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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 process ing of this application. If <br />additional fees are required to cover costs incurred from processing of the application, the City has the r ight 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 imp lem entation of an approved plan . I understand that approval <br />from other agencies may be required before commencement with the stated proj ect. <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 .u5 if you have any questions regarding this application . <br />May 2013 <br />27