HomeMy WebLinkAboutAFFIDAVIT OF LEGAL INTEREST - 20-00141 - 150 N 2nd W - RezoneAffidavit of Legal Interest
City of Rexburg
35 North 10 East Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
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Name
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City
Address
State
C I TY OF
REXBURG
NnerimS Faintly Conununity
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: Ray McDougal, DBA South Fork Design Group LLC 1066 N. Yellowstone Hwy., Rexburg, ID 83440
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.
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Dated this 17 day of -ea v G 1209-6
Subscribed and sworn to before me the day and year first above written.
Drandon Tlghe
Notary Public
State of Idaho
Commission No, 65760
Notary PublifMdaho {,� �(%>
Residing at: / y`a �/ N! (� )
My commission expires: t/k -le