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Sec.13.04 RIGHTS OF SUB.TECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is storeri or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning hiraself shall <br /> be informed of: (a) the purpose and intended use of the requested data within the colleccing'state agency,polirical subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the idenaty of other persons or entides authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigadve data,pursuant to seccio� 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nocice required under this subdivision in the individual income tax or propercv tax refund <br /> inscructions 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 subject <br /> of stored data on individuals, and whether i[is classified as public, private or confidenaal. Upon his further request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the conteot <br /> and meaning of that data. After an individual has been shown the private data and informed of i�meaning, the data need not be disclosed to him for <br /> six months thereafrer unless a dispute or action purs�.ui[to this secdon is pending or addirional daca on the individual has been collected or created. <br /> The responsible authoriry shali provide copies of the private or public data upon request by[he individual subject of the data. The responsible authoriry <br /> may require the requesrin�person to pay the actual costs of making,certifying, and compiling the copies. <br /> The responsible authority shal(comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,exc(uding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compl}�with th�request <br /> within that time,he shall so inform the individual,and may have an additional five days within�vhich to comply with che request, excluding Sacurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure�vhen data is not accurate or compiete. An individual may contest the accuracy or comple[eness of public or private <br /> data conceming himseff. To exercise this ri�ht,an individual shall notify in writing the responsible aurhoriry describing the nature of the disagreement. <br /> The responsible authority shall within 30 days either: (a)correct[he data found to be inaccurate or incomptete and attempt to notify past recipients of <br /> inaccurate or incomplete data, includin� recipients named by the individual; or(b)notify the individua!that he believes the data to be correct. Data <br /> in disQute shall be disclosed only if the individual's statement of disagreement is included wi�h thz disclosed data. <br /> The determinacion of che responsible authoriry may be appealed pursuant to the provisions of the administrative procedure acc relating co <br /> contested cases. <br /> DATA PRNACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we�vould like.io inform you that your request <br /> for a permit or license from the City of Orono or any of its departments ma_y require }�ou to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you fumish will be used to determine your qualification for the permit or license 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 process <br /> the permit or license. <br /> 4. If your requested pernut or license requires Council action to approve, some information may become <br /> public. <br /> 5, Yeu ha�•e certain ri7tits und�r M.S. 13.04 �avail�ble upon :eguest),to revie:v private data on yourself. <br /> 6. Your full name is required to process this applicat;on o- permit. : <br /> ���� 1 0����� Lt �L�s� <br /> Fi:st IvIiddle Last <br /> a � s ma� i��f s��f- s�, � �4�_ <br /> Address . <br /> {'Y1 �v� v�c .��� (�5 1`')�l �5-4c�S ���-- 3��'( —/7 3�— <br /> ���y State : Zip Phone <br /> I understand my rights as stated ove. <br /> /; <br /> Signarure <br />