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Sec.13.Q4 RIGHTS OF S[lBJECTS OF D.�T.� ' Subd. i. Type of data. The righcs of individual oa whom�he dara is srored or to be stoced shali be as set forrh in this secrion. Subd.2. Information reqirired to be given indiridual. ?.n individual asked to supply private or coafidcnoal dara concerning himself shall be infora:ed o`: (a)the purpose and incended use of the ttquuied dam wichin the collecang�tatt ageacy,poliacal subdivision,or scacewide ryscem; (b)whether he may refuse or is.legally requir.d to supply[he r:quesud data:(c)any Imown coasequeace arising from his supplying or refusing co supply privace or eonndeadal dara;and(d)che idendry of ocha persons or enddes auchorized by sc�ce ar fedecal law to receive che daca. 'Ihis requiremeac sha?I noc apply when an ir.dividuaI is asked to supply invesdgadve dan,pursuaa�[o secaon 13.82,subdivision 5, co a Iaw enfo�cemeat officer. 'Che eee-�missioner of revenue mav Dlac� che node- r_�uird under this subdivision in the individual income tix or orooectv taz refund inscrucuons inscezd of on ehose forms. Subd. 3. Access to data by iadiridual. Upon request to a responsible aurhoriry,an individual shall be informed whtther he ic che subject of stor:d daa on individuals,and whecher ic is classifi:d as pubiic, private or confidenrial. Upon his further rquest,an individual who is th:subjecc of stored private or public data on individuals shall be shown che dara wichout any charge to him and;if he desires, shall be infocmed of che content and meaning of chat dara. Aher an individual has been shown tbe privare dara and infocmad of ics meaning,che dara ae:d not be d'uclased ro him for six monchs[hereafter unless a dispuce oc acdon pursuanc to this secdon is pending oc addidooal daca on the individual hu been eollecc_d or ereaced. 'Ihe rnspocuibie authoriry shall provide copies of che privac�or pubiic data upon request by the individual subject of the da[a. The responsible authoriry may require the requesdng person to pay the accual cosu oi making,cerdfying,and compiling the eopics. The responsible auchoriry sha11 comply immediately, if possible,with any tequest made puauant co this subdivision,or wichin five days of the dace of the cequest,ezcluding Satutdays,Sundays and lega]hotidays,if immediace compliaace is noc possibte. If he cannoc comply with the teques� within that dme,he shal!so inform the individual,and may have an addidoaal five days within which to comply with the requesc,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or eomplete. An individual may concest the accurdcy or completeness of public or privacc data conceming himself. To exercise�his right,an individual shall noafy in wriung�he responsible authoriry describing the natuce oF the disagreemea� The responsible authoriry shall within 30 days eitt:er: (a)correct[he data found to be inaccurdte or incompiece and attempt to nodfy past recipienes of inaccuate or incomple[e data, including recipien�s named by che individual:or(b)noafy the individual thac he believes the daca to be correcc. Data in dispuce shall be disclosed only if the individual's statemenc of disagreement is includtd wich the disclosed data. The de�erminaaon of the responsible au�horiry may be appealed pursuant to the provisions of[he adminisaarive procedure act relaang to concesmd cases. � DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts of subjects of data", we would like to inform you tha[your requesc for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or confidential information. You aze notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to suppty data, but refusal may require that the Ciry deny the permit or licease. 3. The information may be shared with ocher local, state or federal a�encies to the ettent necessary to process the pernut or license. 4. If your reques[ed permit or license requires Council action to approve, some information may become public. �. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or perm.it. ��< ��n s s�-. ��,w,,., Firsc �fiddle I.asc '-11`lk ny:��i, =54.c-�., ��. Addreu ��/ ��!o t• .� �'��v2 � �� -1 7� �'L�_ Ciry Sace Zip Phone I understand my ri;hts �s stated above. , �e.�v Signacure