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. . <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. The rights ot individusl on w6om t6e data is stored or w be stored shall be u set forth ln this section. <br /> Subd.2. Information requlred to be given individual. An individual asked to mpply private or conSdential data concerning h(msdf s6a11 be <br /> informed of: (a)the purpose and intended use of the requested data withln the collecting state agency,politiesl subdlvision,or statewide system;(b) <br /> whet6er he may refuse or is legally requtred to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or rnnfidential data;and(d)the identity of other persons or entities authorized by siate or federal law W receive the data. This requirement shall <br /> not spply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law eniorcement ofticer. <br /> The rnmmissioner of revenue mav olace the notice reauired under this subdirision in the individnal income tax or orooertv tu refund <br /> instructions mstead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible suthorin•,aa Individual shall be informed whether he is the sabject of <br /> stored data on iodividuals,and whether it is classitled as publtc,private or conRdential. t'poo hfs furt6er reqnest,an individusl who is the sabject of <br /> stored private or public data on indlviduals shall be shown the data without any c6arge to him and,if he desim,shall be Informed of t6e content and <br /> meaning of that data. After an individual has beea shown t6e private data and informed of its meaning,the data need not be disclosed to 6im for six <br /> months thereafter unless s dispute or action pursuant to this section is pending or additional data oo the indi�idaai has been collected or creatsd. The <br /> responsible authority shall provide rnpies of the private or public data upon request by t6e Individual subject of tLe data.The responsible authority may <br /> requlre the requesting person to pay the actual rnsts of maldng,certifying,and rnmpiling the rnpies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of the <br /> date of the request,excluding Saturdays,Sundays and legal holidays,it immediste compliance ls not possible.If he cannot comply with the request within <br /> that time,6e shall so inform the individual,and may 6ave an additional five days within w�hich to comply with the request,excluding Saturdays,Sundays <br /> and legal holldays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual s6a11 notity io writing the respoau'bie suthority describing the nature of the dlsagreement The <br /> responsible authority shall withln 30 days either: (a)correct the data found to be lnaccarate or inrnmplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the indlvidual;or(b)notif�•the individual that 6e believes the data to be correct Data in <br /> dtspute shall be disclosed only if the individual's statement of disagreement is included Rith the disclosed data. <br /> The determination of the responsible suthority may be appealed pursuant to the provisions of t6e sdministrative procedure act rdating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request <br /> for a permit or license from the City of Orono or any of its departments may require�ou to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish 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 den�the permit or license. <br /> 3. The information may be shared with other local,state or federal agencies to the eztent necessary to process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council acdon 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 this application or permit. <br /> ���� �B'� !z J d tti'��/`�'�/ <br /> First Middle Last <br /> `�SY� �.,. ... �� <br /> Address <br /> 'I,Ja.�� ��... S���i /� `{7/d5` 3 z <br /> City State Zip Phone 1 <br /> I understand my rights as stated above. . <br /> Signature <br /> �.� <br />