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� - � <br /> Sec.13.04 HIGHTS ON'SUBJECTS OF DATA <br /> Subd.1. Type of data. Thc rights of individual on whom the data is stored or to be stored st�all be as set fo�th in[his section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or con�dential da[a concerning himself shall be <br /> in(ormed oL• (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or state�vide system;(b) <br /> whether he may refuse or is legally required to supply the requcsted data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other pe�sons or entities authorized b}'state or federal law to receive the data. This requiremenf shall <br /> not apply when an individual is asked to suppl,y investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement of[icer. <br /> The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or nropertv tax refund <br /> instructions instcad of on thuse 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 of <br /> stored data on individuals,and whcther it is classi�ed as public,private or confidential. Upon his furthcr request,an individual who is thc subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be inCormcd of the content and <br /> meaning of that data. After an individual has been shown the private data and intormed of its meaning,the data necd not be disdosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may <br /> requirc the requesting person to pay the actual costs of making,certifying,and compi�ing the copies. <br /> Thc responsible authority shall comply immediatcly,if possiblc,with any request madc pursuant to this subdivision,or within fivc days of the <br /> date of the request,excluding Satw•days,Sundays and legal holidays,if inunediate compliance is not possible. If he can�wt comply with the request avitl�in <br /> that timc,hc shall so inform thc individual,and may have an additional five days within which to comply with thc request,exduding Saturdays,Sundays <br /> and legal holi�ays. <br /> Subd.4. Procedure whco data is not accurate or complete. Ao individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To esercisc this right,an individual shall notify in writing thc responsible authority describing thc naturc of thc disagrcemenL Thc <br /> responsible authm•ity shall rvithin 30 days eiU�er. (a)correct thc data found to be inaccm�atc or incomplete and attempt to notify past rccipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notifV the individual that he bclieves the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagrecment is included with the disclosed data. <br /> The Jctermination of[he responsible authurity may be appealed pursuant to the provisions o(the adminislrative procedure act relating to <br /> contested cases. <br /> DA1'A NRIVACY ADVISORY <br /> In accordance with M.S.13.04,Subd.Z,"Rights of subjects of data",we would like to inform you tliat yoor request <br /> for a pernrit or license fro�n the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You arc notifed tliat: <br /> 1. Tlie information you furnish will be used to deterrnine your qualification for the pernut or license requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny thc 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 permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04 (available upon request)to review private data on yourself. <br /> 6. Your full name is required to process tliis application or permit. <br /> Charles D. Wilson <br /> First Middlc Last <br /> --���I� �Sf�9�'� �Fl �l <br /> Address <br /> Ply. Mn. 55441 763-559-2316 <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> C��� � L-���_ <br /> Signature <br />