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<br /> <br />City of Arden Hills  1245 West Highway 96  Arden Hills, MN  55112-5743 <br /> _________________________________________________________________________________________________________________________________________________________________________________________ <br /> Phone 651-792-7800  Fax 651.634.5137  www.cityofardenhills.org <br /> <br /> <br /> <br />Escrow Account Set Up Form <br /> <br />Date: _______________________ <br /> <br />Site Address: __________________________________________________________________ <br /> <br />Deposit made by: _______________________________________________________________ <br /> <br />Amount: $___________________ <br /> <br />Address to send statements: _______________________________________________________ <br /> <br />Contact Person: ________________________________________________________________ <br /> <br />Telephone No.: ____________________ Email Address: ____________________________ <br /> <br />Purpose of Escrow Account: ______________________________________________________ <br /> <br />______________________________________________________________________________ <br /> <br />Arden Hills Finance Department policy requires that escrow deposits be held for six months once <br />a permit has been closed in order to ensure all costs associated with the project have been <br />covered. I acknowledge that I have read this policy and fully understand that any remaining <br />escrow balance will be released after a six-month waiting period. <br /> <br />___________________________________ __________________ <br />Applicant Signature Date <br /> <br /> <br />Office Use Only <br /> <br />Staff Name: _______________________________ Department: ________________________ <br /> <br />Type of Escrow: <br /> Landscaping <br /> Grading & Erosion (PW#______________) <br /> Site Improvements (PW#______________) <br /> <br /> Security Deposit – Do Not Charge <br /> <br /> <br /> Land Use Application (PC#____________) <br /> Temporary Certificate of Occupancy <br /> Other: _____________________________ <br /> <br /> <br />Additional Notes: _______________________________________________________________ <br /> <br />______________________________________________________________________________