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.. <br /> Sec.l3.N RIGHTS OF SUBJECT3 OF DATA <br /> � Subd. 1, 7ype of dats. The rights of individual.on whoro tha deu is stoned or oo be stored a6s11 be es ett forth in this section. <br /> . Subd.2. IzflSrmetionrequirad�ebegivenindividual. Anindividuslaskedtosupplyprivauorco�daitlaldsteconcemtngh{maelfshallbe <br /> into rtned of (s)the purpose and incendofl use of the requested dm within the collati�state agency,politicel subdiviaioo.or statewide syttem;(b) <br /> whether he may reti�ae oris legally requited to suppy ri�e requested data;(e)any known conuquence ariaing ttom hia supplying e�refusingto auppty <br /> private or confidential data;aed(d)We identiry ofother pe�soos or entitios suthoTized by steoe or fedenl law Io mceive the dea.T'hianquirement ahtll <br /> not apply when an individual is a�lcad to auppiy inve�figative data,pu�suant to seetion 13.82,9ubdivisinn 3,ro e lew enfoccement offieer. <br /> The oommi�inr�er of reven�e may tllaae_the naticc rene�ice� �ndsc thia aLdi 'nion in h 'n�vid�el ine..�ttY o(,p�y,e�y Y M� <br /> inatn�tiQns in9teed of on those tbnns. <br /> S ubd.3.Access to deu by individuel. Upon roqueet to a responsible autharity,an individupl ahel)be iotormod whether he is the enbject of <br /> atored date on individusls,and whether it is clasaified e�pubik,private or conC�denlial. Upon his furthor ieqaest,an individuai who ls the eubject of <br /> atomd privata or public data on individuals 6ha11 be showo t6e dats withoutany chatga W him and,ifhe desires,shsll be infocnKd ofthe¢a►tentand <br /> tneaning of thst date. Afta an individual has beert shown the p�vete data and informed of ite meaning,the datp need not be diecbaed to Mm 1br six <br /> months tl►ereafter unless a dispute or w-tion pursuant to thia section i s pending or additionel duta on the iadividusl has been collected or crated. The <br /> ieaponsible autharity sfiell provide copies of the ptivaie or public dala upon rcAuest by tfie individual subject of du dau. T6e nsponsiWe sntl►arity <br /> may raquin the requesting person ro pay the sctual caots ofmaking,cartitying,and¢ompiling the copies. <br /> The responsible authority shdl cortq�ly immedistely,i f poosible,with ury raquest made pws uent to thia subdivbion,or wilhin five days of <br /> the dete of the cequest;exciuding 3aturdaya,�3undays end le�l holidays,lFinenedisee compliance ia not pos�ible. lfhe cannot con►p1y witl►tl►e reque�t <br /> wit6m tMt time,he shall eo inforrn the individwl,and euy have an additionel five dsya witt�in which to oomply with ths requast,atcludieg Sahudays, <br /> Sundsys sr�legal holidays. <br /> 8ubd.4.Procedurewhen�telsnotaecuraleorcomplete.Mindtvidualmnyeonte�thesecnracyorcaeQleoenessofpublicorprivatedeta <br /> conceraing himself.To exaroiee this right,en iodividuel shall notify in writing tlfe reepoosible authority deecribing the netuee ofthe diu�ee�tent. 17� <br /> responai6le autl►oriry ahell wifhin 3a days eid�er: (a)rnRect the date found tu be inaecurete or u�compleh md atternpt b notity paet recipienle of <br /> inaccurate orincomplate data,i�luding recipimts named by the individual;or(b)notify the mdividual thst he believes tbe dets to be wrrect. Data in <br /> dispute ehall be disclosed onty if the individuel'a statement of disagreement is ineluded with the diecloscd data. <br /> TAe deterrninada►of the reeponaible aulhoriry mey be appealed pursuant to the pnavisioea oftha adrrtini�lretive procedure ect rclating to <br /> contested csses. <br /> DATA PA?VACY ADV[SORY <br /> le accordance with M.S. l 3.04,Subd.2,"Rights of subjects of data",we would like to inform you that yourrequest <br /> for a permit or license from the City of Orono or any of its �partments may require you to ftanish certain private or <br /> confidential information. <br /> You are norified that: <br /> 1, The informetion you fumish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may nequire that the City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent neceasary to <br /> procesa the permit or license. <br /> 4. If your requested permit or license requires Council ection to approve, some infonnation may beoome <br /> public. <br /> S. You have ceRain righta under M.S. 13.04(available upon request)to review private data on yo�aself. <br /> 6. Your flill name is required to process this application or permit. <br /> � �� ���7 <br /> First Middle Last <br /> �33- ?51��-� �' � <br /> Address <br /> '�v. �c a,n C�, , v�n�v (_o�1 -(0�-�l-!�-(o(v <br /> City State Zip P6one <br /> [ understend m right!sa atat above. <br /> 3igaature <br /> -:::s��..eii,'••:- ",�;+'�_••��s,:. • -•���.,..�,. ...... <br /> ....:w�.n....: ..A ....,_. �� ,+^,�� 32 <br /> E 'd 06T-9�G91S9 3�IA213S 1IW213d Q '8 S M 9T =4i 600Z Bi ��C <br />