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Sec.13.04 RIGHTS OF S[fBJECTS OF D�►TA , <br /> Subd. i. Type of data. The rights of individual on whom the data is stored or to be stoced s6all be as set forth in this secrion. <br /> Subd.2. Information req�rired to be given individual. An iadividual asked to supply private or confidenrial data conceraing himself shall <br /> be informed of: (a)the purpose and intended use of the cequcs�ed data wichin�e collecring�tate agency,poliacal subdivision,or statewide rysum; <br /> (b)whecher he may refuse oY is legaily required co supply the mquesud data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidenaai data;and(d)the idendry of other pe�sons or enades au[horized by state or federal law m receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdgadve data,pursuant to secrion 13.82,subdivision 5, to a law enfocsement officer. <br /> The commissioner of revenue mav alace che nodce reauircd under this subdivision in the individual income tax or prooertv taz refund <br /> instructians inscead of on chose forms. <br /> Subd.3. Access to data by iadtviduai. Upon requesc to a responsible authoriry,an individual shall be informed whether he u the subject <br /> of stored data on individuals,and whether it is classified as pubtic,privace or confidential. Upon his further request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown[he data wirhout any charge to him and;if he desires,shall be informed of the content <br /> and meaning of chat data. Afur an individual has been shown the privau data and informed of iu meaniag,the data need not be disclosed ro him for <br /> six months thereafter unless a dispute o�acdon pursuanc to this secrion is pending or addidonal data on the individual has been collected or created. <br /> The respoasible authoriry shall provide copies of the private or public dara upon mquest by the individual subject of the data. The respoasible authority <br /> may require the requesang person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible au[horiry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saardays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc <br /> wirhin that time,he shall so inform the individual,and may have an addiriooal five days within which to compiy wich the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. An individual may conusc the accuracy or completeness of public or private <br /> data concerning himsetf. To exercise rhis right,an individual shall nodfy in writing the responsible authoriry describiag che nature of the disagreement. <br /> The asponsible authoriry shall within 30 days either: (a)correcc the daca found to be inaccurau or incomplete and aaempt W nodfy past recipienss of <br /> inaccurdte or incomplete data, including recipients named by che individual;or(b)noafy the individual tha[he believes the data to be correcc. Data <br /> in dispute shall be disclosed only if the individual's statemenc of disagnement is inciuded with the disclosed data. <br /> The decerminadon of the responsible authoriry may be appealed pursuanc to the provisions of the administrarive procedure act retating 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 Ciry of Orono or any of its departments may require you to fumish 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 Ciry 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 permit 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 ri.,,¢hts 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 /> T�a,�Q �„�G `7�o,�osa,� <br /> First Middle Last <br /> ,��3� L Uo��-,ea .�vE <br /> Addcess �J��/ 7��_7'��—���-C. <br /> �XC�1Sro� /��. <br /> City Stam Zip Phone <br /> I understand my righu as stated above. <br /> - � <br /> Signamrc <br />