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Acknowledgement and Signature <br />I acknowledge that I have read all of the information listed in the City of St. Anthony Village Land Use Application and <br />fully understand that I am responsible for all costs incurred by the City related to the processing of this application. If <br />additional fees are required to cover costs incurred from processing of the application, the City has the right to require <br />additional payment from one or more of the undersigned, who shall be jointly liable for such fees. Such expenses may <br />include (but are not limited to) direct city payroll and overhead costs, fees paid to consultants and other professionals, <br />and the cost of printing, mailing, and supplies. Applicants are advised that an escrow deposit is required at the time of <br />the submittal of the land use application to offset costs associated with the proposed project. Unused portions of an <br />escrow are returned to the applicant upon successful implementation of an approved plan. I understand that approval <br />from other agencies may be require efore commencement with the stated project. <br />Z-6 <br />Property Owner Signature (Required) Date <br />Applicant Signature (If different than the property owner) Date <br />Please contact the City Planner at 763-287-8521 or <br />planner@ci.saint-anthony.mn.us if you have any questions regarding this application. <br />May 2013 <br />