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� <br /> Sec.13.0.:RIGHTS OF SUBJECTS OF DaT?. <br /> Sutd. I. Type o!data. Tha righc�of ir.dividual oa whom the data is Stored o�to be smr:d shall be as set focv`�ia this secdoo. - <br /> Snrd.2. Informatioa reqirired to be�vea indicidual. ?.n icdividual asYed ro supply privat�or conFdendal dara eoncem:ng himseif shail <br /> be ilFormed of: (a) the purpose aad ineed:d use of the rtquau3 da�within the collecdng Stace ageacy,polidcal suhdivision,or sa[ewide ryr�m; <br /> (b)whe�her he reay r°use or is le3ally requir_d�o supply rhe r:quesud daca;(c)any 3rnown coasequeace arisin3 from his supplyiag or cofusing to supply <br /> p;ivaco or co��den3al dam;ar:d(d)che ideedry of o�her pe:soas or enddes a�choriz:d by sc�ta or federbl law to rceive[he dam. This requiremeat shall <br /> r.ot app[y whea an udividu�is asked to supply invesdgarive da3, pursuaac to secdon 13.82,subdivision 5, to a Iaw enforcemea�ofrccec. - <br /> The comrnissioner of revenue mav olace �he nodce r_auir_d under ehis subdivision in the individu�l incone tax or orooem az rFued <br /> �.s:rucdor.s ins::ad of on chose forms. <br /> Sutd.3. Access to data bv indiridual. Upon requesc to a ruponsible au[horiry,an individual shall be inforraed whed:er he is the subject � <br /> of scnr_d daca on individuals,and whc�her ic is elassified as pubiic, privace or conf:denoal. Upon his furcher requesc,an icdividual who is the subjecc <br /> of stored priva!e or public daca on individuals shall be shown ch�dati wichouc any charge to him and;if he desires, shal[ba informed of the eoncent <br /> ar.d meaning of chat dara. Aher tn individua!has been shown the priva�.da�a and informed of iu meaaing,tha dzta need noc be disciased ta hua for <br /> siz�onchs cl:ereaitr.�uniess a dispute or acdon pursuanc to chis secdon is pending or addidoaal dac�on the individual tas been cotlecc�d or ereac�d. <br /> The rspons;b4-auchoriry shall provide copies of the privau:orpublic data upon requesc by the individual subjecc of the da�. Tha tesponsibie aua4ority <br /> may requir_ ttte requesang person to pay th=accual coses of making,cecrifying,and compiling the eopies. <br /> 'Il:e responsible auchoriry shall conply immediac:ly,if possibl:, wich aay rcquest mad:punuant to this subdivision,or wichin five days of <br /> the dace of�he r:quesc,ezcluding Saturdays,Sundays and legal holidays,if ic;smtdiate compliance is noc possible. If he cannot compty with the requesc <br /> wichin that dr.ie,he shall so inform�he individual,and may have an adGidonal fivt days wi�hin which to comply wich the request,excteding Sacurdays, <br /> Sundays and legal hotidays. <br /> Subd.4. Pracedure r�hea data is not accurate or complete. An individual may contest tht accuracy or compieteness of public orpri�ate <br /> daci cor.ceming hunself. To exercise chis ri¢h�,an individual shall noa"ry in wridng che responsible auchoriry dtscribing the nature af the disagreemenc <br /> The responsible auchoriry shall within 30 days eicher: (a)cocrecc ehe dsta found to be ic�aceurate or incomplete and attempt to nodfy past recipieau oE <br /> inaccurate or incompte�e dac�, inc[uding re:ipiencs namcd by the ir:dividual; or(b)noafy ctte individuai that he believes rhe data to be correc� Data <br /> in dispute shall be disclosed only if the individual's s��ement of disagrecr,.cnc is indudzd wich[he disctosed daca. <br /> The de[erminaaon of the r�sponsibla authoriry rr�y be appeated pursuanc to 4`�e provisions of che administrarive procedute act refaan� to <br /> contesced eases. <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 cenain private or <br /> confidential informacion. J <br /> You are notified thar.- <br /> 1. "Ihe 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 City deny the permit or license. <br /> 3. The information may be shared wich other local, state or federal a�encies to the extent necessary to process <br /> � the permit or license. <br /> 4. If your requested permit or license requires Council actlbn to approve, some iaformation maq become <br /> public. <br /> 5. You have certain rights under NS.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permic. <br /> �.,,�__1`�, � �� ���'. / � <br /> First �iiddle\ Lasc <br /> � / \� <br /> r���-;�-� _ � ,, ��_�,�._ i _ <br /> Address � _ / � �/ .--__. <br /> ��+ ' - ��_ <br /> ., ,— , � � <br /> , � �, �, �; > , . ; <br /> � �� <br /> Ciry _ Smce Zip Phoae <br /> I understand my n��cs�as stated above. <br /> � <br /> / ; j '� . <br /> �� ,_ t , <br /> Signaa:re - <br />