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Sec.13.0-L RIGHTS OF SiJB.TECTS OF DaT�. <br /> Subd. 1. Type of data. 'Ihe righ�s of iadividual on whom[he data is s[ored or co be stored shall be as set for[h in this secrion. <br /> Subd.'_. Informadon reqirired to be�ven individual. An individual asked to supply privare or confideorial data concerning himself shall <br /> be informed of: (a) the purpose and inrPnded use of[he requesud data within the collecdng"s[ate agency,polidcal subdivision, or sratewide system; <br /> (b)whe[her he may refuse oY is legally tequired ro supply[he rtquested da[a:(c)any Imown coasequence arising from his supplying or refusing to supplv <br /> privace or conndenoai data;and(d)[he idennry of orher persors or enaaes authorized by sta�e or federal law to receive the data. This requirement sball <br /> not apply when an individual is asked to supply in�'�sdeaave dam, pursuanc to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enu r�av pla-� the rodr r�auired under rhis subdivision in the individual income tax or propzrtv raz refund <br /> insttucuons inscead of on those forms. <br /> Subd. 3. Access to data bc indi�-iduaI. lipon request ro a responsibfe authoriry,an individual shall be informed whether he is che subjecc <br /> of stor_d daca on individuals,and wherher it is class�ed as puelic, privace or confidendal. tipon his funher request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be showv�e data without any charge co him and, if he desires, shall be informed of the content <br /> and meaning of[hat data. Afrer an individual h�t been shown[he private data and informed of its meaning,the data need not be disdosed to hirn for <br /> six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addiaooal data on the individual has been collected or creaced. <br /> The responsible aurhoriry shall provide copies of che privace or public data upon request by che individual subjecc of[he data. The responsible au�horiry <br /> may require che requesring person to pay the acaial costs of s.akine, certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of[he request,exciuding Sacurdays,Sundays and le2al holidays,if immediate compliance is not possible. If he cannot comply with the requesc <br /> wichin rhat time,he shall so inform the individual,ar:d may have an addiaonal five days wi[hin which to compiy with the request,excluding Saturdays, <br /> Sundays and tegal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accutacy or completeness of public or pri�•a�e <br /> data concerning himself. To exercise[his right,an individuai shail noafy in writing the responsible authority dzscribing the nature of the disagreement. <br /> The responsible authority shall within 30 days ei[.`.ec: (a)corr:ct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, including recipiena named by [he individual; or(b)nodfy the individual [hat he believes the data to be correct. Data <br /> in dispuce shall be disclosed only if the individual's statement of disagreemen[is included with the disclosed data. <br /> The determinadon of the responsible au�horiry may be appealed pursuant to the pro�isions of the adaunistrarive procedure act reladng ro <br /> contested cases. <br /> DAT�. PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri�ts of subjects of data", we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or <br /> confiden[ial information. <br /> You are notified that: <br /> 1, The information you furnisn 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 a�encies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested perm.it or license requires Council action to approve, some informa[ion may become <br /> public. <br /> �. You have certain ri�hts under i�1.S. 13.04 (available upon request) [o review private data on yourself. <br /> 6. Your full name is required to process this applicacion or permit. <br /> �.____._� � � �_ <br /> �GZ,�4td1.�� �`3' �tiddl� Last <br /> FirSt <br /> a--�j 2� .�-�-L -. � Z� <br /> Address ��3 7 � ol ff`�—/ � �� <br /> G��-a�w �'1 r� <br /> Ciry Stare Zip Phone <br /> I understand my ri�hts as stated above. <br /> Signa[ure <br />