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Sec.13.04 RIGHTS OF SC1BdEC1'S OF DATA <br /> Subd. 1. Type o[data. The rights of individual on whom the data is stored or ro be stored shali be as set forth in this secaon. <br /> Subd.2. Information required to be given individual. An individual asred to supply private or confidendal data concerning himself shall <br /> be info�med of: (a)the purpose and inte�xled uu of the requested data within the collecting state agency,poliacal subdivision,or statewide system; (b) <br /> whe[her he may refuse or is legally nquired to supply the requested data;(c)any lmown consequence arising from his suppiying or refusing to supply <br /> private or confidential data:and(d)the identiry of other persons or enaties authorized by state or federal law w receive the data. This roquirement shall <br /> not apply when an individual is asked to supply investigative da�,pursuant to section 13.82,subdivision 5,w a law enforcement o�cer. <br /> 'Ihe commissio�r of cevemre mav nlace dx mace isauued ucder this subdivision in the individuat income taz or orocertv tax refund instiucdons <br /> instead of on those forms. <br /> S�bd.3. Access to data by iadiridual. Upon request to a responsible suthority,an individual shall be informed whether 6e is the subject of <br /> storod data on iniividuals,and w�ther it is clasdfied u public,privax or wnfidential. Upon his further request,an individual who is the subject of stored <br /> private or public data on individuals shall be shown the data without any c6arge to 6im and, if he desines, shall be informed of the content and meaning <br /> of that data. Afur an individual has been shown the private data and informed of its meaning, the data need not be disclosed to him for six months <br /> thereafter unless a dispure or acrion pursuant w this section is pending or addidonal data on the individual has been collected or created. The responsible <br /> authority shall provide copies of the private or public data upon request by the individual subject of t6e data. The rosponsible authoriry may requiro the <br /> requesting penon to pay the actual costs of making,certifying,and compiling the copies. <br /> Tt�e responsible authority shall comply unmediately, if possible,with any tequest made pursuant to this subdivision,or within five days of the <br /> date of the�equest,excluding Sanudays,Slmdays a�lega(holidays,if immediate cotnpliance is not possible. If he cannot comply with the nquest within <br /> that rime,he shall so inform the individual,and may have an addidonal five days within which w comply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure whm data�not accu�ate or oompkte. An iadividual may contest the accutacy or completeness of public or private data <br /> corueming himself. To exercise this right,an individual shall nodfy in wridng the nspoasble authority describing the nature of the disagreement. The <br /> �espoosible authoriry shall within 30 days either. (a)comect the data found ro be inaccurate or incomplete and aaempt to notify past recipients of inaccurate <br /> or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data to be cornct. Data in dispute shall <br /> be disclosed only if the individual's staument of disagreement is included with the disclosed data. <br /> 'Ibe deoerminadon of d�e�rsponsible audwriry may be appealed punvant ao the p�ovisions of the adminisuadve procedure act relating to contested <br /> 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 you to furnish certain private or <br /> confidential information. <br /> You aze notified that: � <br /> 1. The information you fiunish 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 tke permit or license. <br /> 3. The informadon may be shazed 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 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 /> ��o�. 5• �����a� <br /> First Middle Last <br /> �o. �,�y� � � � <br /> Address <br /> ����r �1.�� �s'�7 G/Z .r�,^�Z 7Z� <br /> City State Zip Phone <br /> I understand ' ts ated above. <br /> / �`f <br /> Sign e <br /> 10 <br />