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� , <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or co be stored shall be as set forth in this section. <br /> Subd.2. Informadon reqtrired to be given individual. �.n individual asked to supply private or confidendal data conceming himself shall <br /> be inforated of: (a) the purpose and in[ended use of the requesttd data within the collecting'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply[he requested data;(c)any lmown coasequence arising fmm his supplying or refusing to supply <br /> privace or confidential data;and(d)the idenary of ocher persons or enaaes authorized by state or federal law to receive the data. This requiremenc shall <br /> not apply when an individual is asked to suppty invesrigadve dara,pursuant[o secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�•enue mav place the norice reauired under this subdivision in the individual income tax or propem taz refund <br /> instructions inscezd of on chose forms. <br /> Subd. 3. Access to data by individuai. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her i[is class�ed as public, private or confidenual. Upon his further request, an individual who is che subjec� <br /> of stored private or public data on individuals shall be shown che data wichout any charge to him and,if he desires, shall be informed of the contenc <br /> and meaning of[hat data. Aher an individual has been shown the priva[e data and informed of its meaning,the dara need not be disclosed to hun for <br /> siz months[hereafrer unless a dispuce or acdon pursuanc to this secaon is oending or addiaoaal data on the individual 6as been collected or created. <br /> The responsible auchoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the actual costs of makin¢,cerrifying,and compiling the copies. <br /> The responsible authoriry shall comply immediacely, if possib(e, wieh any request made pursuant to this subdivision,or within five days of <br /> the date of the request,ezcluding Sacurdays,Sundays and legal holidays,if immediate compliance is noc possibie. If he cannot comply with the requesc <br /> within[hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with che request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate <br /> data conceming himself. To exercise this right,an individual shall noafy in wriring ehe responsible authoriry describing�he nature of the disagreement. <br /> The responsible authoriry shall within 30 days ei[her: (a)correcc che data found to be inaccurate or incomplete and attempe to nodfy past recipients of <br /> inaccurate or incomplete data, including recipients named by che individual; or(b)nodfy the individual that he believes che data to be correct. Data <br /> in dispu[e shall be disclosed only if the individuat's statement of disagreement is included with the disclosed data. <br /> The decerminarion of the responsible authoriry may be appealed pursuan[to the provisions of[he adaunistradve procedure act reladng to <br /> contesred cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rig.hts of subjects of data", we would like to inform you that your reauest <br /> for a permit or license from the City 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 che Ciry deny the pemut or license. <br /> 3. The information may be shared with o[her local, state or federal a;encies to the extent necessary to process <br /> the pernut or license. <br /> 4. If your requested pernvt or license requires Council action to approve, some information may become <br /> public. <br /> j. You have certain rights under M.S. 13.04 (available upon request) to review priva[e data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �'� ����� C � �` �� <br /> First Middle 1� Last <br /> ��i -7 S L�Iv �.'a� �1 F��L�� ' <br /> Address <br /> ��`��,� �� `l�!\�c� S�s'� � i��� - y 7�- �6 S 3 �l <br /> Cih, Stare Zip Phone <br /> I u derst d my hts stated abo <br /> � �� <br /> Signature <br />