <br /> informcd of: (a)thc pucposc and intcndcd usc of lhe ccqucstcd data within thc collxting ctatc agcncy,political aubdivision,a statewidc�ystcm;(b) <br /> whcthcn c�may rcfuse or is Icgally rcquic�cd to supply the rcqucstcd data;(c)any l�own consequcnce ui+ing firom his aupplying or refuaing to cupP�Y <br /> private or co�drntial data;md(d)the idcntity of other pecsons or rntities authorizod by state or federal law tn reocive thc dati This eequiccnait ahall <br /> not apply whrn an individual is aslccd to:upply mvcstigativc data,pucauant W taction 13.82,subdivuion 5,lo a law caf'occcmcnt offica. <br /> T'he commissionct of revcnuc may,place lhe noticc roauircd undcr this eubdivision in the individual incomc tax or nrooertv tax refund <br /> �nstn�ctinns instead of on those fornta. <br /> Subd.3. Acecsa to data by individual.Upon rcqucst to a respons ble authority,an individyal shall bc infocmed whetha he is the tubjcct of <br /> storod data on mdividus(s,and whctha it is classi£icd u public,privatc or confidcntiaL Upon his furtha tequcst,an individual who is ihe tubjoct of <br /> atorcd privatc or public data on individuals ehall be ahown the data without any chacge W him and,if hc desires,shall be infocmed of the content and <br /> meaning of that data. Afia an mdividua!hu becn shown thc privatc data and infortned of its meaning,the data nced not be d'uclosed to him for six <br /> months thcrcafta unlcss a disputc or action pwsuant to this scction is pcnding or additional data on the individual has bccn collcctcd or crcated.'flie <br /> responsible authority etull provide copics of thc pcivatc or public data apon rcqucst by thc individual aubjcd of thc data. Thc respocuible authocity <br /> may require lhe requesting person to pay the actual costs of malang,certifying,and compiling the copiea. <br /> The responsiblc authority ahall comply immediately,if possibic,wilh any requcst made pursuant to Ihis subdivision,or within feve days of <br /> Uu date oflhe requcst,cxcluding Sa[urdays,Sundays and legal holidays,if imficdiatc compliance is not possble.If hc cannot comply with Ihe request <br /> within that time,he shall so infocm the individual,and may have an addilional five days wilhin which to comply with the rcquest,exe(uding Saturdays, <br /> Sundays and legal holida}'s. <br /> Subd.4.Procedurewhendataisnolaccurateorcomplete. MindividualmaycontcstU�eaccuracyorcompletenessofpublicorprivaledala <br /> conceming himself.To eccrcise this right,an individual shall nolify in w'riting thc raponsib(e authority describing lhe naWre of thc disageemenL The <br /> responsible au4iority shallµ�ithin 30 da}�s either: (a)correct the data found to be inaccurate or incomplete and ariempt to notify past recipients of <br /> inaccurate or incomplete daW,including recipients named by the individual;or(b)notif}'lhe individual thal he believes Ihe daL�to be coaecL Data in <br /> dispute shail be disdosed only if lhe individuaPs sUtement of disagreemcnt is induded with the disclosed data. <br /> The detertnination of the respons ble authority may be appealed pursuant to the provisions of[he administrative procedure act relating lo <br /> contested cases. <br /> i <br /> DATA PRNACY ADVISORY <br /> In accordance���th M.S.13.04,Subd.2,"Rights of subj ects of data",we would lil:e to inform you that your request <br /> for a permit or license from the City of Orono or any of its departments may require you to fiunish certain private or <br /> conl`idential informaUon. <br /> You are notified that: <br /> 1. The information you fumish will be used to deternunc your qualification for the pernut or license t <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 infonnation may be shared with other local, state or federal agencies to the extent necessary to <br /> process the pernut or license. <br /> 4. If your requested pernut or license requires Council action to approve,some information may become <br /> public. <br /> 5. You have certain rights under MS. 13.04(available upon request)to review private data on yoiuself. <br /> 6. Your full name is required to process this application or permit <br /> William James Ulrich <br /> Fi rst M idd le Lbst <br /> 600 12 Oak Center Drive, Suite 648C <br /> Ad d ress <br /> Wayzata MN 55391 952-476-6599 <br /> City State Zip Phone <br /> I underst d my rights as ated above. <br /> Sign re <br /> 32 <br />