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. <br /> Sec.13.04 RIGHTS OF SUB.TECTS OF D�1TA <br /> Subd. i. Type of data. The righ�s of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.'_. Information reqirired to be given individual. An individual asked to suppiy private or confidendal data concerning himself shal! <br /> be informed of: (a) the purpose and intended use of the requested data within the collecting'state agency, policical subdivision,or statewide rystem; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply <br /> priva[e or co�dential data;and(d)[he idenciry of other persons or enrides authorized by state or fedecal law ro receive the data. This requirement shall <br /> noc apply when an individual is asked to supply invesrieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund <br /> instructions 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 whe[her i[is classified as public, private or confidenaal. Upon his further request, an individual who is the subjec[ <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 infomted of the content <br /> and meaning of�hat data. Afrer an individual has been shown rhe private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuan[to this section is oending or addidonal dara on the individual has been coilected or created. <br /> The responsible au[horiry shall provide copies of the private oc public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of makine, certifying, and compiling the copies. <br /> The responsible authoriry shal(comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compiiance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addirional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of public or pri�•ate <br /> data concerning himself. To exercise this rieht,an individual shall no[ify in writing the responsible authori[y describing[he na[ure of the disagreement. <br /> The responsible authonry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccunte or incompfete data, including recipients named by the individual; or(b) notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> Tlie de[ermination of the responsible authoriry may be appea(ed pursuant to the provisions of the administrarive procedure act reladng to <br /> contesred 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 are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the pemut 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 pernut 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 this application or permit. <br /> �� 1/I'1�zi <br /> First tifiddle Lasc <br /> Address <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> ( � �� --_ <br /> C�\/' <br /> �v--- <br /> Signature <br />