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� � <br /> Sec.13.Q4 RIGFiTS OF SLJBJECTS OF DATA ' <br /> Sutd. 1. Type o[data. The righ�s of iadividual on whom[he data is scored or ro be storad shall be u set focch in this setaon. <br /> Subd.2. Intormation reqinred to be givea iadiridual. �1n individual uk:d w supply priva�e or coafidendal daca concerning himself sbaIl <br /> be iafora:ed of: (a)the purgose and inrendcd use of the requcsted dara wichin the collecting�ate ageuty,polidcaI subdivision,or scatewide rysc-m; <br /> (b)whec�er he may reFuse oc u,legalIy requir:d to suppty.che rquesud data:(c)aay Imawn coasequcnce arisiag from his supplyiag or reCusing to supply <br /> privace or co:i.=�der.ria.1 data;and(d)the ideadry of o�her pecsoas or ead¢es auchorizcd by st�te or fedecal law to rnceive the dara. This requirement zha1I <br /> nat apply when an ir.dividua!is asked to supply iaves¢garive dam,pursuaac ro secdon 13.82,subdivuioa 5, co a law enfaccemeat oE,lcar. . � <br /> 'T�a cenmiszioner of rovenve mav D1ace �he nodr rauird und-r this subdivision in the individual income taz or orooem eaz refund <br /> inscrucdons tinstead of on chose Corm.s. <br /> Subd.3. Accas to data by individual. Upon requesc ro a rzspansible authoriry,an individaal shall be informed wharher he is the subjecc <br /> of stnr:d dsn on individuaIs,and whe�her it is c(ass�ed as public,privac�or conEdenaal. Upon his furchec r_quest,an iadividual who is ehe subjecc <br /> of s:or.d privace ar pubiic data on individuals sha1l be shawn the daci wichout any charge to him and;if he desira,shall be infocmed oE the eontanc <br /> ar.d meaning oE chat dara. Aher an individual has been shown�he privare dan and infocmed oC ie�meaaing,the daea aeed not be disclosed to him far <br /> su mancfu thereafter unlas a dispuce or acaon purruanc to this se:aon is pending oc addiaoaal daca on the individuat bas been eollecc�d or crear_d. <br /> The respocuible aud:ariry shall�provide copies of che privac�or public data upon request by[he individual subject of che dara. Tha respocuible auchoriry <br /> may requir.rhe requesdng person ro pay the accual coses or making,eecrifying,and eompiling che capia. <br /> The responsible auchoriry shalI compiy immediataly, if possible,wi�h any requesc made pursuanc to�his subdivision,or wi�hin five days of , <br /> the date of che reqaesc,ezcluding Sacucdays,Sundays and leg�l holidays,if immediace compliance is not possible. If he cannot comply with the reques� � <br /> wichin d�ac drrse,he shall so inform che individual,and may have an addirioaat five days wichin which ro comply wich the request,excluding Sacurdays, ! <br /> Sundays and legat holidays. . . <br /> Subd.4. Pracedure whea data ts not accurate or eomplete. An udividual may eonGsc ehe accurncy ar eompiec�ness oFpublic orprivace <br /> dara conceming himself. To exercise chis right,an individual shaIl nodfy in wridag�he responsibie auctioriry describing the nacure of the d'isagreemeac <br /> The respoasibic authoriry shall within 30 days ei�:cr: (a)cocrec�che data found to be inaccurdte or incomplece and attempt to nodfy past recipiencs of <br /> inaccurdce or incomptece data, including recipien�s named by the individual;or(b)naaFy[he individual that he believes the data to be correcc. Dat� <br /> in dispuce shali be disclosed only iF the individual's statemenc of disagrcement is induded with the d'uclosed data. <br /> The decerminadon of the responsibte auchoriry may be appealed pursuanc to the p�ovisions of the adminisaarive procedure act relating to <br /> contesud tases. • <br /> DATA PRIVACY ADYISORY � <br /> In accordance wich M.S. 13.04, Subd.2, "Ri�bts of subjecu of data", we would like to inform you tha[your request <br /> for a pennit or license from the City of Orono or any of its depanments 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 detemune your qualification for che pecm.it or license requested. <br /> 2. You may refuse to suppty da[a, but refusal may require that the Ciry deny the permit or license. <br /> 3. The information may be shazed wich other local, stace or federal a�encies to the etcent necessary to process <br /> the permit or license. <br /> 4. If your requested permic or licease requires Council action to approve, some information may become <br /> public. � <br /> 5. You have certai.n rights under M.S. 13.04�(availabte upon request) to review private data on yourself. <br /> 6. Your full name is required to process this applicacion or permic. <br /> _' J�i�,�C� C�����'LJ �� � ��f-' ���(-'� <br /> First _�fiddle � Last <br /> � � �7 ���S (..�� I �`ct_,�'� ��( <br /> �aa� � , <br /> f� �� w�e v��� � �,� ti ��S��Y�7 ��7�--3� `i �7 . <br /> Ciry Sace Zip P�one <br /> I u rsi�d my ' hts as stated above. � <br /> � ' <br /> � <br /> Signacure ' <br />