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STATE OF MINNESOTA ) <br />ss. <br />COUNTY OF HENNEPIN ) <br />67 <br />AUTUMN WOODS III, LLC, a Minnesota limited <br />liability company <br />I3y: <br />Print Name: <br />Its: Chief Manager <br />The foregoing instrument was acknowledged before me this day of <br />_ 2012, by , the Chief Manager, on behalf of <br />Autumn Wood III, LLC, a Minnesota limited liability company. <br />Notary Public <br />Drafted by and <br />when recorded return to: <br />Dorsey & Whitney LLP (KGW) <br />50 South Sixth Street <br />Suite 1500 <br />Minneapolis, MN 55402 <br />Signature Page to Agreement for Special Assessment Petition, Consent, and Waiver <br />C-5 <br />