HomeMy WebLinkAboutAFFIDAVIT - 18-00269 - T-Mobile - Tenant FinishC I TY OF
REXBURG
0
Americas Family Community
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
&�W
Affidavit of Legal Interest
State of4dahe-Cg1ik0x-v\\'q
County of-MadisorrLos h"Oelg.S
I, Meckv wm!r ova bt\nal A CF? XJev(„ te-
Namet DC 60VHa4tS LLG Address
VI� e eA a rc -6.cY1, o"
City State
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:
Gary Wang & Associates 1900 Corporate Center Dr. Ste. 550, Monterey Park, CA 91754
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
ZZ
day of 1A0,� 20
4 Z o-� 6F7 N V 1�-eve(C fvAe►Xk, LLCM
Signa ure
Subscribed and sworn to before me the day and year first above written.
RMu
.. =. Cominftion No. 2231378 Notary Public ofd Calil;drv%Iq
NOTARY PUBLIC -CALIFORNIA
LOS ANGELES COUNTY Residing at:Los &i�o c S
Mycomm.EWm FEWWANY te.2032
My commission expires: Feb �b 2oZL
Inspection Hotline— (208) 372.2344 www.rexburg.org Permit Technician — (208) 372.2341 Revised 10, 2016