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Y � <br /> Sec.13.04 RIGATS OF SCTB.TECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be sto�ed shall be as set forth in this secdon. <br /> Subd.2. Information req�rired to be givm iadividual. An individuai asked to supply private or con6dendal data concerning himseff shall <br /> be informed of: (a)the purpose and intended use of the requesred data wi[hin the collecting 3tate agency,political subdivision,or sratewide sysum; <br /> (b)whether he may refuse oY is legally required to supply the requesud data;(c)any imown consequence arising from his supplying or refusing to suppty <br /> priva[e or confidendal data;and(d)the idendty of o[her persoas or enaaes authorized by state or federnl law to roceive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigadve dara,pursuant to secdon 13.82,subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav alace che nodce required under this subdivision in the individual income tax or oroaem tax refund <br /> instnicdons instead of on those forms. <br /> Subd.3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and wherhec it is classified as public,priva[e or confidential. Upon his further request,an individual who is the subject <br /> of stored private or pubiic 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 its meaning,the data need not be disclosed to him for <br /> siz months therea8er unless a dispute or action pursuant to dvs secrion is pending or addidonal data on the individual has been collecud or creaud. <br /> The responsibie authoriry shall provide copies of the private or public data upon requesc by the individual subject of the dara. The responsible authoriry <br /> may require the requesdng person to pay the actuai costs of making,certifying,and compiling the copies. <br /> The responsible authoriry 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 Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he sh�U so inform the individual,and may have an addidoaal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. M individual may contest the accuncy or completeness of pubiic or private <br /> data concerning himself. To exercise[his right,an individual shall nodfy in wricing the responsibte authoriry describing che nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurau or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incompiete data, including recipiencs named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data <br /> ia dispute shall be disclosed only if the individual's stacemenc of disagreement is included with the disclosed data. <br /> The de[erminadon of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act reladng to <br /> contesud 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 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 infonnation may be shared with other local, state or federal agencies to the eztent 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 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 /> w Patt,r�� � ��►�l_�- <br /> First Middle 1.ast <br /> ��''1 —7� �—�'1�1��p ��/Y� — <br /> Addross `n^. , ���_ / ���—�.7� <br /> Y �YM� �� <br /> Ciry State Zip Phone <br /> I und rstand my rights stated a e. <br /> Signamre <br />