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HomeMy WebLinkAboutAFFIDAVIT OF LEGAL INTEREST - 433 Airport Rd - Barney Storage35NJS'E Building Safety Department o44ExazR� cI T vvo7' P Rexburg, ID 83440 City of Rexburg �BUT7'�{ R [��� O a www.rexburg.org — - -- 00rlrnerictr'si~iamiJyCanrminJty Phone: 208.359.3020 Fax: 208.359.3422 Ho fline:208.372.2344 or Text: inspections@rexburg.org State of Idaho County of Madison 1, / - ��-Z/ Name r City Affidavit of Legal Interest Address State Being first dull 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 rant my permission to: i'I °C c/ y© 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 day of , 2016 Signature Subscribed and sworn to before nae the day and year first above written. o��, ydy •' " •Q.p /iii N aid ulAic of Idaho _ "M CD y _ Residing at: _k go W _ -'o Zz hty commission ex pires: /j ! 3