At the time that the amount of initial deposit is established, the petitioner shall be provided with a copy of this chapter and shall deliver to the village the following statement signed by the petitioner: (2013 Code § 1-17-5)
To: Village of Campton Hills
The undersigned, having filed or expecting to file, a development petition with the Village of Campton Hills, certify that I have received a copy of Title 3, Chapter 2 of the Village of Campton Hills Code, have read and understand the same and agree to make the deposits as provided in said Code Chapter, including the following:
Escrow deposit of $
Check #
Dated:
Type of Project:
Project Name:
Project Address:
PIN(s):
Owner's Name:
Owner's Address:
Petitioner's Name:
Petitioner's Address:
Owner's Signature:
Petitioner's Signature:
Office Use:
Received By: Date:
Permit #:
(2013 Code § 1-17-5; amd. 2016 Code)