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, . ��.^l � _ r <br /> � � f <br /> ,� ����, _ -, � : � . <br /> . . , �'�.5�, <br /> i ' <br /> ' . 6 <br /> See.13.04 RIGHTS OF SLIBJECTS OF D�T.1 r �' - <br /> � , . �� <br /> Subd. 1. Type of data. The righes of icdividual oa whom the dara is stoced or to be swred shalt be u set torth ia this secrioa j � - , <br /> Subd.2. InformatIon reqtrired to be�vea indirldual. An individusl uYed w suppty privare or coafideatial daa,concerning himtelf shall <br /> be informed of: (a)the pcupose aad iamaded use of the requesr�l dsra within the eotlecdng Stace ageacy,poliricai iubdivisioa,or srate.wide rysrem:�-: i ..• <br /> (b)whechec he may refuse or is legalIy«quir_d ta suppty the raquesud dae;(e)aay lmown coacequeqce uising fcam his supplying or refusiag to supply <br /> privace oc eor..�dead3l dars;ar.d(d)che idendry of other pecsoas or eariria au�horiz:d by sate'or federel law w teeeive che dam. This requiremeat 36a11�%�..:....;::�`s. <br /> not appty whea an individual is uked co supply invesdgadve dan,pucsuanrto secdoa 13.82,subdivision 5,co a law enfo�cement office�. - - <br /> 'Ihe eamnissioner oC revenue mav ofaee che nodce reauir:d under chis subdivision in ehe individual income tax or orooectv az tefucd ,. • <br /> inscrucaons inscead o[on thase forms. . <br /> a,� Subd.3. Aceas to data by indiridual. Lipon requesc te a cesponsibie auchoriry,an iadividuai shall be informed whe�her he is the subject � <br /> of smr:d dari on individuals,and whecher ic is etassifi:d as pubtic,privac�or confidenrial. Upon tiis turcher cequesc,aa individual who is the subjecc <br /> of scored privam or publie data on individuals shall be shown the daca wi�houc any eharge to him and;if he desires,shall be infocmed of che eoatenc <br /> and meaning of chat daa. Afur an individaal has been shown the priva�data and informed of ics meaning,the da�a need not be dis.losed to hua for <br /> si�c monchs th.ereaiter unless a d'upute oc acdon pursuant w�his secdon is ptnding or addidoaal data on the individual has been collacc�d o�ereared. <br /> The rsponsible aa�horiry shall provide eopies of�he priva�e or public dan upon cequest by ehe individu�l subjecc of che daca. Zhe respansible auehariry <br /> �nay cequire che requesang peaon w pay the accual cosu of ma3cing,cecrifying,and eomp�7ing the copia. <br /> The responsible authoriry shall conply immediatety,if possible,wich any request made purntant to rhis subdivision,o�wi�hin five days of <br /> the dac�oE the requesc,ezctudiag Saaic+days,Sundays and legal holidays,if immediate eompliance is aot possible. Ithe cauaot comply with the requesc <br /> wirhin thac dme,he shall so inform the individual,and may have an addidoaal f ve days wichin which ro comply wich the requat,exciudiag Saturdays, <br /> Sundays and legal hotidays. <br /> Subd.4. Procedure whea data Ls not accurate or eomplete. An individual may contesc ette accuncy or eompleteneu of public oc private <br /> daca eonceming ti�nself. To ezeccise this cighG an individual shall noafy in wridng the responsibie au�horiry deseribing the natuce of the disagreement <br /> The cuponsible authoriry shalt within 30 days ei�her: (a)corr:cc�he dan fourtd oo be inaccurate or incomplete and accempt to nodfy past reeipieau of <br /> inaccurdte or incomplete data,including recipiencs named by[he individ�al;or(b)aodfy the individual that he believes che dara to be cocmt Data <br /> in dispute shall be disclosed only if the indir•idual's sc3tem:nt o[disagre:meat is induded with[ha d'uclosed daca. <br /> The decerminadon of the responsible auchoriry may be appealed punuant to the provisions of che adminis�aave procedure act retadng w <br /> contesttd eases. <br /> DATA PRIVACY ADVISORY � _ <br /> In accordance with M.S. 13.0�, Subd.2, "Rights of subjects of data",we would like to inform you that your request <br /> for a pernut or license from the Ciry of Orono or any of its departmencs may require you to furnish certain private or <br /> confidencial informacion. " <br /> You aze notified that:• <br /> 1. The information you furnish will be used to determiae 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 with other local, state or federal agencies to the excent necessary to process <br /> ' the permit or license. <br /> 4. If your requested permit or license requ'tres Couacil actibn to approve� some information maq become <br /> pubtic. _ . <br /> 5. You have certain riQhts under M.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 /> ��i{/'�^ L—• V�. . <br /> First �fiddle Lasc <br /> �� �l r� �� � <br /> Add�ess �C�`(�(� I i �� ��� / / ���� <br /> Ciry Sate Zip Phone . . <br /> I under tand my ri�hhcs as scated above. . <br /> � <br /> Signacu:e <br />