HomeMy WebLinkAboutAFFIDAVIT - 21-00084 - Chang Affidavit02/08)2021 01:21PM 7149858987 VCC
Affidavit of Legal Interest
City of Rexburg
35 North N East Phone; 20$.359.3020
Rexburg. ID 83440 www.re)d rurg.org vox; 208.359.3022
State of 1d2bo
County of Madison
N"a--
4q
City
Being first duly sworn upon oath, depose and say:
Addvast
5tatel
(If Applicant is also Owner of Record, ship to B)
PAGE 01)01
.1. ".Mat I am the xccotd owner of the property described on the attached, And I grant my
permission to: Brent McF9Man4 JRW & Associates, Pl l -Q 1152 Bond Avg RexbuM lt7
Name Address
to su6mft the accompanying appEm6n pertaining to that property ��d' x '✓2c2£ Yw7aniT , U%p
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless fxom any Cl
claim or liability resulting from any dispute as to the statements contained herein or as to the
-o-gmersh#p of the pkopeziy n izh is tht;vabjttt *£ the ajsplicaiion.
gated this J� day of"'7��>
$i atur
i
Subscribed and sworn to before me the day and year fust above v itten,
Notary Nibiic of Idaho
Residing at:
My camraission expires:
/ir- 11�e.- �lZorle, �ur�C�,
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.1. ".Mat I am the xccotd owner of the property described on the attached, And I grant my
permission to: Brent McF9Man4 JRW & Associates, Pl l -Q 1152 Bond Avg RexbuM lt7
Name Address
to su6mft the accompanying appEm6n pertaining to that property ��d' x '✓2c2£ Yw7aniT , U%p
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless fxom any Cl
claim or liability resulting from any dispute as to the statements contained herein or as to the
-o-gmersh#p of the pkopeziy n izh is tht;vabjttt *£ the ajsplicaiion.
gated this J� day of"'7��>
$i atur
i
Subscribed and sworn to before me the day and year fust above v itten,
Notary Nibiic of Idaho
Residing at:
My camraission expires:
/ir- 11�e.- �lZorle, �ur�C�,
�,,� �;��� .,aGt.e- ✓�-�-��� `z cod-'�' rs� 71�u� �eu��.