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TY OF ORONO ID 6124730510 09/24/96 14:00 5 :03/03. N0:522 • Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data Is stored or to be stored shall be es set fordh in this section. Subd.2. Information required to be giver individual. An Individual asked to supply prima or confidends'data concerning himself shall be befetmed of: (a)due purpose and intended use of the requested dam within the collecting ante agency.poUdcal subdivision,or statewide system: (b)whether he may refuse of is legally required to supply the requested data:(c)any known consequence arising from his supplying or refusing to supply private Orconldendal data;and(d)the Identity of other persons or enddes authorized by sate or federal law to receive die data. This requirement shell not apply when an individual Is asked to supply investigadve dam.pursuant to secdon 13.82.subdivision S.to a law enforcement officer. The commissioner of revenue may place the notice moulted under thisjthbdivision in the individual income tax or orooenr ax,rePStrid jg uucdons ipsmad u[on those fonds. Subd.3. Access to data by Individual. Upon request to a responsible authority.an Individual shall be informed whether he is the subject of stored data on individuals.and whether it is classified u 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 infonned of the content and mooning of that data. After en individual has been shown the private dam and infomred of its meaning,the dam need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or addidonal data on the individual has been collected or created. The respwinde authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may requite the requesting person to pay the actual costs of making.esrdfying.and compiling the copies. The responsible authorityshall comply immediately,if possible.with any request made pursuant to this subdivision,or within five days of the date of the requeu.excluding Saturdays.Sundays and legal holidays,If immediate compliance is not possible. Ifbe COMM comply with the request within that time,he shell so infirm the individual,and may have en additional five days within which to comply with the request.excluding Saturdays. Sundays and legal holidays. Subd.4. Proeedur a whin data Is net accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right.an indii'iduel shall notify in wridng the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete end attempt to natty pest recipients of inaewute or incomplete dem,including recipients named by the Individual;or(b)nodly the individual that he believes the data to be comet Dam in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dad. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. . • • ],IATA PRIVACY A)VISORY . 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 confidential information. You are 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 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. S. 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 permit. • . ' Pint Middle Last. Address . • C1ty Rhea Zip Phone ' 1•understand m r stated above. • L Signature D... ....] T!. A A. a 1AT7f 71. I T. w w. . .cow.•