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� . � Sec.13.04 RIGHTS OF SUBdECTS OF DATA Subd.1. 'fype of data. 7'he righis of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2.InformaUon required to be given individual.An individual asked to sup�rly private or confidential data conceming himselfshalt be informed o£ (a)the puipose and intended use ofthe requested data within the collecdng state iagency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)arry known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal l not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. � The commissioner of revenue may place the noHce reauired under this subdivision in the individual income tax or pronerty t�refund instructions instead of on those forms. Subd.3.Access to data by individual.Upon request to a responsible authority,an individual shall be infonned whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential.Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed ofthe 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 section is pending ar additional data on the individual has been collected or created. The responsible suthority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority may require the requesting peison to pay the actual costs of making,certifying,and compiling the copies. ' T'he responsible authority shall comply immediately,if possible,with any request made pursuant to Uus subdivision,or within five days of the date ofthe request,excluding 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 additional 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 ihe accuracy or completeness of public or private data conceming himself.To exercise this right,an individual shall notify in writing the responsible suthority describing the naUire of the disagreement The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the 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 determination of the responsible authority may be appealed pursuant to the provisions of the administraiive 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 furnish certain private or confidentiai information. • You are 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 licens�. 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 data on yourself. 6. Your full name is required to process this application or permi. f1 � First Middle Last � I zZ3�l Il��l`e..� �vc� Address J�urrtSvi��e f�2�U �533� �'S'�o� ��a -Co�7a C�tY State Zip _ P6one I u ers y ghts as stated above. s; � � ;�� .�es�t�cum�� ` �.�'; 32 � �