HomeMy WebLinkAboutAFFIDAVIT - 16-00656 - 460 Rolling Hills Dr - SFR AdditionC IT Y OF
REXBURG
America's Family Community
State of Idaho
County of Madison
1 Kevin Andeson
Name
Submit By Emall
Affidavit of Legal Interest
460 Rolling Hills or
Address
L7
City State
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
A. That I am the record owner of the property described on the attached, and I grant my permission to:
Kevin Anderson 460 Rolling Hills Dr, Rexburg 834'
Name Address
to submit the accompanying application pertaining to that property.
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any claim or liability
resulting from any dispute as to the statements contained herein or as to the ownership of the property
which is the subject of the application.
Dated this 27 _ day of September Zp
Sign Pre
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires:
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016