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.r.. . <br /> _ � <br /> � <br /> Sec.13.04 RIGHTS OF SLTB.TECTS OF DATA <br /> Subd. 1. Type of data. The righ�s of individual on whom the data is stored or tobe stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supp(y private or co�dential data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested data wichin the colleccing'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is leeally required to supply the reques[ed data;(c)any imown consequence arising from his supplying or refusing to supply <br /> privace or confidencial data;and(d)che idenary of other penons or enaaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigaave dara, pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whecher it is classified as public, private or confidenrial. Upon his funher request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown the data wi[hout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafrer unless a dispute or action pursuant to this secaon is pending or addiaonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the Private or public data upon request by the individual subject of che data. The responsible authority <br /> may require the requesting person to pay rhe actual costs of making, cerafying, and compiling the copies. <br /> The responsibte authoriry shall compiy immedia[ely, if possible, with any reques[made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that tune,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Sacurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accu:ate or complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall notify in wriring the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shal(within 30 days either: (a)correc[the data found to be inaccurate or incomplete and attempt to norify past recipiencs of <br /> inaccurate or incomplete 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 disciosed only if the individual's statemen[of disagreement is included wi[h[he disciosed data. <br /> The detzrminadon of the responsible authoriry may be appealed pursuant to the provisions of the adtninistrative procedure act relating 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 pernut 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 deternune 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 pernut 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 ]icense 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 /> , - <br /> ;�_� � �� ` � /`,- - : %�. ��':r� <br /> , �, v� � `2 �'�_ <br /> First , �tidd}e Last <br /> . �,�/��-!r i r �f r� <br /> Address � c - � i — <br /> i <br /> L i G� !;7 G� '� G;1 ,%L l , j � 1 �i - /'/l', <br /> C�n, �State Zip Phone <br /> I understand m ri hts as sta d ab <br /> Y g, � _4�--__ ��'j- / . <br /> , ,-/� <br /> � ' ' ; �, <br /> , ,�. ;� � <br /> � _ <br /> Signatura, <br />