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� Sec.13.04 RIGHTS OF STJBJECTS OF DATA Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set focth in this secdon. Subd.2. Information required to be given individual. An individual asked to supply private or co�dendal dara conceming himself shall be informed of: (a)the purpose and intended use of[he requested data within the collecting'state agency,polidcal subdivision,or sratewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing w suppty private or confidenda(data;and(d)the idendty of other persons or endaes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesagadve data,pursuant to secdon 13.82, subdivision 5, to a law enforeement officer. The_.commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or oro�ertv tax refund inswcaons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individuai shall be informed whether he is the subject of stored data on individuais,and whether it is class�ed as public,private or confidenrial. Upon his fur[her request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to hicn and, if he desires,shall be informed of the content 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 six months thereafter unless a dispute or action pursuant to this secaon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. T'he responsible authoriry may require the requesting pecson to pay the actual costs of making,certifying, and compiling the copies. The responsible authoriry shall comply unmediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienu of inaccurate or incomplete data, including recipients named by the iadividual;or(b)notify�e individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon of the responsible authority may be appealed pursuant to[he provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. You aze notified that: . 1. The information you fumish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private dafa on yourself. 6. Your full name is required to process this application or permit. � ��f ��M �-G vtS (�tn�/`r First Middle �� (�� 'z2^'4 S; sw Ad cess v-�� I�,-� � r 3 6 ��- ��/s ��. C��Y State Zip Phone I un erstand my rights tated above. �— tur