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Engineer Name <br /> Address <br /> Phone Fax Email <br /> Architect Name <br /> Address <br /> Phone Fax Email <br /> C. SIGNATURE <br /> I certify that all information provided in this application is true and correct to the best Of my knowledge. I <br /> authorize the City of Mounds View and its consultants to check credit references and verify financial and other <br /> information. I further agree,if approved,to the loan security and guarantees required by the Business Subsidy <br /> Policy. I agree to provide any additional information as may be requested by the City. <br /> APPLICANT SIGNATURE: <br /> TITLE: DALE: <br /> Agreement to Pay Costs of Review <br /> It is the policy of the City of Mounds View to require applicants to pay costs incurred by the City in reviewing and <br /> acting upon applications,so that these costs are not borne by the taxpayers of the City.These costs include all of <br /> the City's out-of-pocket costs for expenses,including the City's costs for review of the application by the City's <br /> Financial Consultant and City Attorney,or other consultants,recording fees,and necessary publication costs. <br /> The application processing fees cover anticipated costs;costs incurred above the application fee will be invoiced as <br /> they are incurred,and payment will be due within thirty(30)days.Application fees are not refundable.If payment <br /> is not received as required by this agreement,the City may suspend the application review process and may deny <br /> the application for failure to comply with the requirements for processing the application.Payment for costs will <br /> be required whether the application is granted or denied. <br /> The undersigned has received the City's policy regarding the payment of costs of review, understands that <br /> reimbursement to the City of costs incurred in reviewing the application will be required,agrees to reimburse the <br /> City as required in the policy and make payment when billed by the City,and agrees that the application may be <br /> denied for failure to reimburse the City for costs as provided in the policy. <br /> Note:All Major shareholders will be required to sign personal guarantees and a minimum assessment <br /> agreement if up front financing of the project is required. <br /> APPLICANT SIGNATURE: <br /> TITLE: DA LE: <br /> City of Mounds View Public Financing Policy&Application <br /> Adopted February,2016(Expected) <br /> Page 10 of 21 <br />