HomeMy WebLinkAboutAFFIDAVIT - 20-00273 - Madison High School Field HouseAffidavit of Legal Interest
City of Rexburg
35 North Ist East Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
I� Madison School District #321
Name
Rexbu
City
Being first duly sworn upon oath, depose and say:
A
60 West Main
Address
Idaho
State
(If Applicant is also Owner of Record, skip to B)
C I T Y 0
REXBURG
1..11.1_.....__._ 04611 --- ..............._ _
America Rirmxly Cotrrnn mq,
That I am the record owner of the property described on the attached, and I grant my
permission to: Brent McFarland, AIA NCARB, JRW & Associates 1152 Bond Ave, 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.
4MA
Dated this day of i , 20 ZO
Subscribed and sworn to before mi
tItNHNJ
®••••"Y "••.�• /� Notary Publi 11 Idaho
Residing at: myca Ws" z
(P I Q f� e)
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My commission expires:
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