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·96 . <br />Acknowledgement and Signature <br />I acknowledge that I have read all of the information listed in the City of St. Anthony Village Land Use Applicatlon 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, malling, 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 required before commencement with the stated project. ~ """ \0) 2-8) 1-0\ 4 <br />Date <br />~ ~ -~,.........:? , 6.bN 'I c11 116\-1.\ F { t.<""'" "''"" \ b/?.!ir/ -z.o 1 + <br />Ml c..t-\.,4. l::L ~ H~'\" <br />Applicant Signature {If different than the property owner) Date <br />Please contact the City Planner at 763-287-8521 or <br />planner@cl.salnt-anthony.mn .us If you have any questions regarding this application . <br />May 2013