HomeMy WebLinkAboutAFFIDAVIT - 21-00165 - Lot 1, Grover Subdivision - RPR4GVR0000010 - Lot SplitSubmit by E-mail
35 North I °' East
Rexburg. ID 83440
State of Idaho
County of Madison
Affidavit of Legal Interest
City of Rexburg
Phone: 208.359.3020
www.rexburg.org Fox: 208.359.3022
I Dean R Grover Family Trust
Name
Rexburg
City
930 River Run
Address
State
CITY OF
REXBURG
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Anserica's Family Connnunlry
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, slip to B)
A. That I am the record owner of the property described on the attached, and I grant my
permission to: Michael Wade Utah
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 oftheapplication.
Dated this 15 day of _ Iy 1 A t(f —12021
Signature
Subscribed and sworn to before me the day and year first above written.
�'j.•Ot?M. r,t
E 0
lM�c� , IA�r10�i
Notary Public of Idaho
Residing at: Ion'IdL4 yt)
My commission expires: Co ` 2 2— 2-6 2-