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2. Company Name*
4. Address*
6. City*
7. State*
8. Zip Code*
10. Contact Name*
12. Email Address*
14. Phone Number*
15. Fax Number
19. Assessment Search Address*
21. Assessment Search PID*
23. Additional Information
25. Assessment Search Fee*

    1. $20.00
29. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree
31. Electronic Payment Agreement*

    I acknowledge a convenience fee of 3% will be applied to credit/debit card payments. An additional fee of 50¢ is applied for payments below $100.

    1. I agree and will be paying online.
    2. I will pay via check/cash in person or by mail. Make Check payable to: City of Orono. Payment can be dropped off at City Hall or mailed to: 2750 Kelley Parkway, Orono, MN 55356
33. Electronic Signature*
34. Date*
    Date
36. Application is not complete until payment is received.

    Upon submittal of this form, you will be prompted to the payment screen. If you choose to send payment via check/cash, you may close out after hitting Submit. Thank you!

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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field